Effects of Preemptive Analgesia on Pain and Cytokine Production in the Postoperative Period

Beilin, Benzion; Bessler, Hanna; Mayburd, Eduard; Smirnov, G.; Dekel, Arie; Yardeni, I. Z.; Shavit, Yehuda

doi:10.1097/00000542-200301000-00024

Cited by 143 publications

(99 citation statements)

References 13 publications

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“…Perioperative complications can lead to a modulation of the immune state, decrease in tumor surveillance, and possibly increased risk of disease recurrence and disease-specific death. [12][13][14][15] To the best of our knowledge, the current study is the first to examine the association between the occurrence of a postoperative complication and long-term outcomes among patients undergoing hepatic resection for ICC. The current study is important because the data have demonstrated that postoperative complications were independently associated with both RFS and OS.…”

Section: Discussionmentioning

confidence: 99%

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Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

Spolverato

Yakoob

Kim

et al. 2015

Cancer

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BACKGROUND:The impact of postoperative complications on the long-term outcomes of patients undergoing surgery for cancer is unclear. The objective of the current study was to define the incidence of complications among patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC) and identify the association between morbidity and long-term outcomes. METHODS: A total of 583 patients undergoing surgery with curative intent for ICC between 1990 and 2013 at 1 of 12 participating institutions were identified. The association between the occurrence and severity of postoperative complications on long-term survival was analyzed. RESULTS: The median age of the patients was 59.9 years and the majority of patients were male (52.3%). A total of 91 patients (15.6%) and 153 patients (26.2%) developed a major and minor postoperative complication, respectively; 18 patients (3.5%) died within 90 days of surgery. Median, 1-year, 3-year, and 5-year recurrence-free survival were 10.0 months, 43.3%, 16.7%, and 11.1%, respectively. Postoperative complications (hazard ratio [HR] CONCLUSIONS: Postoperative complications were found to be independent predictors of worse long-term outcomes. The prevention and management of postoperative complications is crucial to increase both short-term and long-term survival. Cancer 2015;121:2730-9.

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Section: Discussionmentioning

confidence: 99%

“…[12][13][14] In turn, perioperative complications may exacerbate this inflammatory response and induce a state of immunosuppression. 14 This state of immunosuppression may decrease tumor surveillance and lead to detrimental effects, including worse long-term oncological outcomes.…”

Section: Introductionmentioning

confidence: 99%

Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

Spolverato

Yakoob

Kim

et al. 2015

Cancer

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“…17 The important role that inflammation plays in cancer and operative outcomes is being increasingly recognized. [18][19][20][21][22] Increased preoperative NLR may be an important indicator of the inflammatory state of patient at the time of surgery. This marker is easily obtained from a patient's routine preoperative laboratory studies and is easily calculated.…”

Section: Introductionmentioning

confidence: 99%

Elevated NLR in gallbladder cancer and cholangiocarcinoma – making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium

Beal

Wei

Ethun

et al. 2016

HPB

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“…The mean value of serum IL-10 measured 1 h postoperatively increased significantly in both RAM and GAM group when compared with preoperative IL-10 with p<0.05. It shows there is a possibility of regional anesthesia anti-inflammatory effects due to blockade of C fibers, 7 thereby reducing the production of cytokines 8 and block the activity of the sympathetic nerve fibers. [9][10] Therefore, postoperative pain caused primarily by tissue inflammation and activation of C-fibers by reducing the production of cytokines that may limit the inflammatory response after surgery and postoperative pain severity.…”

Section: Discussionmentioning

confidence: 99%

Regional Anesthesia Continuous Brachial Plexus Block With Ultrasonography Guidance

et al. 2015

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Background:Regional anesthesia has an anti-inflammatory effect that blockade the C-fiber hence reduced cytokine production and blocked the activity of the sympathetic nerve fibers. Postoperative pain caused primarily by tissue inflammation and activity of the C-fibers in the manner of reduced the production of cytokines, regional anesthesia may limit the inflammatory response after surgery and severity of postoperative pain. Methods: This study is a clinical experimental study with randomized pre and post test control group design. A total of 24 samples were recruited in this study divided into two groups each consisting of 12 samples. The first group was given regional anesthesia method of continuous brachial plexus block with ultrasound guidance and the second group with general anesthesia method. T-test or Mann-Whitney continued multivariate linear regression analysis was performed to analyze the differences in treatment and not because of differences in the initial values with significance level of p<0.05. Results: This study reports that the mean decreased levels of IL-6 postoperatively in 1 st group is 29.8 lower than in 2 nd group and it is statistically significant p< 0.05. There was an increase of IL-10 mean levels from preoperative to postoperatively with significance level of p<0.05 in both groups. Declined in the mean levels of PAF postoperatively in 1 st group 1.3 lower than 2 nd group and it was statistically significant p<0.05. The declined of postoperative VAS in 1 st group is 3.1 lower than 2 nd group and it is statistically significant p< 0.05, and it also contained the pure effect of PAF levels against value of VAS that any increased 1ng/ml levels of PAF then an increase in the value of 0.18 cm VAS and this was statistically significant p<0.05. Selection of this anesthesia technique in orthopedic antebrachii surgery provides better inflammatory response and improved clinical outcomes.

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Effects of Preemptive Analgesia on Pain and Cytokine Production in the Postoperative Period

Abstract: Proinflammatory cytokines are key mediators of illness symptoms, including hyperalgesia. The present results suggest that preemptive epidural analgesia is associated with reduced postoperative pain and attenuated production of proinflammatory cytokines.

Cited by 143 publications

References 13 publications

Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

Impact of complications on long‐term survival after resection of intrahepatic cholangiocarcinoma

Elevated NLR in gallbladder cancer and cholangiocarcinoma – making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium

Regional Anesthesia Continuous Brachial Plexus Block With Ultrasonography Guidance

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