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    The associations between severity of early postoperative pain, chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast surgery.

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    Authors
    Iohom, Gabriella
    Abdalla, 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
    2012-02-03T15:04:26Z
    MeSH
    Acetaminophen/administration & dosage
    Adult
    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
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    Citation
    Anesth Analg. 2006 Oct;103(4):995-1000.
    Journal
    Anesthesia and analgesia
    URI
    http://hdl.handle.net/10147/208820
    DOI
    10.1213/01.ANE.0000240415.49180.4A
    PubMed ID
    17000819
    Abstract
    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
    eng
    ISSN
    1526-7598 (Electronic)
    0003-2999 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1213/01.ANE.0000240415.49180.4A
    Scopus Count
    Collections
    Cork University Hospital

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