Does preemptive gabapentin modulate cytokine response in total knee arthroplasty? A placebo controlled study
| Autor: | Süleyman Ellik, Ezgi Erkilic, Duygu Sahin, Aylin Sepici-Dincel, Elvin Kesimci, Bulent Bektaser, Nadir Yalçın |
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| Rok vydání: | 2018 |
| Předmět: |
Time Factors
Cyclohexanecarboxylic Acids Gabapentin Analgesic Total knee arthroplasty Placebo-controlled study Administration Oral Medicine (miscellaneous) Placebo Drug Administration Schedule General Biochemistry Genetics and Molecular Biology Pacu 03 medical and health sciences 0302 clinical medicine Double-Blind Method Oral administration Internal Medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Amines Arthroplasty Replacement Knee Genetics (clinical) Aged Pain Measurement Aged 80 and over Analgesics Pain Postoperative 030222 orthopedics biology business.industry Diclofenac Sodium Middle Aged biology.organism_classification Treatment Outcome Anesthesia Reviews and References (medical) Cytokines business medicine.drug |
| Zdroj: | Advances in Clinical and Experimental Medicine. 27:487-491 |
| ISSN: | 1899-5276 |
| DOI: | 10.17219/acem/68630 |
| Popis: | Background Gabapentin, as a structural analogue of γ-aminobutyric acid, has been investigated to provide pain relief in the early postoperative period following various surgical interventions. Objectives The objective of this study was to investigate whether preemptive oral administration of gabapentin 800 mg can reduce postoperative pain and modulate the inflammatory cytokine response in comparison to placebo in patients undergoing total knee arthroplasty under general anesthesia. Material and methods Fifty-two patients were randomly divided into 2 groups before surgery, either to receive peroral gabapentin 800 mg or placebo drug, 1 h before surgery. All patients had general anesthesia with endotracheal intubation, in a standardized fashion, by the same anesthetist. Thirty min before completion of surgery, intramuscular diclofenac sodium 75 mg was administered. Following extubation, visual analogue pain scale (VAS) scores and additional analgesic requirements were recorded at 15 min at post-anesthesia care unit (PACU), and at 4th and 24th h postoperatively. Plasma levels of interleukin 6 (IL-6), and tumor necrosis factor R (TNF-R) were measured at predetermined time points (T0 1 h before administration of gabapentin, T1 at postoperative the 4th h mark, and T2 at postoperative at the 24th h mark). Results The VAS scores at postoperative 4th h were significantly higher in placebo and gabapentin groups compared with VAS scores at PACU and at 24th h. The groups did not differ in terms of additional analgesic requirements. In gabapentin group, IL-6 levels at T1 and T2 were significantly lower in comparison to values measured in placebo group at the same time points. This difference was not significant in TNF-R levels between the groups. Conclusions Though preemptive oral gabapentin administration did not reduce postoperative pain and analgesic requirements in total knee arthroplasty surgery, it attenuated IL-6 production on the first postoperative day. |
| Databáze: | OpenAIRE |
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