Saimanen Iina, Kärkkäinen Jari, Selander Tuomas, Purdy Martin, Kokki Merja, Kokki Hannu, Eskelinen Matti
Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
Science Service Center, Kuopio University Hospital, Kuopio, Finland.
Anticancer Res. 2018 Nov;38(11):6479-6484. doi: 10.21873/anticanres.13011.
BACKGROUND/AIM: The relationship of plasma concentrations of the oxidative stress biomarker catalase with pain on numeric rating scale at rest (NRSr) and under wound pressure 24 hours postoperatively (NRSp) in midline laparotomy patients with rectus sheath block (RSB) analgesia are unknown. Our original hypothesis was that RSB analgesia might reduce postoperative pain.
Initially, 56 patients were randomized to four groups: control group (n=12), single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) RSB analgesia groups. The plasma concentrations of catalase were measured immediately before, immediately after and 24 hours after surgery. The pain at rest and under pressure were scored on an 11-point numeric rating scale 24 hours postoperatively (NRS and NRS; 0: no pain; 10: worst pain).
The median plasma concentration of catalase increased immediately after surgery (p=0.007), but then decreased 24 hours postoperatively compared with immediately after surgery (p<0.001). The control group and the RSB groups did not differ in individual NRS and NRS values following surgery. Scatter plots of the plasma catalase versus superoxide dismutase concentrations were positively correlated in the patients (r=0.314, p<0.001). In addition, scatter plots of the individual NRS and NRS values versus plasma values of catalase were inversely correlated in patients (r=-0.221, p=0.03 and r=-0.238, p=0.02, respectively).
The RSB analgesia does not reduce postoperative pain. Plasma catalase levels and pain following surgery are significantly correlated in patients regardless of disease type.
背景/目的：在接受腹直肌鞘阻滞（RSB）镇痛的中线剖腹手术患者中，氧化应激生物标志物过氧化氢酶的血浆浓度与术后24小时静息时数字评分量表（NRSr）及伤口受压时（NRSp）疼痛之间的关系尚不清楚。我们最初的假设是RSB镇痛可能会减轻术后疼痛。
最初，56例患者被随机分为四组：对照组（n = 12）、单剂量组（n = 16）、重复剂量组（n = 12）和持续输注组（n = 16）RSB镇痛组。在手术前即刻、手术后即刻和手术后24小时测量过氧化氢酶的血浆浓度。术后24小时采用11分数字评分量表对静息时和受压时的疼痛进行评分（NRSr和NRSp；0：无疼痛；10：最剧烈疼痛）。
过氧化氢酶的血浆浓度中位数在手术后即刻升高（p = 0.007），但与手术后即刻相比，术后24小时下降（p < 0.001）。术后对照组和RSB组的个体NRSr和NRSp值无差异。患者血浆过氧化氢酶与超氧化物歧化酶浓度的散点图呈正相关（r = 0.314，p < 0.001）。此外，患者个体NRSr和NRSp值与过氧化氢酶血浆值的散点图呈负相关（分别为r = -0.221，p = 0.03和r = -0.238，p = 0.02）。
RSB镇痛并不能减轻术后疼痛。无论疾病类型如何，患者血浆过氧化氢酶水平与术后疼痛显著相关。
