The associations between severity of early postoperative pain, chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast surgery.
Authors
Iohom, GabriellaAbdalla, Hamza
O'Brien, James
Szarvas, Szilvia
Larney, Vivienne
Buckley, Elisabeth
Butler, Mark
Shorten, George Declan
Affiliation
Department of Anesthesia & Intensive Care Medicine, Cork University Hospital,, Cork, Ireland.Issue Date
2012-02-03T15:04:26ZMeSH
Acetaminophen/administration & dosageAdult
Aged
Analgesia/*methods
Anxiety/etiology
Breast Neoplasms/*surgery
Bupivacaine
Chronic Disease
Depression/etiology
Dextropropoxyphene/administration & dosage
Diclofenac/administration & dosage
Female
Humans
Isoxazoles/administration & dosage
Mastectomy
Middle Aged
Morphine/administration & dosage
Nerve Block/methods
Nitric Oxide/*blood
Nociceptors/physiology
Pain Measurement/drug effects
Pain, Postoperative/*blood/*drug therapy/etiology
Pyrazoles/administration & dosage
Sulfonamides/administration & dosage
Metadata
Show full item recordCitation
Anesth Analg. 2006 Oct;103(4):995-1000.Journal
Anesthesia and analgesiaDOI
10.1213/01.ANE.0000240415.49180.4APubMed ID
17000819Abstract
In this study, we compared the effects of two analgesic regimens on perioperative nitric oxide index (NOx) and the likelihood of subsequent development of chronic postsurgical pain (CPSP) after breast surgery and sought to determine the association among early postoperative pain, NOx, and the likelihood of subsequent development of CPSP. Twenty-nine consecutive ASA I or II patients undergoing breast surgery with axillary clearance were randomly allocated to one of two groups. Patients in group S (n = 15) received a standard intraoperative and postoperative analgesic regimen (morphine sulfate, diclofenac, dextropropoxyphene hydrochloride + acetaminophen prn). Patients in group N (n = 14) received a continuous paravertebral block (for 48 h) and acetaminophen and parecoxib (followed by celecoxib up to 5 days). Visual analog scale pain scores at rest and on arm movement were recorded regularly until the fifth postoperative day. A telephone interview was conducted 10 wk postoperatively. The McGill Pain Questionnaire was used to characterize pain. NOx was estimated preoperatively, at the end of surgery, 30 min and 2, 4, 12, 24, 48 h postoperatively. Twelve (80%) patients in group S and no patient in group N developed CPSP (P = 0.009). Compared with patients with a pain rating index > or =1 (n = 18) 10 wk postoperatively, patients with a pain rating index = 0 (n = 11) had lesser visual analog scale pain scores on movement at each postoperative time point from 30 min until 96 h postoperatively (P < 0.005) and at rest 30 min (0.6 +/- 1.5 versus 30.2 +/- 26.8; P = 0.004), 4 h (2.3 +/- 7.5 versus 19.0 +/- 25.8; P = 0.013), 8 h (4.4 +/- 10.2 versus 21.4 +/- 27.0; P = 0.03) and 12 h (0.7 +/- 1.2 versus 15.4 +/- 27.0; P = 0.035) postoperatively. NOx values were greater in group N compared with group S 48 h postoperatively (40.6 +/- 20.1 versus 26.4 +/- 13.5; P = 0.04).Language
engISSN
1526-7598 (Electronic)0003-2999 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1213/01.ANE.0000240415.49180.4A
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