Ceccherelli F, Diani M M, Altafini L, Varotto E, Stefecius A, Casale R, Costola A, Giron G P
Institute of Anesthesiology and Intensive Care, University of Padova Padova, Italy Department of Anesthesia and Intensive Care, ULSS 1, Cadore, Italy A.I.R.A.S. Padova, Italy Service of Clinical Neurophysiology, Rehabilitation Center, IRCCS, Montescano, Pavia, Italy.
Pain. 1991 Nov;47(2):163-172. doi: 10.1016/0304-3959(91)90201-8.
The effectiveness of intravenous administration (i.v.) of L-tryptophan, which is the precursor of cerebral serotonin, was verified in the treatment of postoperative pain. The study was carried out on 45 female patients, aged between 34 and 61 years, undergoing cholecystectomy who were randomly divided into three groups. Group 1 (age: 50.33 +/- 8.64 years) received 100 ml of 5% mannitol solution i.v.; group 2 (age: 49.80 +/- 11.11 years) 100 ml of a mannitol solution containing 7.5 mg/kg L-tryptophan; and group 3 (age: 53.46 +/- 9.60 years) 100 ml of a mannitol solution containing 15 mg/kg L-tryptophan. Vital capacity (preoperative VC) was measured before surgery. Anesthesia used was isoflurane. Narcotics or neuroleptics were not used. Pain was assessed before treatment (T-0 min), at the end of administration (T-30) and at T-60, 120, 180, 240, 300 and 360 min by the following variables: respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), Scott-Huskisson test (VAS), pain vital capacity (PVC), analgesic vital capacity (AVC), and respiratory restoration factor (RRF) calculated from Bromage's formula (RRF = (AVC - PVC/preoperative VC - PVC) X 100). As regards variables RR, HR, MAP and VAS, differences between the values from T-30 to T-360 and the value at T-0 were calculated. Means and S.E.M. were calculated on the obtained values and on RRF values for each group. The significance of the differences between groups was calculated using Student's t test and Bonferroni's test. Results show a significant decrease of pain in groups 2 and 3 treated with L-tryptophan, in comparison with group 1 (controls). No significant difference was observed between the treated groups, although more lasting pain relief was observed in group 3 in comparison with group 2. Intravenous L-tryptophan showed its effectiveness in the treatment of postoperative pain even when used alone. Its use may be considered for patients with renal failure, in order to strengthen pharmacological analgesia or to prevent postoperative pain by its intraoperative administration.
作为大脑血清素前体的L-色氨酸静脉注射（i.v.）在术后疼痛治疗中的有效性得到了验证。该研究针对45名年龄在34至61岁之间接受胆囊切除术的女性患者进行，这些患者被随机分为三组。第一组（年龄：50.33±8.64岁）静脉注射100毫升5%甘露醇溶液；第二组（年龄：49.80±11.11岁）静脉注射100毫升含7.5毫克/千克L-色氨酸的甘露醇溶液；第三组（年龄：53.46±9.60岁）静脉注射100毫升含15毫克/千克L-色氨酸的甘露醇溶液。术前测量肺活量（术前VC）。使用异氟烷进行麻醉。未使用麻醉剂或神经安定药。通过以下变量在治疗前（T-0分钟）、给药结束时（T-30）以及T-60、120、180、240、300和360分钟评估疼痛：呼吸频率（RR）、心率（HR）、平均动脉压（MAP）、斯科特-赫斯基森试验（VAS）、疼痛肺活量（PVC）、镇痛肺活量（AVC）以及根据布罗米奇公式计算的呼吸恢复因子（RRF）（RRF =(AVC - PVC/术前VC - PVC)×100）。关于RR、HR、MAP和VAS变量，计算了从T-30至T-360的值与T-0时的值之间的差异。计算每组获得的值以及RRF值的均值和标准误。使用学生t检验和邦费罗尼检验计算组间差异的显著性。结果显示，与第一组（对照组）相比，用L-色氨酸治疗的第二组和第三组疼痛显著减轻。尽管与第二组相比，第三组的疼痛缓解更持久，但在治疗组之间未观察到显著差异。静脉注射L-色氨酸即使单独使用也显示出在术后疼痛治疗中的有效性。对于肾衰竭患者，为了加强药物镇痛或通过术中给药预防术后疼痛，可以考虑使用L-色氨酸。
