Association of Acute Postoperative Pain and Cigarette Smoking With Cerebrospinal Fluid Levels of Beta-Endorphin and Substance P

Abstract

Objectives: Cigarette smoking is associated with postoperative pain perception, which might be mediated by beta-endorphin and substance P. These effects on postoperative pain perception have never been investigated in human cerebrospinal fluid (CSF), which reflects biochemical alterations in the brain. Therefore, we investigated the associations among cigarette smoking, postoperative pain, and levels of beta-endorphin and substance P in human CSF.Methods: We recruited 160 Chinese men (80 active smokers and 80 nonsmokers) who underwent lumbar puncture before anterior cruciate ligament reconstruction, and 5-ml CSF samples were collected. Pain visual analog scale (VAS) scores, post-anesthetic recovery duration (PARD), and smoking variables were obtained. CSF levels of beta-endorphin and substance P were measured.Results: Compared to non-smokers, active smokers had significantly higher pain VAS (2.40 ± 0.67 vs. 1.70 ± 0.86, p < 0.001) and PARD scores (9.13 ± 2.11 vs. 7.27 ± 1.35, p = 0.001), lower CSF beta-endorphin (33.76 ± 1.77 vs. 35.66 ± 2.20, p = 0.001) and higher CSF substance P (2,124.46 ± 217.34 vs. 1,817.65 ± 302.14, p < 0.001) levels. Pain VAS scores correlated with PARD in active smokers (r = 0.443, p = 0.001).Conclusions: Cigarette smoking is associated with increased postoperative pain intensity, shown by delayed pain perception, higher pain VAS scores, and lower beta-endorphin and higher substance P levels in the CSF of active smokers. The more extended postoperative pain perception is delayed, the more pain intensity increases.

Effect of Zusanli Acupoint Injection with Anisodamine on Postoperative Recovery Quality of Patients Undergoing Bariatric Surgery

“…β-EP is an endogenous morphine biochemical synthetic hormone with endogenous analgesic effect [ 22 ]. The levels of SP and β-EP in peripheral blood serve as valuable indicators for assessing patient pain [ 23 ]. Acupoint injection has been recognized for its ability to stimulate the production of vascular endothelial growth factor and transforming growth factor β1, thereby enhancing angiogenesis and improving blood flow.…”

Incidence and Risk Factors of Chronic Postoperative Pain in Same-day Surgery: A Prospective Cohort Study

“…37,38 Several mechanisms have been suggested explaining the association between nicotine and pain, including changes in the endogenous opioid system mediated by exposition to nicotine. 39 Preoperative chronic pain is also a common risk factor for chronic postsurgical pain reported in the literature. 8,23,25,27,29 However, in our cohort, chronic preoperative pain at the surgical site was not statistically significantly associated with chronic postsurgical pain (defined as an increase of 1 point or more in the Brief Pain Inventory score) but was associated with moderate to severe chronic postsurgical pain (defined as a score greater than or equal to 4 out of 10).…”