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dc.contributor.authorIohom, Gabriella
dc.contributor.authorAbdalla, Hamza
dc.contributor.authorO'Brien, James
dc.contributor.authorSzarvas, Szilvia
dc.contributor.authorLarney, Vivienne
dc.contributor.authorBuckley, Elisabeth
dc.contributor.authorButler, Mark
dc.contributor.authorShorten, George Declan
dc.date.accessioned2012-02-03T15:04:26Z
dc.date.available2012-02-03T15:04:26Z
dc.date.issued2012-02-03T15:04:26Z
dc.identifier.citationAnesth Analg. 2006 Oct;103(4):995-1000.en_GB
dc.identifier.issn1526-7598 (Electronic)en_GB
dc.identifier.issn0003-2999 (Linking)en_GB
dc.identifier.pmid17000819en_GB
dc.identifier.doi10.1213/01.ANE.0000240415.49180.4Aen_GB
dc.identifier.urihttp://hdl.handle.net/10147/208820
dc.description.abstractIn 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).
dc.language.isoengen_GB
dc.subject.meshAcetaminophen/administration & dosageen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAnalgesia/*methodsen_GB
dc.subject.meshAnxiety/etiologyen_GB
dc.subject.meshBreast Neoplasms/*surgeryen_GB
dc.subject.meshBupivacaineen_GB
dc.subject.meshChronic Diseaseen_GB
dc.subject.meshDepression/etiologyen_GB
dc.subject.meshDextropropoxyphene/administration & dosageen_GB
dc.subject.meshDiclofenac/administration & dosageen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIsoxazoles/administration & dosageen_GB
dc.subject.meshMastectomyen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMorphine/administration & dosageen_GB
dc.subject.meshNerve Block/methodsen_GB
dc.subject.meshNitric Oxide/*blooden_GB
dc.subject.meshNociceptors/physiologyen_GB
dc.subject.meshPain Measurement/drug effectsen_GB
dc.subject.meshPain, Postoperative/*blood/*drug therapy/etiologyen_GB
dc.subject.meshPyrazoles/administration & dosageen_GB
dc.subject.meshSulfonamides/administration & dosageen_GB
dc.titleThe associations between severity of early postoperative pain, chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast surgery.en_GB
dc.contributor.departmentDepartment of Anesthesia & Intensive Care Medicine, Cork University Hospital,, Cork, Ireland.en_GB
dc.identifier.journalAnesthesia and analgesiaen_GB
dc.description.provinceMunster
html.description.abstractIn 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).


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