André P Schmidt1,2,3,4,5,6,7, Enderson D de Oliveira8, Aécio C Fagundes8, Gisele Hansel8, Renata O Pedrini9, Aline Valdameri10, Eduarda S Martinelli11, Sérgio R G Schmidt12, Cristiano F Andrade13, Diogo R Lara14, Diogo O Souza8. 1. Department of Biochemistry, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal Do Rio Grande Do Sul (UFRGS), Avenida Ramiro Barcelos, 2600-Anexo, Porto Alegre, RS, 90035-003, Brazil. aschmidt@ufrgs.br. 2. Department of Anesthesia and Perioperative Medicine, Hospital de Clínicas de Porto Alegre (HCPA), UFRGS, Porto Alegre, RS, Brazil. aschmidt@ufrgs.br. 3. Department of Anesthesia, Santa Casa de Porto Alegre, Universidade Federal de Ciências Médicas de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil. aschmidt@ufrgs.br. 4. Department of Anesthesia, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil. aschmidt@ufrgs.br. 5. Department of Anesthesia, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil. aschmidt@ufrgs.br. 6. Pain S.O.S., Pain Relief Center, Medical Center of Hospital Mãe de Deus, Porto Alegre, RS, Brazil. aschmidt@ufrgs.br. 7. Postgraduate Program in Pneumological Sciences, UFRGS, Porto Alegre, RS, Brazil. aschmidt@ufrgs.br. 8. Department of Biochemistry, Instituto de Ciências Básicas da Saúde (ICBS), Universidade Federal Do Rio Grande Do Sul (UFRGS), Avenida Ramiro Barcelos, 2600-Anexo, Porto Alegre, RS, 90035-003, Brazil. 9. Department of Anesthesia, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil. 10. Department of Anesthesia, Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil. 11. Department of Anesthesia, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil. 12. Pain S.O.S., Pain Relief Center, Medical Center of Hospital Mãe de Deus, Porto Alegre, RS, Brazil. 13. Postgraduate Program in Pneumological Sciences, UFRGS, Porto Alegre, RS, Brazil. 14. Cingulo Mental Health App, Porto Alegre, RS, Brazil.
Abstract
PURPOSE: Allopurinol is a potent inhibitor of the enzyme xanthine oxidase used primarily in the treatment of hyperuricemia and gout. The aim of this study was to compare the analgesic efficacy of preanesthetic allopurinol versus placebo on postoperative pain and anxiety in patients undergoing abdominal hysterectomy. METHODS: This is a prospective, double-blinded, placebo-controlled, randomized clinical trial. We investigated 54 patients scheduled to undergo elective abdominal hysterectomy. Patients were randomly assigned to receive either oral allopurinol 300 mg (n = 27) or placebo (n = 27) the night before and 1 h before surgery. Patients were submitted to evaluation of pain and anxiety before the treatment, for 24 h postoperatively, 30 and 90 days after surgery. Cerebrospinal fluid was collected at the time of the spinal anesthesia to perform the measurement of the central levels of purines. RESULTS: Preoperative administration of allopurinol was effective in reducing postoperative pain 2 h after surgery. Allopurinol caused a reduction of approximately 40% in pain scores measured by the visual analogue pain scale after surgery (p < 0.05). No differences were found between groups in anxiety scores after surgery. There was a significant change in the cerebrospinal fluid concentrations of xanthine and uric acid before surgery (p < 0.01). CONCLUSION: This study showed a short-term benefit of the use of allopurinol as a preanesthetic medication since it was related to a reduction on pain scores 2 h after surgery. The purinergic system is a potential target for new analgesic drugs. New studies investigating more selective purine derivatives in the management of pain should be performed. TRIAL NUMBER REGISTRATION: Brazilian Registry of Clinical Trials-ReBEC #RBR-9pw58p.
PURPOSE: Allopurinol is a potent inhibitor of the enzyme xanthine oxidase used primarily in the treatment of hyperuricemia and gout. The aim of this study was to compare the analgesic efficacy of preanesthetic allopurinol versus placebo on postoperative pain and anxiety in patients undergoing abdominal hysterectomy. METHODS: This is a prospective, double-blinded, placebo-controlled, randomized clinical trial. We investigated 54 patients scheduled to undergo elective abdominal hysterectomy. Patients were randomly assigned to receive either oral allopurinol 300 mg (n = 27) or placebo (n = 27) the night before and 1 h before surgery. Patients were submitted to evaluation of pain and anxiety before the treatment, for 24 h postoperatively, 30 and 90 days after surgery. Cerebrospinal fluid was collected at the time of the spinal anesthesia to perform the measurement of the central levels of purines. RESULTS: Preoperative administration of allopurinol was effective in reducing postoperative pain 2 h after surgery. Allopurinol caused a reduction of approximately 40% in pain scores measured by the visual analogue pain scale after surgery (p < 0.05). No differences were found between groups in anxiety scores after surgery. There was a significant change in the cerebrospinal fluid concentrations of xanthine and uric acid before surgery (p < 0.01). CONCLUSION: This study showed a short-term benefit of the use of allopurinol as a preanesthetic medication since it was related to a reduction on pain scores 2 h after surgery. The purinergic system is a potential target for new analgesic drugs. New studies investigating more selective purine derivatives in the management of pain should be performed. TRIAL NUMBER REGISTRATION: Brazilian Registry of Clinical Trials-ReBEC #RBR-9pw58p.
Authors: Diogo R Lara; Matheus R S Cruz; Flavio Xavier; Diogo O Souza; Emilio H Moriguchi Journal: Int Clin Psychopharmacol Date: 2003-01 Impact factor: 1.659
Authors: Aécio C Fagundes; Enderson D de Oliveira; Samira G Ferrari; Lúcia M M Dos Santos; Leonardo M Botelho; Sérgio R G Schmidt; Cristiano F Andrade; Diogo R Lara; Diogo O Souza; André P Schmidt Journal: Pain Pract Date: 2021-05-12 Impact factor: 3.183
Authors: Pablo Castroman; Ovelio Quiroga; Victor Mayoral Rojals; Maria Gómez; Eleni Moka; Joseph Pergolizzi; Giustino Varrassi Journal: Cureus Date: 2022-04-09