Association of Acute Postoperative Pain and Cigarette Smoking With Cerebrospinal Fluid Levels of Beta-Endorphin and Substance P

Objectives: Cigarette smoking is associated with postoperative pain perception, which might be mediated by beta-endorphin and substance P. These effects on postoperative pain perception have never been investigated in human cerebrospinal fluid (CSF), which reflects biochemical alterations in the brain. Therefore, we investigated the associations among cigarette smoking, postoperative pain, and levels of beta-endorphin and substance P in human CSF.Methods: We recruited 160 Chinese men (80 active smokers and 80 nonsmokers) who underwent lumbar puncture before anterior cruciate ligament reconstruction, and 5-ml CSF samples were collected. Pain visual analog scale (VAS) scores, post-anesthetic recovery duration (PARD), and smoking variables were obtained. CSF levels of beta-endorphin and substance P were measured.Results: Compared to non-smokers, active smokers had significantly higher pain VAS (2.40 ± 0.67 vs. 1.70 ± 0.86, p < 0.001) and PARD scores (9.13 ± 2.11 vs. 7.27 ± 1.35, p = 0.001), lower CSF beta-endorphin (33.76 ± 1.77 vs. 35.66 ± 2.20, p = 0.001) and higher CSF substance P (2,124.46 ± 217.34 vs. 1,817.65 ± 302.14, p < 0.001) levels. Pain VAS scores correlated with PARD in active smokers (r = 0.443, p = 0.001).Conclusions: Cigarette smoking is associated with increased postoperative pain intensity, shown by delayed pain perception, higher pain VAS scores, and lower beta-endorphin and higher substance P levels in the CSF of active smokers. The more extended postoperative pain perception is delayed, the more pain intensity increases.

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Application of preoperative assessment of pain induced by venous cannulation in predicting postoperative pain in patients under laparoscopic nephrectomy: a prospective study

10.21203/rs.2.21736/v1 ◽

2020 ◽

Author(s):

Fei Peng ◽

Yanshuang Li ◽

Yanqiu Ai ◽

Jianjun Yang ◽

Yanping Wang

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Pain Score ◽

Preoperative Assessment ◽

Laparoscopic Nephrectomy ◽

Venous Cannulation ◽

Clinical Trial Registry ◽

Rescue Analgesia ◽

Intravenous Analgesia ◽

Vas Scores

Abstract Backgroud: Postoperative pain is the most prominent concern among surgical patients. It has been reported that venous cannulation-induced pain can predict postoperative pain after laparoscopic cholecystectomy within 90 mins. Its potential in predicting postoperative pain in patients with patient-controlled intravenous analgesia (PCIA) is worth establishing. The purpose of this study was to investigate the application of VCP in predicting postoperative pain in patients with PCIA during the first 24 h after laparoscopic nephrectomy. Methods: 120 patients scheduled for laparoscopic nephrectomy. The nurse recorded the preoperative venous cannulation-induced pain score estimated by patients, and dichotomized the patients into VAS scores < 2.0 group or VAS scores ≥ 2.0 group . After general anesthesia and surgery, all the patients received the patient-controlled intravenous analgesia (PCIA) with sufentanil. The VAS scores at rest and on coughing at 2 h, 4 h, 8 h, 12 h, 24 h, the effective number of presses and the number of needed rescue analgesia within 24 h after surgery were recorded. Results: Venous cannulation-induced pain score was significantly correlated with postoperative pain intensity at rest (rs = 0.64) and during coughing (rs = 0.65), effective times of pressing (rs = 0.59), additional consumption of sufentanil (rs = 0.58). Patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units reported higher levels of postoperative pain intensity at rest (P < 0.0005) and during coughing (P < 0.0005), needed more effective times of pressing (P < 0.0005) and additional consumption of sufentanil (P < 0.0005), and also needed more rescue analgesia (P = 0.01). The odds of risk for moderate or severe postoperative pain (OR 3.5, 95% CI 1.3-9.3) was significantly higher in patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units compared to those < 2.0 VAS units. Conclusions: Preoperative venous cannulation-induced pain can be used to predict postoperative pain intensity in patients with PCIA during the first 24 h after laparoscopic nephrectomy. Trial registration: We registered this study in a Chinese Clinical Trial Registry (ChiCTR) center on July 6 2019 and received the registration number: ChiCTR1900024352. Key words: Venous cannulation, Pain, Postoperative pain, Pain prediction

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Efficacy of Anesthetic Agents to Delay Pain Onset After Periodontal Surgery

Anesthesia Progress ◽

10.2344/0003-3006-58.2.57 ◽

2011 ◽

Vol 58 (2) ◽

pp. 57-60 ◽

Cited By ~ 1

Author(s):

Joao Paulo Steffens ◽

Márcia Thaís Pochapski ◽

Fábio André Santos ◽

Gibson Luiz Pilatti

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Pain Perception ◽

Clinical Signs ◽

Periodontal Surgery ◽

Anesthetic Agents ◽

Parallel Group ◽

Group 2 ◽

Double Blinded ◽

Group 1

Abstract The aim of this study was to evaluate the influence of 2 anesthetic agents on patients' postoperative pain perception after periodontal surgery. For this parallel-group, double-blinded, randomized clinical trial, 36 open flap debridement surgeries were performed on patients who presented with periodontal disease with clinical signs of inflammation after nonsurgical treatment on at least 1 quadrant. Patients were allocated to 1 of the following groups: group 1, 2% lidocaine with 1 ∶ 100,000 epinephrine; group 2, 2% mepivacaine with 1 ∶ 100,000 norepinephrine. Pain intensity was assessed using the visual analog scale during the first 8 hours after surgery. All patients received 750-mg acetaminophen tablets, which they were instructed to take as a rescue medication if necessary. The results demonstrated that postoperative pain intensity was statistically lower in group 2 than in group 1 at the 1-, 2-, and 3-hour periods after surgery, although the pain intensity for all groups could be considered mild. In conclusion, patients in both groups reported similar mild pain after periodontal surgery.

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Whether preventive low dose magnesium sulphate infusion has an influence on postoperative pain perception and the level of serum beta-endorphin throughout the total abdominal hysterectomy

Revista Española de Anestesiología y Reanimación (English Edition) ◽

10.1016/j.redare.2017.05.006 ◽

2017 ◽

Vol 64 (7) ◽

pp. 384-390

Author(s):

K. Haryalchi ◽

M. Abedinzade ◽

K. Khanaki ◽

M. Mansour Ghanaie ◽

F. Mohammad Zadeh

Keyword(s):

Postoperative Pain ◽

Magnesium Sulphate ◽

Pain Perception ◽

Low Dose ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Beta Endorphin

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Preoperative Norepinephrine Levels in Cerebrospinal Fluid and Plasma of Pediatric Patients Predict Postoperative Pain Intensity after Spinal Fusion Surgery

Global Spine Journal ◽

10.1055/s-0036-1582703 ◽

2016 ◽

Vol 6 (1_suppl) ◽

pp. s-0036-1582703-s-0036-1582703

Author(s):

Catherine Ferland ◽

Alexandre Parent ◽

Neil Saran ◽

Pablo Ingelmo ◽

Serge Marchand ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Postoperative Pain ◽

Pain Intensity ◽

Spinal Fusion ◽

Pediatric Patients ◽

Fusion Surgery ◽

Spinal Fusion Surgery

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Application of preoperative assessment of pain induced by venous cannulation in predicting postoperative pain in patients under laparoscopic nephrectomy: a prospective observational study

10.21203/rs.2.21736/v2 ◽

2020 ◽

Author(s):

Fei Peng ◽

Yanshuang Li ◽

Yanqiu Ai ◽

Jianjun Yang ◽

Yanping Wang

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Prospective Observational Study ◽

Preoperative Assessment ◽

Laparoscopic Nephrectomy ◽

Venous Cannulation ◽

Rescue Analgesia ◽

Intravenous Analgesia ◽

Vas Scores ◽

Response Group

Abstract Background: Postoperative pain is the most prominent concern among surgical patients. It has previously been reported that venous cannulation-induced pain (VCP) can be used to predict postoperative pain after laparoscopic cholecystectomy within 90 mins in the recovery room. Its potential in predicting postoperative pain in patients with patient-controlled intravenous analgesia (PCIA) is worth establishing. The purpose of this prospective observational study was to investigate the application of VCP in predicting postoperative pain in patients with PCIA during the first 24 h after laparoscopic nephrectomy.Methods: 120 patients scheduled for laparoscopic nephrectomy were included in this study. A superficial vein on the back of the hand was cannulated with a standard-size peripheral venous catheter (1.1×3.2 mm) by a nurse in the preoperative areas.Then the nurse recorded the VAS score associated with this procedure estimated by patients, and dichotomized the patients into low response group (VAS scores < 2.0) or high response group (VAS scores ≥ 2.0). After general anesthesia and surgery, all the patients received the patient-controlled intravenous analgesia (PCIA) with sufentanil. The VAS scores at rest and on coughing at 2 h, 4 h, 8 h, 12 h, 24 h, the effective number of presses and the number of needed rescue analgesia within 24 h after surgery were recorded. Results: Peripheral venous cannulation-induced pain score was significantly correlated with postoperative pain intensity at rest (rs = 0.64) and during coughing (rs = 0.65), effective times of pressing (rs = 0.59), additional consumption of sufentanil (rs = 0.58). Patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units reported higher levels of postoperative pain intensity at rest (P < 0.0005) and during coughing (P < 0.0005), needed more effective times of pressing (P < 0.0005) and additional consumption of sufentanil (P < 0.0005), and also needed more rescue analgesia (P = 0.01) during the first 24 h. The odds of risk for moderate or severe postoperative pain (OR 3.5, 95% CI 1.3-9.3) was significantly higher in patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units compared to those < 2.0 VAS units. Conclusions: Preoperative assessment of pain induced by venous cannulation can be used to predict postoperative pain intensity in patients with PCIA during the first 24 h after laparoscopic nephrectomy.Trial registration: We registered this study in a Chinese Clinical Trial Registry (ChiCTR) center on July 6 2019 and received the registration number: ChiCTR1900024352.

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Association of Cigarette Smoking With Male Cognitive Impairment and Metal Ions in Cerebrospinal Fluid

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.738358 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hui Li ◽

Qingshuang Mu ◽

Yimin Kang ◽

Xiaoyu Yang ◽

Ligang Shan ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Cognitive Impairment ◽

Cigarette Smoking ◽

Metal Ions ◽

Cruciate Ligament ◽

History Of ◽

Copper Zinc ◽

Csf Levels ◽

Young Smokers ◽

Anterior Cruciate

Objective: Cigarette smoking might accelerate cognitive impairment; however, this has never been investigated using human cerebrospinal fluid (CSF). We conducted this study to investigate the association between cigarette smoking and cognitive impairment through metal ions in CSF.Methods: We obtained 5-ml CSF samples from routine lumbar puncture procedures in patients undergoing anterior cruciate ligament reconstruction before surgery in China. A total of 180 Chinese males were recruited (80 active smokers and 100 non-smokers). We measured specific cigarette-related neurotoxic metal ions in CSF, including iron, copper, zinc, lead, aluminum, and manganese. Sociodemographic data and history of smoking were obtained. The Montreal Cognitive Assessment (MoCA) was applied.Results: Active smokers had fewer years of education (11.83 ± 3.13 vs. 13.17 ± 2.60, p = 0.01), and higher age (33.70 ± 10.20 vs. 29.76 ± 9.58, p = 0.01) and body mass index (25.84 ± 3.52 vs. 24.98 ± 4.06, p =0.03) than non-smokers. Compared to non-smokers, active smokers had significantly higher CSF levels of iron, zinc, lead, and aluminum and lower MoCA scores (all p < 0.05). Average daily numbers of cigarettes smoked negatively correlated with the MoCA scores (r = −0.244, p = 0.048). In young smokers, CSF manganese levels negatively correlated with MoCA scores (r = −0.373, p = 0.009).Conclusions and Relevance: Cigarette smoking might be associated with male cognitive impairment, as shown by lower MoCA scores and higher levels of CSF iron, zinc, lead, and aluminum in active smokers. This might be early evidence of cigarette smoking accelerating male cognitive impairment.

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Comparing the Effectiveness of Intra-Articular Injection of Bupivacaine, Dexmedetomidine Vs. 0.9% Saline on Pain Control after Arthroscopic Anterior Cruciate Ligament Reconstruction

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v4i2.2957 ◽

2020 ◽

Author(s):

Mohammadreza Minator Sajjadi ◽

Reza Zandi ◽

Mohammad Ali Okhovatpour ◽

Pooyan Jalalpour ◽

Mohammadreza Moshari

Keyword(s):

Anterior Cruciate Ligament ◽

Postoperative Pain ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Postoperative Pain Management ◽

Control Group ◽

Saline Administration ◽

Vas Scores ◽

The Mean ◽

Anterior Cruciate

Background: In different ways, drugs are administered to reduce postoperative analgesia after arthroscopic anterior cruciate ligament (ACL) reconstruction. The purpose of this study is to compare the dexmedetomidine (DEX) intra-articular injection with bupivacaine hydrochloride and sterile 0.9% saline administration following arthroscopic ACL reconstruction. Methods: Sixty cases who underwent ACL reconstruction were randomly divided into three groups. The first group received intra-articular DEX; the second group received intra-articular bupivacaine, and the final group received intra-articular 0.9% saline. Postoperative pain was measured by Visual Analogue Scale (VAS). Results: The mean VAS scores at 6 and 24 hours after surgery were lower in the bupivacaine group, compared to the other groups. Pain was more severe in the control group (0.9% saline), with higher VAS scores reported at 1, 6, and 24 hours after surgery. Conclusions: Bupivacaine has more significant effects than DEX in postoperative pain management after arthroscopic ACL reconstruction.

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Using Memory for Pain in Analgesic Research

Annals of Pharmacotherapy ◽

10.1177/106002809302700101 ◽

1993 ◽

Vol 27 (1) ◽

pp. 9-12 ◽

Cited By ~ 49

Author(s):

Najib Babul ◽

Andrew C. Darke ◽

Donald H. Johnson ◽

Karen Charron-Vincent

Keyword(s):

Pain Intensity ◽

Cruciate Ligament ◽

Pearson Correlation ◽

Correlation Coefficients ◽

Analgesic Efficacy ◽

Double Blind ◽

Vas Scores ◽

Highly Correlated ◽

Student’S T ◽

Maximum Minimum

OBJECTIVE: To determine the validity of pain intensity recall at 24 and 48 hours as a substitute for hourly pain assessments in repeated-dose analgesic studies. SETTING: Orthopedic unit of an acute care teaching hospital. PARTICIPANTS: Eighty-four patients undergoing arthroscopic reconstruction of the anterior cruciate ligament, using the patellar tendon, who were participating in a randomized, double-blind, parallel-group analgesic study. INTERVENTIONS: Patients rated their pain intensity every hour (while awake) for 48 hours and their recall of worst, least, and usual pain intensity at 24 and 48 hours using a visual analog scale (VAS). MAIN OUTCOME MEASURES: This study examined the relationship between recall of worst, least, and usual pain intensity at 24 and 48 hours and the experienced maximum, minimum, and mean pain intensity VAS scores obtained from hourly assessments over the 0–24- and 0–48-hour periods, respectively. The significance of differences between recalled and experienced pain intensity variables was assessed. RESULTS: Worst, least, and usual pain recall at 24 and 48 hours were highly correlated with experienced maximum, minimum, and mean pain from hourly reports, respectively, over the 0–24- and 0–48-hour periods (Pearson correlation coefficients, r=0.80–0.89, p<0.0001). Among the three pain recall variables, usual pain showed the highest correlation with hourly measurements. There were no significant differences between recalled pain and the corresponding measures of pain from the hourly VAS scores, except in the case of 48-hour recall of worst pain (Student's t-test, p=0.001). CONCLUSIONS: The close agreement between actual pain experience and recall of pain provides support for the use of pain recall in assessing analgesic efficacy in clinical trials.

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