Indicators of pain syndrome in the postoperative period during endoprosthesis of hip and knee joints in patients with diabetes

Abstract

Hip and knee arthroplasty refer to the widespread surgical interventions. Diabetes mellitus is one of the common diseases that negatively affect the results of these operations.
 Objective — to determine pain syndrome during anesthesia and in the early postoperative period during hip and knee arthroplasty in patients with concomitant diabetes mellitus.
 Materials and methods. The study involved 69 patients who underwent hip and knee arthroplasty surgery. The patients were divided into 3 groups according to the scheme of anesthesia provision. Patients of the first group (n=20) underwent multicomponent low‑flow anesthesia with artificial lung ventilation; in the second group (n=24) spinal anesthesia was used for pain relief; in the third group (n=25) combined spinal‑epidural anesthesia with dexmedetomidine sedation was performed.
 Results. The significant difference in the severity of pain has been reveled in the study groups in the postoperative period after 6 hours, 12 hours, 18 hours and 24 hours. In particular, after 6 hours in group 1, the pain was more severe than in group 2 (p<0,001) and group 3 (p<0,001); in group 2 and group 3, the pain was of the same intensity (p>0,05). At 12 hours postoperatively, the pain in patients in group 1 was significantly higher than in group 2 (p<0,01) and group 3 (p<0,001); and the pain in group 2 was more severe than in group 3 (p<0,05). After 18 hours, the pain in group 1 and group 2 was significantly worse than in group 3 (both p<0,001); at the same time, the pain level in group 1 and group 3 did not differ (p>0,05). At 1 day postoperatively, significantly more pain was observed in group 1 compared to group 3 (p<0,001), and in group 2 compared to group 3 (p<0,001); pain in group 1 and group 2 did not differ (p>0,05).
 Conclusions. Any of the proposed methods can be used for anesthetic support of hip and knee arthroplasty operations, but regional anesthesia methods provided the best results of pain relief in the postoperative period compared to general anesthesia. Patients from group 3 (combined spinal‑epidural anesthesia) were best anesthetized.