Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy
Autor(a) principal: | |
---|---|
Data de Publicação: | 2014 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFC |
Texto Completo: | http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13448 |
Resumo: | The remote ischemic preconditioning (PCIR) results from a series of short nonlethal periods of ischemia interspersed by periods of reperfusion in distant tissues. Experimental and clinical studies have been published in recent years demonstrating the relationship between analgesia and ischemic preconditioning. Promoting PCIR with limb ischemia is feasible in clinical models. The aim of this study was to evaluate the effect of remote ischemic preconditioning on the intensity and quality of acute postoperative analgesia and production of inflammatory mediators in conventional cholecystectomy. Prospectively 20 patients were randomly divided into two groups. One group was subjected to an episode of ischemia in the lower limb before surgery. It was evaluated: the consumption of opioid analgesics in the postoperative period, the presence of primary mechanical hyperalgesia, scores of postoperative pain using a visual analog scale and plasma levels of TNF-alpha and interleukins (IL-6, IL-1β). There were no significant differences in the analysis of the variables: age, weight, duration of surgery and ASA between the two groups. The 24 hours morphine consumption in the tourniquet group compared to the control group was significantly less (p = 0.0156). The analysis of the assessment of pain intensity at rest, during coughing and deep breathing showed significantly lower VAS scores in tourniquet group compared to the control group with p = 0.0087, p = 0.0119, p = 0.0015, respectively. The presence or absence of mechanical hyperalgesia in the demarcated area near the postoperative wound was not different between groups (p = 0.0704). There were no significant differences in the levels of TNF-alpha (p = 0.0724) and IL-1β (p = 0.0532) between the two groups. There were significant differences in the dose of IL-6: between the two groups over time (p<0.0001). The remote ischemic preconditioning promoted satisfactory analgesia and reduced morphine consumption in patients undergoing conventional cholecystectomy, without, however, altering the presence of primary mechanical hyperalgesia at the site of injury or serum levels of inflammatory mediators. |
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info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisEffects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomyEfeitos do prÃ-condicionamento isquÃmico remoto sobre a dor aguda pÃs-operatÃria em colecistectomia convencional2014-06-06AntÃnio Aldo Melo Filho54450039300http://lattes.cnpq.br/0766190838110725JosenÃlia Maria Alves Gomes41687396353http://lattes.cnpq.br/7813338472725202Fernanda Paula Cavalcante96070625315http://lattes.cnpq.br/597218551817407836852996387http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4245474D0Francisco Elano Carvalho PereiraUniversidade Federal do CearÃPrograma de PÃs-GraduaÃÃo em CirurgiaUFCBRCIRURGIAThe remote ischemic preconditioning (PCIR) results from a series of short nonlethal periods of ischemia interspersed by periods of reperfusion in distant tissues. Experimental and clinical studies have been published in recent years demonstrating the relationship between analgesia and ischemic preconditioning. Promoting PCIR with limb ischemia is feasible in clinical models. The aim of this study was to evaluate the effect of remote ischemic preconditioning on the intensity and quality of acute postoperative analgesia and production of inflammatory mediators in conventional cholecystectomy. Prospectively 20 patients were randomly divided into two groups. One group was subjected to an episode of ischemia in the lower limb before surgery. It was evaluated: the consumption of opioid analgesics in the postoperative period, the presence of primary mechanical hyperalgesia, scores of postoperative pain using a visual analog scale and plasma levels of TNF-alpha and interleukins (IL-6, IL-1β). There were no significant differences in the analysis of the variables: age, weight, duration of surgery and ASA between the two groups. The 24 hours morphine consumption in the tourniquet group compared to the control group was significantly less (p = 0.0156). The analysis of the assessment of pain intensity at rest, during coughing and deep breathing showed significantly lower VAS scores in tourniquet group compared to the control group with p = 0.0087, p = 0.0119, p = 0.0015, respectively. The presence or absence of mechanical hyperalgesia in the demarcated area near the postoperative wound was not different between groups (p = 0.0704). There were no significant differences in the levels of TNF-alpha (p = 0.0724) and IL-1β (p = 0.0532) between the two groups. There were significant differences in the dose of IL-6: between the two groups over time (p<0.0001). The remote ischemic preconditioning promoted satisfactory analgesia and reduced morphine consumption in patients undergoing conventional cholecystectomy, without, however, altering the presence of primary mechanical hyperalgesia at the site of injury or serum levels of inflammatory mediators.O prÃ-condicionamento isquÃmico remoto (PCIR) prevÃ, na sua execuÃÃo, uma sÃrie de curtos perÃodos nÃo-letais de isquemia, intercaladas com perÃodos de reperfusÃo, em tecidos distantes. Estudos experimentais e clÃnicos foram publicados nos Ãltimos anos demonstrando a relaÃÃo entre analgesia e prÃ-condicionamento isquÃmico. Reproduzir a tÃcnica PCIR com isquemia de membros à exequÃvel em modelos clÃnicos. O objetivo deste estudo foi avaliar o efeito do prÃ-condicionamento isquÃmico remoto sobre a intensidade e qualidade da analgesia aguda pÃs-operatÃria e produÃÃo de mediadores inflamatÃrios em colecistectomia convencional. De forma prospectiva e aleatÃria, 20 (vinte) pacientes foram divididos em dois grupos: Grupo Controle e Grupo Garrote. Um dos grupos foi submetido a um episÃdio de isquemia no membro inferior antes do procedimento cirÃrgico. Foram avaliados: o consumo de analgÃsicos opiÃides no pÃs-operatÃrio, a presenÃa de hiperalgesia mecÃnica secundÃria, os escores de dor pÃs-operatÃria atravÃs da Escala Visual AnalÃgica e os nÃveis plasmÃticos TNF-alfa e interleucinas (IL-6, IL-1β). NÃo houve diferenÃas significativas na anÃlise das variÃveis: idade, peso, tempo cirÃrgico e ASA entre os dois grupos. O consumo foi, significativamente, menor na dose total de morfina em 24 horas no Grupo Garrote em relaÃÃo ao Grupo Controle (p = 0,0156). A anÃlise da avaliaÃÃo da intensidade da dor em repouso, durante a tosse e na respiraÃÃo profunda demonstrou escores de EVA, significativamente, menores no Grupo Garrote em relaÃÃo ao Grupo Controle com âpâ igual a 0,0087, 0,0119 e 0,0015, respectivamente. A presenÃa ou ausÃncia de hiperalgesia mecÃnica na Ãrea demarcada prÃxima à ferida pÃs-operatÃria nÃo foi diferente entre os grupos (p = 0,0704). NÃo houve diferenÃas significativas na dosagem de TNF-alfa (p = 0,0724) e IL-1β (p = 0,0532) entre os dois grupos. Houve diferenÃas significativas na dosagem de IL-6: entre os dois grupos no decorrer do tempo (p<0,0001). O prÃ-condicionamento isquÃmico remoto promoveu analgesia satisfatÃria e reduÃÃo do consumo de morfina nos pacientes submetidos à colecistectomia convencional, sem, entretanto, alterar a presenÃa de hiperalgesia mecÃnica primÃria no sÃtio de lesÃo ou os nÃveis sÃricos de mediadores da inflamaÃÃo.http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13448application/pdfinfo:eu-repo/semantics/openAccessporreponame:Biblioteca Digital de Teses e Dissertações da UFCinstname:Universidade Federal do Cearáinstacron:UFC2019-01-21T11:26:42Zmail@mail.com - |
dc.title.sl.fl_str_mv |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
dc.title.alternative.pt.fl_str_mv |
Efeitos do prÃ-condicionamento isquÃmico remoto sobre a dor aguda pÃs-operatÃria em colecistectomia convencional |
title |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
spellingShingle |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy Francisco Elano Carvalho Pereira CIRURGIA |
title_short |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
title_full |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
title_fullStr |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
title_full_unstemmed |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
title_sort |
Effects of remote ischemic preconditioning on acute postoperative pain in conventional cholecystectomy |
author |
Francisco Elano Carvalho Pereira |
author_facet |
Francisco Elano Carvalho Pereira |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
AntÃnio Aldo Melo Filho |
dc.contributor.advisor1ID.fl_str_mv |
54450039300 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0766190838110725 |
dc.contributor.referee1.fl_str_mv |
JosenÃlia Maria Alves Gomes |
dc.contributor.referee1ID.fl_str_mv |
41687396353 |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/7813338472725202 |
dc.contributor.referee2.fl_str_mv |
Fernanda Paula Cavalcante |
dc.contributor.referee2ID.fl_str_mv |
96070625315 |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/5972185518174078 |
dc.contributor.authorID.fl_str_mv |
36852996387 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4245474D0 |
dc.contributor.author.fl_str_mv |
Francisco Elano Carvalho Pereira |
contributor_str_mv |
AntÃnio Aldo Melo Filho JosenÃlia Maria Alves Gomes Fernanda Paula Cavalcante |
dc.subject.cnpq.fl_str_mv |
CIRURGIA |
topic |
CIRURGIA |
dc.description.abstract.por.fl_txt_mv |
The remote ischemic preconditioning (PCIR) results from a series of short nonlethal periods of ischemia interspersed by periods of reperfusion in distant tissues. Experimental and clinical studies have been published in recent years demonstrating the relationship between analgesia and ischemic preconditioning. Promoting PCIR with limb ischemia is feasible in clinical models. The aim of this study was to evaluate the effect of remote ischemic preconditioning on the intensity and quality of acute postoperative analgesia and production of inflammatory mediators in conventional cholecystectomy. Prospectively 20 patients were randomly divided into two groups. One group was subjected to an episode of ischemia in the lower limb before surgery. It was evaluated: the consumption of opioid analgesics in the postoperative period, the presence of primary mechanical hyperalgesia, scores of postoperative pain using a visual analog scale and plasma levels of TNF-alpha and interleukins (IL-6, IL-1β). There were no significant differences in the analysis of the variables: age, weight, duration of surgery and ASA between the two groups. The 24 hours morphine consumption in the tourniquet group compared to the control group was significantly less (p = 0.0156). The analysis of the assessment of pain intensity at rest, during coughing and deep breathing showed significantly lower VAS scores in tourniquet group compared to the control group with p = 0.0087, p = 0.0119, p = 0.0015, respectively. The presence or absence of mechanical hyperalgesia in the demarcated area near the postoperative wound was not different between groups (p = 0.0704). There were no significant differences in the levels of TNF-alpha (p = 0.0724) and IL-1β (p = 0.0532) between the two groups. There were significant differences in the dose of IL-6: between the two groups over time (p<0.0001). The remote ischemic preconditioning promoted satisfactory analgesia and reduced morphine consumption in patients undergoing conventional cholecystectomy, without, however, altering the presence of primary mechanical hyperalgesia at the site of injury or serum levels of inflammatory mediators. O prÃ-condicionamento isquÃmico remoto (PCIR) prevÃ, na sua execuÃÃo, uma sÃrie de curtos perÃodos nÃo-letais de isquemia, intercaladas com perÃodos de reperfusÃo, em tecidos distantes. Estudos experimentais e clÃnicos foram publicados nos Ãltimos anos demonstrando a relaÃÃo entre analgesia e prÃ-condicionamento isquÃmico. Reproduzir a tÃcnica PCIR com isquemia de membros à exequÃvel em modelos clÃnicos. O objetivo deste estudo foi avaliar o efeito do prÃ-condicionamento isquÃmico remoto sobre a intensidade e qualidade da analgesia aguda pÃs-operatÃria e produÃÃo de mediadores inflamatÃrios em colecistectomia convencional. De forma prospectiva e aleatÃria, 20 (vinte) pacientes foram divididos em dois grupos: Grupo Controle e Grupo Garrote. Um dos grupos foi submetido a um episÃdio de isquemia no membro inferior antes do procedimento cirÃrgico. Foram avaliados: o consumo de analgÃsicos opiÃides no pÃs-operatÃrio, a presenÃa de hiperalgesia mecÃnica secundÃria, os escores de dor pÃs-operatÃria atravÃs da Escala Visual AnalÃgica e os nÃveis plasmÃticos TNF-alfa e interleucinas (IL-6, IL-1β). NÃo houve diferenÃas significativas na anÃlise das variÃveis: idade, peso, tempo cirÃrgico e ASA entre os dois grupos. O consumo foi, significativamente, menor na dose total de morfina em 24 horas no Grupo Garrote em relaÃÃo ao Grupo Controle (p = 0,0156). A anÃlise da avaliaÃÃo da intensidade da dor em repouso, durante a tosse e na respiraÃÃo profunda demonstrou escores de EVA, significativamente, menores no Grupo Garrote em relaÃÃo ao Grupo Controle com âpâ igual a 0,0087, 0,0119 e 0,0015, respectivamente. A presenÃa ou ausÃncia de hiperalgesia mecÃnica na Ãrea demarcada prÃxima à ferida pÃs-operatÃria nÃo foi diferente entre os grupos (p = 0,0704). NÃo houve diferenÃas significativas na dosagem de TNF-alfa (p = 0,0724) e IL-1β (p = 0,0532) entre os dois grupos. Houve diferenÃas significativas na dosagem de IL-6: entre os dois grupos no decorrer do tempo (p<0,0001). O prÃ-condicionamento isquÃmico remoto promoveu analgesia satisfatÃria e reduÃÃo do consumo de morfina nos pacientes submetidos à colecistectomia convencional, sem, entretanto, alterar a presenÃa de hiperalgesia mecÃnica primÃria no sÃtio de lesÃo ou os nÃveis sÃricos de mediadores da inflamaÃÃo. |
description |
The remote ischemic preconditioning (PCIR) results from a series of short nonlethal periods of ischemia interspersed by periods of reperfusion in distant tissues. Experimental and clinical studies have been published in recent years demonstrating the relationship between analgesia and ischemic preconditioning. Promoting PCIR with limb ischemia is feasible in clinical models. The aim of this study was to evaluate the effect of remote ischemic preconditioning on the intensity and quality of acute postoperative analgesia and production of inflammatory mediators in conventional cholecystectomy. Prospectively 20 patients were randomly divided into two groups. One group was subjected to an episode of ischemia in the lower limb before surgery. It was evaluated: the consumption of opioid analgesics in the postoperative period, the presence of primary mechanical hyperalgesia, scores of postoperative pain using a visual analog scale and plasma levels of TNF-alpha and interleukins (IL-6, IL-1β). There were no significant differences in the analysis of the variables: age, weight, duration of surgery and ASA between the two groups. The 24 hours morphine consumption in the tourniquet group compared to the control group was significantly less (p = 0.0156). The analysis of the assessment of pain intensity at rest, during coughing and deep breathing showed significantly lower VAS scores in tourniquet group compared to the control group with p = 0.0087, p = 0.0119, p = 0.0015, respectively. The presence or absence of mechanical hyperalgesia in the demarcated area near the postoperative wound was not different between groups (p = 0.0704). There were no significant differences in the levels of TNF-alpha (p = 0.0724) and IL-1β (p = 0.0532) between the two groups. There were significant differences in the dose of IL-6: between the two groups over time (p<0.0001). The remote ischemic preconditioning promoted satisfactory analgesia and reduced morphine consumption in patients undergoing conventional cholecystectomy, without, however, altering the presence of primary mechanical hyperalgesia at the site of injury or serum levels of inflammatory mediators. |
publishDate |
2014 |
dc.date.issued.fl_str_mv |
2014-06-06 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
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publishedVersion |
format |
masterThesis |
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http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13448 |
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http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13448 |
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por |
language |
por |
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info:eu-repo/semantics/openAccess |
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openAccess |
dc.format.none.fl_str_mv |
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dc.publisher.none.fl_str_mv |
Universidade Federal do Cearà |
dc.publisher.program.fl_str_mv |
Programa de PÃs-GraduaÃÃo em Cirurgia |
dc.publisher.initials.fl_str_mv |
UFC |
dc.publisher.country.fl_str_mv |
BR |
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Universidade Federal do Cearà |
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reponame:Biblioteca Digital de Teses e Dissertações da UFC instname:Universidade Federal do Ceará instacron:UFC |
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Biblioteca Digital de Teses e Dissertações da UFC |
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Biblioteca Digital de Teses e Dissertações da UFC |
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Universidade Federal do Ceará |
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UFC |
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UFC |
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mail@mail.com |
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1643295199075500032 |