Acute phase response in patients undergoing lumbar spinal surgery: modulation by perioperative treatment with naproxen and famotidine

Biochemical Measurement of Injury and Inflammation in Musculoskeletal Surgeries

“…For example, intravenous diclofenac reduced postoperative pain and use of analgesics in a heterogenous sample having various surgeries (Claeys et al1992). Naproxen reduced postoperative pain following knee arthroscopy (Code et al, 1994) and following spinal surgery (Munoz et al, 2004).…”

“…This is despite uncertainty about its clinical significance, leading to claims that it may simply be a normal response to surgeries (Andres et al, 2003, Pile 2006Shaw & Chung 1999,). It has been argued that unusually high or prolonged post-operative fever is a risk factor for complications (Munoz et al 2004;Pile 2006). There are numerous previously suggested causes (Fanning et al, 1998) including: urinary tract infections, pneumonia, blood transfusions, infections at the wound, surgical site, intravenous catheter or created by the prosthesis, deep venous thrombosis, and C-deficile related to peri-operative antibiotics.…”

“…Using spinal surgery as a model, patients undergoing spinal fusion with instrumentation were assigned alternately to 2 groups of 20 subjects each, one that received 500 mg/day of naproxen combined with 40 mg/day famotidine in an attempt to blunt the inflammatory response, or to a no anti-inflammatory treatment control (Munoz et al 2004). Following the operation, patients who received the anti-inflammatory treatment had lower body temperatures and requested less analgesic.…”

Injury Measurement Properties of Serum Interleukin-6 Following Lumbar Decompression Surgery

“…While measurement of IL-6 is not made in current clinical practice in surgery, it has been of interest within research on surgical trauma . Increases in IL-6 concentrations in blood have provided a basis to study accidental injuries [4][5][6][7][8][9][10] and surgical injuries [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. In surgery research, increases in circulating IL-6 concentrations have been used to compare different surgery approaches or techniques on the relative amounts of trauma they produce [17,21] and to study potential prediction of postsurgical risks and complications [13][14][15][24][25][26][27].…”

C-Reactive Protein

“…Although we did not use steroids or non steroidal anti inflammatory drugs post operatively, but these medications seems to effect on the level of CRP. Munoz m. et al [35] revealed that preoperative treatment with naproxane and famotidine was well tolerated and reduced the acute phase response after instrumented spinal surgery. In this study we could not find any correlation of the raised CRP level they age , sex , ESR , WBC count , body temperature duration of surgery blood transfusion [36] with exception of Orrego LM et al [37] who noticed that more complex surgical procedure had higher CRP level and explained due to the amount of tissue trauma.…”