Document Type : Review Article


1 Assistant Professor of Orthopaedics, Department of Orthopedics, School of Medicine,Tabriz University of Medical Sciences, Tabriz, Iran

2 Department of anesthesiology, Faculty of medicine, Tabriz medical sciences, Islamic Azad University, Tabriz, Iran


Introduction: Most patients experience moderate to severe pain after ankle surgery. Early and appropriate treatment of postoperative pain is essential for effective treatment that leads to preservation of lung function, normal breathing, rehabilitation and prevention of chronic pain. In this retrospective study, we aimed to identify potential predictors of moderate-to-severe postoperative pain in the post-anesthesia care unit (PACU) in patients undergoing gastric bypass surgery.

Material and Methods: In this systematic review VAS/vNRS score of 4-6 is considered moderate, and 7-10 is considered severe. Additional factors investigated included time from ankle fracture to surgery, anesthesia procedure, preoperative anesthesia, medication use and postoperative medication use, classification radiation, bone complexity, surgical technique, and tourniquet operative time.

Results: Data from 336 patients who underwent ankle arthroplasty between January 2009 and December 2022 were analyzed. None of the following variables had a significant effect on pain; age, weight, smoking, time from fracture to surgery, type of anesthesia, opioids to control dysfunction, complexity of the fracture, surgical procedure or tourniquet technique increase. Gender predicted moderate to severe pain after PACU by 2 differences.31 (1.39–3.86, P = 0.001). To our knowledge, this is the first study to report gender differences in pain reporting in the hours following joint surgery.

Conclusion: Female patients who had surgery for ankle sprains reported higher pain scores in the PACU than men.


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