Pain Associated With Treatment of Dupuytren Contracture With Collagenase Clostridium histolyticum

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• 作者：Rafael Sanjuan-Cerveró ; MS^&lowast ; ; ^&dagger ; ; ^{rafael.sanjuan@marinasalud.es} ; Francisco J. Carrera-Hueso ; PhD^&Dagger ; ; Pedro Vazquez-Ferreiro ; MD^&dagger ; ; ^§ ; ; Narjis Fikri-Benbrahim ; PhD^‖ ; Nuria Franco-Ferrando ; MD^&lowast ; ; Clayton A. Peimer ; MD^¶ ;
• 关键词：Collagenase Clostridium histolyticum ; Dupuytren disease ; injection ; extension ; pain
• 刊名：The Journal of Hand Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：42
• 期：2
• 页码：e109-e114
• 全文大小：202 K
• 卷排序：42

文摘

The primary objective of this study was to quantify the degree of pain associated with collagenase Clostridium histolyticum (CCH) injection and to determine whether it is related to other factors in the intervention.MethodsA prospective study of 135 patients was performed to evaluate pain at 3 points during treatment: (1) after CCH injection, using a numerical rating scale (NRS), (2) a binary (positive/negative) assessment before manipulation 24 hours after CCH and after removing the bandage, and (3) after joint manipulation performed with wrist block anesthesia.ResultsThe average NRS for pain during infiltration was 4.7. Pain was present before manipulation in 52.6% of patients. Pain from manipulation showed an average NRS score of 3.6. The amounts of pain at CCH infiltration, pain after 24 hours, and pain from the manipulation were correlated because patients who experienced pain during CCH infiltration were more likely to report experiencing pain during manipulation.ConclusionsCollagenase Clostridium histolyticum injection for treating Dupuytren contracture can be a painful process. There is a clear relationship between a patient’s level of pain during injection of CCH and the likelihood that the patient will experience pain during manipulation, even with the use of local anesthesia.Type of study/level of evidencePrognostic IV.