Gonyautoxins: First evidence in pain management in total knee arthroplasty

Autor: Néstor Lagos, Maximiliano Barahona, Jaime Hinzpeter, Matias Guerra, Eric Tapia, Alvaro Zamorano, Rodrigo Wulf, Álvaro Martinez, Miguel del Campo, Joaquín M. Sepúlveda, Cristian Barrientos, Miguel Palet, Tamara Bustamante
Rok vydání: 2016
Předmět:
Zdroj: Toxicon. 119:180-185
ISSN: 0041-0101
DOI: 10.1016/j.toxicon.2016.06.010
Popis: Improvements in pain management techniques in the last decade have had a major impact on the practice of total knee arthroplasty (TKA). Gonyautoxin are phycotoxins, whose molecular mechanism of action is a reversible block of the voltage-gated sodium channels at the axonal level, impeding nerve impulse propagation. This study was designed to evaluate the clinical efficacy of Gonyautoxin infiltration, as a long acting pain blocker in TKA. Fifteen patients received a total dose of 40 μg of Gonyautoxin during the TKA operation. Postoperatively, all patients were given a standard painkiller protocol: 100 mg of intravenous ketoprofen and 1000 mg of oral acetaminophen every 8 hours for 3 days. The Visual Analog Scale (VAS) pain score and range of motion were recorded 12, 36, and 60 hours post-surgery. All patients reported pain of 2 or less on the VAS 12 and 36 hours post-surgery. Moreover, all scored were less than 4 at 60 hours post-surgery. All patients achieved full knee extension at all times. No side effects or adverse reactions to Gonyautoxin were detected in the follow-up period. The median hospital stay was 3 days. For the first time, this study has shown the effect of blocking the neuronal transmission of pain by locally infiltrating Gonyautoxin during TKA. All patients successfully responded to the pain control. The Gonyautoxin infiltration was safe and effective, and patients experienced pain relief without the use of opioids.
Databáze: OpenAIRE
Externí odkaz: