Decreased patient analgesic requirements after liver transplantation and associated neuropeptide levels

Transplantation
K L DonovanC W Pinson

Abstract

Decreased morphine requirements have been reported after liver transplantation when compared with other types of major abdominal surgery. The aim of this study was to examine plasma concentrations of three neuropeptides involved in pain modulation-metenkephalin (ME), beta-endorphin (BE), and substance P (SP)-in patients undergoing orthotopic liver transplantation (OLT) and in control patients undergoing other liver operations. We then compared the postoperative analgesic requirements in these two groups of patients. Plasma levels of ME, BE, and SP were measured by radioimmunoassay at preincision, preemergence, and for 3 days after operation in 13 patients undergoing OLT and in 10 control patients. Patient-controlled analgesia morphine delivery was recorded for all patients postoperatively, and plasma morphine, its metabolites, and patient pain and sedation scores were also measured. ME levels were elevated in all OLT patient samples when compared with control patient samples. BE levels were not significantly different at any time. SP levels were significantly decreased only in preincision and preemergence OLT patient samples. Total patient-controlled analgesia morphine delivered during the first 3 postoperative days was signifi...Continue Reading

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Citations

Aug 12, 2000·Acta Anaesthesiologica Scandinavica·H J Toivonen
Jul 24, 2004·Anesthesia and Analgesia·Tae W Kim, Mark Harbott
Dec 23, 2011·Anesthesia and Analgesia·Yan YinTao Zhu
Dec 19, 2013·Saudi Journal of Anaesthesia·Ashraf S HasaninKhaled A Yassen
Sep 23, 2014·Transplantation Proceedings·P FeltraccoC Ori
May 2, 2006·Transplantation Proceedings·R FumagalliL R Sperti

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