Assessment of biochemical markers in patients with pain of vascular origin.

The aim of this study was to analyse blood plasma biochemical parameters in patients with pain of vascular origin. Blood samples were taken from 62 patients (38-86 years of age) with critical limb ischaemia, claudication or lower limb embolism, and from a control group. The samples were taken at the time of hospital admission, 1 h after surgery, 24 h after surgery, and before discharge. Pain intensity was assessed as mild, moderate or intense. The following biochemical parameters were measured: C reactive protein, total protein, albumin, total cholesterol, HDL and LDL cholesterol, glucose, triglycerides, reduced glutathione, malondialdehyde (MDA), and total antioxidative capacity. In the control subjects, MDA increased postoperatively, whereas albumin, total protein, HDL and total cholesterol decreased. In patients with claudication triglycerides and LDL cholesterol also decreased postoperatively. In patients with critical limb ischaemia, reduced glutathione and antioxidative capacity decreased postoperatively and MDA increased. Except in patients with embolism, MDA and C reactive protein increased following surgery. Patients with critical limb ischaemia and embolism reported the worst preoperative pain. In patients with ischaemia, intense pain persisted during the whole postoperative period while in patients with embolism pain continuously decreased. At different time intervals, pain intensity was related to different biochemical markers. We suggest that the described blood plasma changes might play an important role in pain assessment and pain management.