Background and Goal of Study: Total knee (TKA) and total hip (THA) arthroplasties are associated with moderate to severe postoperative pain (POP). This study aims to identify a relationship between POP associated with THA and TKA and sociocultural level of the patient.
Materials and Methods: After approval by the Ethics Committee, a prospective cohort study was conducted, between september and december 2014. Written informed consent was obtained for all patients. The study population consisted of adult patients admitted to elective THA and TKA. Preoperative questionnaire was carried out up to 24 hours before surgery, aiming to identify the variables that are related to the sociocultural level of the patient: ethnicity, geographical distribution, schooling (no studies, 1st Cycle Basic Education (CEB), 2nd CEB, 3rd CEB, secondary, graduation, masters, doctorate), profession (employee, unemployed, retired), satisfaction with the profession (not satisfied, little satisfied, satisfied, very satisfied, totally satisfied), desired profession and lifestyles (sports practice, frequency of sports practice). The postoperative questionnaire was obtained at 48 hours after surgery and aimed to evaluate the intensity of POP, using the Brief Pain Inventory. Descriptive analysis of variables was performed and non- parametric tests (Mann-Whitney and Kruskal-Wallis) were used in the analysis of POP levels. It was performed a multiple linear regression to determine the significant predictors of the minimum, medium, maximum and at the time POP.
Results and Discussion: We included 95 patients, all caucasian, 58 of which underwent TKA and 37 to THA. Regarding the variables ethnicity, geographical distribution, desired profession and lifestyles there were no changes in the intensity of the POP (p>0.05). Retirees with 1st CEB had higher levels of minimum pain (2,15±1,87) (p=0,004). Patients not satisfied with the profession had medium (6±0) and maximum (8±0) pain scores higher (p=0,002;p=0,003). Totally satisfied patients had lower levels of maximum pain than very satisfied patients (p=0.002), and totally satisfied patients had lower levels of minimum pain than satisfied (p=0,025) and than very satisfied patients (p =0,016), according to the multivariate regression. Patients with these factors may benefit from individualized perioperative analgesia schemes for better pain relief.
Conclusions: Professional satisfaction was identified as a predictor factor of pain after TKA and THA.

03 / Relationship between postoperative pain in major orthopedic surgery and patient ´s sociocultural level