Effects of postoperative analgesia on acute phase response in thoracic surgery.
The aim of this research is to determine: the influence of continuous opiate and intermittent non-opiate postoperative analgesia on thoracic surgical patients' acute phase response, based on acute phase response protein serum values (IL-6 and C-reactive protein) 24, 48 and 72 hours aftersurgery; to analyze the acute phase responses in those thoracic surgical patients in which the postoperative complications have developed and in those in which they haven't. The study itself has a prospective character involving 60 patients divided into two homogenous groups, 30 patients each, which are of the same age, sex, pathological substrate, and are the patients of the University Clinical Centre in Tuzla. The first group of patients were those to whom the non-opiate intermittent analgesia of methamisol natrium was applied, and the second group were the patients to whom the continuous tramadol chloride opiate analgesia was applied after the thoracic surgical procedure had been performed. According to the examined patients and applied types of analgesia, the following results were obtained: CRP values enhanced in both groups, all three measurements, with no significant statistical differences (p = 0.051; p = 0.054; p = 0.1). While the IL-6 values enhanced in all measurements in group I, in group II they remained within reference range, with a significant statistical difference (p = 0.042; p = 0.039; p = 0.035). This study suggests that CRP enhanced values in both groups are the result of the response to surgery. The enhanced IL-6 values in group I, and maintained IL-6 values within reference range in group II, are the result of continuous tramadol chloride opiate analgesia, which turned out to be more efficient and safer.
Clinic of Anesthesiology and Reanimation, Clinical Center of University of Tuzla, Bosnia and Herzegovina. selma.sijercicavdagic@ukctuzla.ba
Selma Sijercic
SS
Avdagic
Goran
G
Krdzalic
Harun
H
Avdagic
Vasvija
V
Uljic
Melika
M
Piric
D000210:Acute-Phase Reaction / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002097:C-Reactive Protein / Q000032:analysis*; D004177:Dipyrone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D019616:Thoracic Surgical Procedures; D014147:Tramadol / Q000008:administration & dosage
D000700:Analgesics; D000701:Analgesics, Opioid; D015850:Interleukin-6; D014147:Tramadol; D004177:Dipyrone; D002097:C-Reactive Protein