Effect of somatostatin analogue octreotide on pain relief after major abdominal surgery.
BACKGROUND
Octreotide acetate is an 8-amino-acids synthetic octapeptide analogue of somatostatin with much-enhanced duration of action and lower incidence of side effects. We assessed the utility of using intravenous octreotide as an adjuvant to opioid analgesia that might exert a post-operative opioid-sparing effect.


METHODS
Forty-four patients were randomly allocated, to receive either a placebo or intraoperative octreotide 0.33 microg kg(-1)h(-1) intravenous infusion that was maintained in the post-operative period. Patients received for post-operative analgesia an intravenous piritramide patient controlled analgesia (PCA), set to deliver a piritramide 0.02 mgkg(-1) dose.


RESULTS
Two-way ANOVA revealed significantly fewer (P=0.0003) mean+/-SD weighted piritramide dose requirements in the octreotide group (19.5+/-6.3 microg kg(-1)h(-1)) than in the control group (35.7+/-8.2 microg kg(-1)h(-1)). Dunnett's two-sided multiple-comparison post hoc test revealed a significant difference between the two groups during the first 22 post-operative hours, following which there were no differences between the two groups. There were no significant differences over time in the mean arterial pressure (P=0.722), heart rate (P=0.579) and respiratory rate (P=0.823) between the octreotide group (80+/-10mm Hg, 74+/-12, 14+/-2) and the control group (82+/-9 mm Hg, 76+/-11, 15+/-3), respectively.


CONCLUSIONS
We demonstrated that perioperative octreotide intravenous infusion could be an adjuvant to opioid analgesia as it exerted a piritramide opioid-sparing effect. We encountered more systemic side effects such as nausea, abdominal discomfort, and diarrhea in the octreotide group than in the control group. Our findings could be beneficial to patients who cannot tolerate the adverse effects of opioids.
Dahaba
Ashraf A
AA
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria. ashraf.dahaba@medunigraz.at
Mueller
Gabriele
G
Mattiassich
Georg
G
Rumpold-Seitlinger
Gudrun
G
Bornemann
Helmar
H
Rehak
Peter H
PH
Linck
Guillermo
G
Mischinger
Hans-Joerg
HJ
Metzler
Helfried
H
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000704:Analysis of Variance; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D010892:Pirinitramide / Q000008:administration & dosage / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000150:complications / Q000453:epidemiology
D000701:Analgesics, Opioid; D018757:GABA Modulators; D010892:Pirinitramide; D008874:Midazolam; D015282:Octreotide