Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland;
Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
In Vivo. 2022 Mar-Apr;36(2):773-779. doi: 10.21873/invivo.12764.
BACKGROUND/AIM: The present study investigated the plasma concentration of the lipid peroxidation (LP) biomarker 4-hydroxynonenal (4-HNE) in benign and cancer patients having the rectus sheath block (RSB) analgesia after midline laparotomy. Plasma concentrations of catalase (CAT) and malondialdehyde (MDA) were used as a reference.
This study assessed three LP biomarkers; CAT, MDA and 4-HNE and compared the plasma levels to the patient satisfaction 24 h postoperatively (SFS; 0=fully unsatisfied; 10=fully satisfied); the overall pain at rest (NRS) and when pressing the wound at 20 Newton force (NRS) were surveyed and filed on a 11-point numeric rating scale at 24 h following surgery (NRS; 0=no pain; 10=worst pain). There were 56 patients in the study, of whom 12 were excluded due to missing plasma samples. The final study cohort consisted of 15 patients with benign disease and 29 patients with cancer.
The RSB analgesia enhanced significantly the SFS scores in the study groups (p=0.001). The plasma 4-HNE decreased immediately after operation (POP1) and the postoperative decrease between the preoperative and the POP1 values in the 4-HNE marker were statistically significant (p<0.001). The individual plasma 4-HNE and MDA concentration correlated significantly in benign and cancer patients (r=0.413, p<0.001).
The present study confirms the applicability of the plasma biomarker 4-HNE to cast further light on the postoperative pain in midline laparotomy patients.
背景/目的：本研究调查了经腹正中切口手术后行腹直肌鞘阻滞（RSB）镇痛的良性和癌症患者的血浆脂质过氧化（LP）生物标志物 4-羟基壬烯醛（4-HNE）浓度。同时使用过氧化氢酶（CAT）和丙二醛（MDA）作为参考。
本研究评估了三种 LP 生物标志物；CAT、MDA 和 4-HNE，并将血浆水平与术后 24 小时患者满意度（SFS；0=完全不满意；10=完全满意）进行比较；还对患者术后静息时的总体疼痛（NRS）和在 20 牛顿力按压伤口时的疼痛（NRS）进行了评估，并在术后 24 小时使用 11 点数字评分量表进行记录（NRS；0=无痛；10=最痛）。本研究共有 56 名患者，其中 12 名因缺少血浆样本而被排除。最终的研究队列包括 15 名良性疾病患者和 29 名癌症患者。
RSB 镇痛显著提高了研究组的 SFS 评分（p=0.001）。术后即刻（POP1）血浆 4-HNE 降低，4-HNE 标志物的术前与 POP1 值之间的术后降低具有统计学意义（p<0.001）。良性和癌症患者的个体血浆 4-HNE 和 MDA 浓度呈显著相关（r=0.413，p<0.001）。
本研究证实了血浆生物标志物 4-HNE 在进一步阐明经腹正中切口手术后患者的术后疼痛方面的适用性。
