scholarly journals The relationship between the level of μ -opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Opioid Receptor ◽  
Recovery Room ◽  
Control Group ◽  
Analgesic Requirement ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Analgesic Agents ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use

Abstract Background : In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods : In our prospective study,120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group)(n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24 th hour post-operative period. Results: Demographic data and peri-operative variables were similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/mL (max:489.92±22.36 pg/mL, min:94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group (p<0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1 st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration: This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date:26/11/2019).

scholarly journals The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Muzaffer Gencer ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Opioid Receptor ◽  
Recovery Room ◽  
Control Group ◽  
Analgesic Requirement ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Analgesic Agents ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use

Abstract Background In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n = 60) was patients given tramadol (1–2 mg/kg) for post-operative analgesia, and the second group (control group) (n = 60) was initially prescribed only fentanyl (1 μg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results Demographic data and peri-operative variables were similar in both study group (p < 0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94 ± 15.34 pg/mL (max:489.92 ± 22.36 pg/mL, min: 94.56 ± 11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p < 0.05), 1st (p < 0.05) and 3rd hours (p < 0.05).The VAS scores were lower in the tramadol group compared to the control group (p < 0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p < 0.05) for arrival at the recovery room and 1st hour. Patients in the tramadol group needed a second pain killer much later than patients in the control group. Conclusions Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).

scholarly journals The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Opioid Receptor ◽  
Recovery Room ◽  
Control Group ◽  
Analgesic Requirement ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Analgesic Agents ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use

Abstract Background: In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group) (n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results: Demographic data and peri-operative variables was similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/Ml (max:489.92±22.36 pg/mL, min: 94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room, (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group p <0.05.Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration:This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).

scholarly journals The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Opioid Receptor ◽  
Recovery Room ◽  
Control Group ◽  
Analgesic Requirement ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Analgesic Agents ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use

Abstract Background: In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty.Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n=60) was patients given tramadol (1-2 mg/kg) for post-operative analgesia, and the second group (control group) (n=60) was initially prescribed only fentanyl (1 µg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period.Results: Demographic data and peri-operative variables were similar in both study group (p<0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94±15.34 pg/mL (max:489.92±22.36 pg/mL, min: 94.56±11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p<0.05), 1st (p<0.05) and 3rd hours (p<0.05).The VAS scores were lower in the tramadol group compared to the control group (p<0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p<0.05) for arrival at the recovery room and 1st hour.Patients in the tramadol group needed a second pain killer much later than patients in the control group.Conclusions: Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents.Trial registration:This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).

scholarly journals The relations between the level of Mu-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Postoperative Pain ◽  
Opioid Receptor ◽  
Control Group ◽  
Pain Level ◽  
Analgesic Requirement ◽  
Receptor Level ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use ◽  
Μ Opioid Receptors

Abstract Background In this study, the μ-Opioid receptor activity was examined before the septoplasty. We assessed preoperative μ-Opioid receptor activity association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into preop 2 groups. The first group (n=60) was patients given tramadol (1-2 mgr/kg) for postop analgesia, and the second group (control group) (n=60) was initially performed only fentanyl (1 µg/ kg-i.v.) in the induction. The μ-Opioid receptors activities were investigated in preoperative blood samples and compared post-op pain level and requiring time for second analgesic agent. The visual analogue score(VAS) was used to evaluate the postoperative pain degree (0 no pain,10 worst pain). Patients' post op VAS scores were evaluated upon arrival to recovery room, and at 1st, 3rd, 7th, 10th, and 24 th hours in postoperative period. Results Demographic data and perioperative variables was similar in both study group (p<0.05). There was no significant difference between the receptor levels in both two groups and the mean receptor level was 200.94 pg/ml. While the highest receptor level was 489.92 pg/ ml, the lowest receptor level was 94.56 pg/ml. In patients who used tradomal, as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period. Vas scores were lower in the tramadol group compared to the control group. Patients in Tramadol group needed second pain killer later than patients in the Control group. Conclusions In this study, we revealed that postoperative pain level and second analgesic requirement decreased as μ-Opioid receptor levels increased in tramadol group.

scholarly journals The relations between the level of Mu-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: A prospective randomized controlled trial.

2020 ◽  
Author(s):  
MUZAFFER GENCER ◽  
Ayşe Yeşim Göçmen
Keyword(s):  
Postoperative Pain ◽  
Opioid Receptor ◽  
Control Group ◽  
Pain Level ◽  
Analgesic Requirement ◽  
Receptor Level ◽  
Vas Scores ◽  
Μ Opioid Receptor ◽  
Analgesic Use ◽  
Μ Opioid Receptors

Abstract Background: In this study, the μ-Opioid receptor activity was examined before the septoplasty. We assessed preoperative μ-Opioid receptor activity association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty.Methods: In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into preop 2 groups. The first group (n=60) was patients given tramadol (1-2 mgr/kg) for postop analgesia, and the second group (control group) (n=60) was initially performed only fentanyl (1 µg/ kg-i.v.) in the induction. The μ-Opioid receptors activities were investigated in preoperative blood samples and compared post-op pain level and requiring time for second analgesic agent. The visual analogue score(VAS) was used to evaluate the postoperative pain degree (0 no pain,10 worst pain). Patients' post op VAS scores were evaluated upon arrival to recovery room, and at 1st, 3rd, 7th, 10th, and 24th hours in postoperative period.Results: Demographic data and perioperative variables was similar in both study group (p<0.05). There was no significant difference between the receptor levels in both two groups and the mean receptor level was 200.94 pg/ml. While the highest receptor level was 489.92 pg/ ml, the lowest receptor level was 94.56 pg/ml. In patients who used tradomal, as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period. Vas scores were lower in the tramadol group compared to the control group. Patients in Tramadol group needed second pain killer later than patients in the Control group.Conclusions: In this study, we revealed that postoperative pain level and second analgesic requirement decreased as μ-Opioid receptor levels increased in tramadol group.Trial registration: This trial was registered retrospectively (The ACTRN: ACTRN12619001652167, registration date: 26/11/2019).

scholarly journals Comparison of the analgesic effects of Post-operative Morphine, Pre-emptive and Post-operative Paracetamol in Septorhinoplasty Surgery

2015 ◽  
Vol 4 (2) ◽  
pp. 121-25
Author(s):  
Shoja-Al-hagh Taregh ◽  
Mohammad Reza Hadavi ◽  
Shahriyar Omidvari ◽  
Mohammad Ali Daneshforouz
Keyword(s):  
Pain Score ◽  
Acute Pain ◽  
Recovery Room ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Analgesic Effects ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Total Pain ◽  
Significant Difference

Background: According to previous studies there are some different opinions on the pre-emptive effects of paracetamol in controlling post-operative pain, we aimed to compare the analgesic effects of pre-emptive paracetamol with post-operative paracetamol and morphine in patients undergoing septorhinoplasty.Materials and methods: A hundred and six patients aged 15 to 50 were divided into 3 groups. One received 1 g paracetamol 30 minutes before the operation, another group received 1 g paracetamol after the surgery and the control group received 3 mg morphine sulfate in the recovery room after the surgery. The pain severity was recorded for each patient using a 10 slot table. Any signs of nausea and vomiting (N/V) or apnea were closely observed and recorded. Patients with pain score 5 or more received 2 mg morphine intravascularly.Results: There was not any significant difference between the groups in total pain score and N/V (p>0.05). Post-operative morphine intake was significantly lower in pre-emptive group (P<0.05). None of the patients experienced apnea during the study. Conclusion: We concluded that pre-emptive paracetamol can lower the opium consumption in post-operative period but pre-emptive paracetamol cannot reduce the post-operative acute pain noticeably.

Coblation tonsillectomy versus cold steel dissection tonsillectomy: a morphological study

2019 ◽  
Vol 133 (09) ◽  
pp. 770-774 ◽  
Author(s):  
N Lieberg ◽  
M Aunapuu ◽  
A Arend
Keyword(s):  
Skeletal Muscle ◽  
Mast Cell ◽  
Tissue Damage ◽  
Morphological Study ◽  
Mast Cell Degranulation ◽  
Histological Investigation ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Analgesic Use ◽  
Cold Steel Dissection

AbstractObjectiveTo compare the extent of tissue damage produced by conventional cold steel and coblation tonsillectomy.MethodsTwenty patients underwent conventional and 18 underwent coblation tonsillectomy. The removed tonsils were histopathologically evaluated.ResultsAnalgesic use was lower in the coblation group during the early post-operative period. Histological investigation of tonsils removed by the conventional method showed intensive haemorrhage and hyperaemia in the tonsillar capsules, which was not seen in the coblation group. Furthermore, in the coblation group, there was less mast cell degranulation (p = 0.0081) and a smaller amount of skeletal muscle tissue (p = 0.0043) in the tonsillar capsules, indicating less tissue damage.ConclusionCompared to the cold steel technique, coblation tonsillectomy is superior in terms of less early post-operative pain and less damage to surrounding tissues. Significantly lower mast cell degranulation in coblation tonsillectomy may contribute to the reduction of post-operative pain.

scholarly journals Auricular Acupuncture for Pain Relief after Ambulatory Knee Arthroscopy—A Pilot Study

2005 ◽  
Vol 2 (2) ◽  
pp. 185-189 ◽  
Author(s):  
Taras I. Usichenko ◽  
Maria Hermsen ◽  
Torsten Witstruck ◽  
Andre Hofer ◽  
Dragan Pavlovic ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Analogue Scale ◽  
Knee Arthroscopy ◽  
Auricular Acupuncture ◽  
Control Group ◽  
Acupuncture Points ◽  
Analgesic Requirement ◽  
Post Operative Pain ◽  
Analgesic Medication

Auricular acupuncture (AA) is effective in treating various pain conditions, but there have been no analyses of AA for the treatment of pain after ambulatory knee surgery. We assessed the range of analgesic requirements under AA after ambulatory knee arthroscopy. Twenty patients randomly received a true AA procedure (Lung, Shenmen and Knee points) or sham procedure (three non-acupuncture points on the auricular helix) before ambulatory knee arthroscopy. Permanent press AA needles were retainedin situfor one day after surgery. Post-operative pain was treated with non-steroidal anti-inflammatory ibuprofen, and weak oral opioid tramadol was used for rescue analgesic medication. The quantity of post-operative analgesics and pain intensity were used to assess the effect of AA. The incidence of analgesia-related side effects, time to discharge from the anesthesia recovery room, heart rate and blood pressure were also recorded. Ibuprofen consumption after surgery in the AA group was lower than in the control group: median 500 versus 800 mg,P= 0.043. Pain intensity on a 100 mm visual analogue scale for pain measurement and other parameters were similar in both groups. Thus AA might be useful in reducing the post-operative analgesic requirement after ambulatory knee arthroscopy.

The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques

2017 ◽  
Vol 132 (3) ◽  
pp. 240-245 ◽  
Author(s):  
D Wiltshire ◽  
M Cronin ◽  
N Lintern ◽  
K Fraser-Kirk ◽  
S Anderson ◽  
...  
Keyword(s):  
Normal Activity ◽  
Normal Diet ◽  
Pain Level ◽  
Single Institution ◽  
Common Procedure ◽  
Pain Scores ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Single Blind ◽  
Analgesic Use

AbstractObjectives:Tonsillectomy is a common procedure with significant post-operative pain. This study was designed to compare post-operative pain, returns to a normal diet and normal activity, and duration of regular analgesic use in Coblation and bipolar tonsillectomy patients.Methods:A total of 137 patients, aged 2–50 years, presenting to a single institution for tonsillectomy or adenotonsillectomy were recruited. Pain level, diet, analgesic use, return to normal activity and haemorrhage data were collected.Results:Coblation tonsillectomy was associated with significantly less pain than bipolar tonsillectomy on post-operative days 1 (p= 0.005), 2 (p= 0.006) and 3 (p= 0.010). Mean pain scores were also significantly lower in the Coblation group (p= 0.039). Coblation patients had a significantly faster return to normal activity than bipolar tonsillectomy patients (p< 0.001).Conclusion:Coblation tonsillectomy is a less painful technique compared to bipolar tonsillectomy in the immediate post-operative period and in the overall post-operative period. This allows a faster return to normal activity and decreased analgesic requirements.

scholarly journals Is metronidazole a panacea for post-hemorrhoidectomy pain?

2018 ◽  
Vol 5 (11) ◽  
pp. 3598 ◽  
Author(s):  
Probal Neogi ◽  
Anuvrat Sinha ◽  
Mayank Singh
Keyword(s):  
Pain Relief ◽  
Controlled Trial ◽  
Control Group ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Topical Metronidazole ◽  
Background Pain ◽  
The Difference ◽  
Clinically Significant ◽  
Grade 3

Background: Pain following Milligan Morgan hemorrhoidectomy is a significant cause of morbidity. The present study was carried out to find out if using metronidazole in the post-operative period of these patients results in less post-operative pain.Methods: This was a prospective randomized controlled trial which was conducted on 67 consecutive patients attending the Surgical OPD at SRN Hospital, Allahabad during the study period between August 2016 and July 2017 who underwent surgery for grade 2, grade 3 and grade 4 hemorrhoids. The patients were allocated to 3 groups-one group was the control group, the second group received oral metronidazole post-operatively for 7 days while the third group received only topical metronidazole for 7 days. All the three groups received 500 mg of metronidazole in 100 ml infusion pre-operatively. The post-operative analgesic usage was standardized for all the three groups. Appropriate tests of significance were applied to assess if the difference in the intensity of post-operative pain was significant in the immediate post-operative period and on days 1, 3 and 7 post-surgery.Results: Pain relief was significantly better in the groups using metronidazole at post-operative day 1, 3 and 7 and this was also borne in the lesser number of analgesics used by the patients of these groups.Conclusions: Use of oral or topical metronidazole in the post-operative period results in clinically significant pain relief. There is no additional benefit of one over the other and hence either can be used.

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