Article

Little is known about the risk factors for procedural pain during
spinal and joint injections. In this prospective national multicentre
study, procedural pain was investigated by rheumatologists who visited four
consecutive patients undergoing synovial aspiration and infiltrations of the knee
(K), and four consecutive patients undergoing spinal (S) injections. Pain
assessments were carried out just before, during, and 48 hours after the
procedure. RESULTS: The 249 rheumatologists enrolled 1350 patients (720 K and 630
S; 64 +/- 14 years, 64.6% female). Instantaneous procedure-induced pain was
reported in 76.1% of cases, was generally mild (mean 2.6 +/- 2.5 on 10) and not
different between the two sites. The frequency of procedure-induced pain
increased significantly with pain related to the underlying disease and level of
anxiety before the procedure. Procedure-induced pain was recalled after 48 hours
later by 66.2% of the patients, with an intensity of 2.4 +/- 2.6. The recall of
procedure-induced pain increased with pain due to the underlying condition, with
the intensity of instantaneous procedure-induced pain, with the level of anxiety,
but was less frequent if the patient underwent the procedure for the first time.
Patients' and physicians' estimates of procedural pain were poorly concordant
(kappa coefficient 0.45), physicians tended to overestimate the frequency of pain
but to underestimate its intensity. CONCLUSION: Procedural pain is common, but
mild, in patients undergoing musculoskeletal injections. Instantaneous procedural
pain and its recall 48 hours later depend principally on the level of underlying
pain and anxiety, regardless of the injection site and the analgesic procedure
performed.
CI - Copyright (c) 2011 Societe francaise de rhumatologie. Published by Elsevier SAS.
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Langue : ANGLAIS