Transdermal nicotine patch for postoperative pain management: a pilot dose-ranging study

Anesthesia and Analgesia
Daewha HongPamela Flood

Abstract

Nicotine has been shown to be antinociceptive in the postoperative period in animal studies. Human studies with nasal nicotine sprays have had mixed results, possibly due to variability in pharmacokinetics and potential patient variables such as exposure to nicotine in tobacco smokers. In this pilot study, we examined the analgesic effect of a transdermal nicotine patch applied before surgery in nonsmokers. We conducted a randomized, double-blind, prospective placebo-controlled trial of 40 subjects, undergoing general surgery that required postoperative patient-controlled analgesia and an overnight hospital admission. Immediately before surgery, a transdermal nicotine patch containing 0, 5, 10, or 15 mg was applied. The primary outcome variable was pain report using a numerical rating scale (NRS) in the first hour after surgery and over the next 5 days. Secondary outcomes were pain medication use, hemodynamic values, nausea, and sedation. Patients treated with nicotine reported lower pain scores when compared with those treated with placebo during the first hour after surgery (P = 0.003, average NRS decrease = 1.4, 95% CI = 0.3-2.6) and for 5 days after surgery (P = 0.03, average NRS decrease = 1.0, 95% CI = 0.1-1.9). There was...Continue Reading

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Citations

May 8, 2013·European Journal of Pharmacology·Lorenzo Di Cesare MannelliCarla Ghelardini
Apr 10, 2013·British Journal of Anaesthesia·N SidhuP Flood
Oct 31, 2012·The Journal of Pain : Official Journal of the American Pain Society·Elizabeth J RichardsonJ Scott Richards
Jan 25, 2011·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Benjamin YagoubianPamela Flood
Dec 18, 2009·The Journal of Pain : Official Journal of the American Pain Society·Henrietta L LoganWilliam M Mendenhall
Feb 3, 2011·British Journal of Clinical Pharmacology·Christoph CzarnetzkiMartin R Tramèr
Apr 20, 2016·Journal of Controlled Release : Official Journal of the Controlled Release Society·Felix HammannJuergen Drewe
Jan 13, 2016·The Cochrane Database of Systematic Reviews·Annette M MatthewsRoger Chou
Jun 28, 2018·Revista do Colégio Brasileiro de Cirurgiões·Euclides Dias Martins FilhoÁlvaro Antônio Bandeira Ferraz
May 13, 2011·European Journal of Anaesthesiology·Christopher J JankowskiJuraj Sprung
Sep 25, 2010·Anesthesiology·Yu ShiDavid O Warner
Aug 21, 2008·Anesthesia and Analgesia·Neal L Benowitz
Jan 5, 2014·Anesthesia and Analgesia·Basem M Mishriky, Ashraf S Habib
Jun 16, 2021·Journal of Ethnopharmacology·Matthias S GeckMarco Leonti

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