Postoperative Analgesia Induced by Subarachnoid Lidocaine plus Calcitonin

Miralles, F; López‐Soriano, Francisco J.; Puig, Margarita M.; Pérez, Domingo G.; López-Rodríguez, F

doi:10.1213/00000539-198707000-00005

Cited by 27 publications

(13 citation statements)

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“…The differences of duration of analgesia (in minutes) in group I, group II and group III with baseline value (group IV) were statistically significant (P value <0.05). Simialr results were observed in studies by Miralles FS et al and Moraby et al 10,11 The observed side effects of salmon calcitonin administration are as shown in Table 4. Three (15%) cases in group I and group III; four patients in group IV; five in group II had hypotension at some point of time during the procedure which was easily managed by volume resuscitation and use of injection mephentermine 5mg intravenously.…”

Section: Resultssupporting

confidence: 63%

“…9,10 In our study, 5 patients were observed to have restlessness in group I as compared to one in group III group and none in other groups. There is an increase in restlessness with the use of increased dose and the incidence in this series is similar to the one observed by Miralles FS et al and Moraby et al, but the restlessness could easily be attenuated with the use of midazolam 1-2mg intravenously.…”

Section: Discussionmentioning

confidence: 45%

“…11 Miralles et al in their group of patients have used 100IU. 10 of salmon calcitonin mixed with 5% lignocaine given intrathecally also observed that the patient treated with salmon calcitonin had significantly less pain at 6hours and even the request for analgesic was significantly less frequent.…”

Section: Discussionmentioning

confidence: 79%

“…8 It has also been used as an adjuvant to local anesthetic in subarachnoid block to increase the efficacy of block, duration of postoperative analgesia and reduce postoperative analgesic requirements. [9][10][11] This study was carried out with the aim to compare and evaluate the efficacy of calcitonin in two different doses to provide postoperative analgesia and, to evaluate the side effect of intrathecal calcitonin administration.…”

mentioning

confidence: 99%

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Efficacy and safety of two different doses of intrathecal calcitonin, a randomized controlled study

2018

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Background: Adjuvants play an important role in enhancing the quality of anesthesia and also in reducing the requirement of primary anesthetic and its related adverse events. Calcitonin is one such adjuvant. But there is still uncertainty regarding the appropriate dose of calcitonin to achieve maximum analgesic efficacy and safety. The current study is conducted to add to the existing evidence on the subject and was aimed to compare the efficacy and safety of two different doses of calcitonin as an adjuvant in patients undergoing spinal anesthesia.Methods: A prospective randomized controlled double-blind trial was conducted in the Department of Anesthesiology and Intensive Care, Sir Sunderlal Hospital, Banaras Hindu University from May 2006 to May 2007. A total of 80 participants aged between 18 to 60 years, with ASA I and II physical status, undergoing infra-umbilical surgeries were randomly allocated to one of the 4 intervention groups. All the 4 intervention groups received 0.5% bupivacaine (H) 3ml as a primary anesthetic agent. Group I and III received 50 IU and 100 IU salmon calcitonin as an adjuvant. Group II received placebo and group IV (control) received no adjuvant. Pinprick test, Bromage scale and 10-point Visual analog scale (VAS) were used to measure the efficacy.Results: All the study groups were comparable with respect to all baseline variables. The time interval to the first dose of analgesia was longest in 100 I.U. calcitonin group, followed by 50 I.U. calcitonin group, placebo control group. The mean duration of analgesia (in minutes) among group I (100I.U. calcitonin) was 230.00±92.39, 159.25±21.59 among group II (Placebo), 161.50±31.20 among group III (50 I.U. calcitonin) and 142.75±20.22 among group IV. Considering group IV (control group) as base line. The differences of duration of analgesia (in minutes) in group I, group II and group III with baseline value (group IV) were statistically significant (P value <0.05). Even though the proportion of subjects developing adverse events was slightly higher in 100 I.U calcitonin groups compared to other groups, they were minor adverse events and were managed appropriately. There were no significant differences across the study groups in terms of hemodynamic stability.Conclusions: Salmon calcitonin as adjuvant increases the duration of postoperative analgesia. Even though the there slightly higher incidence of adverse events with 100 I.U calcitonin they are minor and the risk-benefit ratio favors calcitonin use. To make a categorical recommendation on the appropriate dose, there is further need for large-scale studies and pooled analysis.

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Section: Resultssupporting

confidence: 63%

Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 99%

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Efficacy and safety of two different doses of intrathecal calcitonin, a randomized controlled study

2018

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“…Besides pain management in osteoporosis, 14,15 CT has shown an analgesic action in painful conditions such as phantom limb pain, 16 diabetic neuropathy, 17 complex regional pain syndrome, 18 adhesive capsulitis, 19 rheumatoid arthritis, 20 vertebral crush fractures, 14 spondylitis, tumor metastasis, 21 cancer pain, 22 migraine, 23 Paget's disease of bone, 24 as well as postoperative pain. 25 Interestingly and which may hint toward the mode of action, epidural CT in combination with local anesthetic produces an analgesic effect similar to that of fentanyl and with stable hemodynamic results. 13 It also eliminates postoperative hyperglycemia indicating that CT is a suitable alternative for the treatment of acute postoperative pain.…”

Section: Clinical Evidence Of Calcitonin In Pain Controlmentioning

confidence: 93%

Role of calcitonin in management of musculoskeletal pain

et al. 2009

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Calcitonin was discovered more than 40 years ago and the scientific community continues to debate the primary and secondary pharmacological actions of calcitonin. Presently calcitonin is accepted by agencies only for treatment of osteoporosis, but many studies have indicated an effect on pain in many different experimental settings both pre-clinically and clinically. The effects of calcitonin on clinical pain conditions have received increasing attention in the past decades, although a consensus on mode of action and potential indications still has to be reached. Several key advances in the pain field may enable a deeper understanding of the putative analgesic effects of calcitonin. Most studies have focused on the effect of calcitonin on musculoskeletal pain problems. Ample lines of independent evidence suggest that calcitonin exerts putative analgesic effects. Well-designed clinical trials, particularly in the field of musculoskeletal pain, are needed to validate fragmented evidence of analgesic actions. This in combination with advanced mechanism-based pain assessment tools can provide new insight into the role of calcitonin, alone or in combination with other compounds, in management of pain.

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