Comparison Of Pain Threshold And Anxiety Status In Patients With Acute Or Chronic Pain

Objective To evaluate the effects of pain types and anxiety state on pain threshold of patients with acute fracture or chronic osteoarthritis or cancerous pain by observing changes of pressure pain threshold(PPT),anxiety scores(SAS)and serum level of inflammation factors,and provide a standard for the individualized clinical analgesic treatment.Methods We prospectively enrolled 120 patients of both sexes,aged 40-70 yrs with body mass index of 18-24 kg/m~2,II to III grades of American Society of Anesthesiologists physical status.They were divided into 4 groups(n=30)according to pain type:acute fracture(A);chronic osteoarthritis(B);cancer pain(C)and control group(D).We assessed PPT with electric Von Frey test,and evaluated anxiety state by the Zung anxiety self-rating scale.The blood sample was taken to measure CRP,IL-6,IL-17.We assessed PPT with electric Von Frey test at the location of the medial tissue of forearm Brachial radial muscle on the day of admission,and evaluated anxiety state by the Zung anxiety self-rating scale.The blood samples were taken to measure CRP,IL-6,IL-17 on the second day of admission.PPT and Serum levels of inflammatory factors were measured on the first day after surgery in patients undergoing total knee replacement and internal fixation for fracture reduction.Results Compared with group D,the PPT in group A,B and C decreased(p<0.05),while anxiety scores increased with r~2=0.661,b=-1.691.The concentrations of serum CRP,IL-6,IL-17 of group B and C were higher than that of group D,and group C was the highest.There was a significant difference in serum levels of IL-6 between group B and group C,group A and group C.There was statistical difference among the four groups of serum levels of CRP.Compared with the D group,the serum concentration of IL-17 increased in group B and C.Conclusion1.Three types of pain in patients with acute fracture or chronic osteoarthritis orcancerous pain can affect pain threshold in varying degrees,and cancerous pain was the most one,which mechanism may be related to the change of serum level of inflammation factors.2.Pressure pain threshold is interrelated with the state of anxiety for the patients.