Maaret Eskelinen1, Iina Saimanen2, Riika Koskela3, Anu Holopainen4, Tuomas Selander5, Matti Eskelinen2. 1. Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland; matti.eskelinen@kuh.fi. 2. Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland. 3. Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland. 4. Department of Clinical Chemistry, Eastern Finland Laboratory Center, Kuopio University Hospital, Kuopio, Finland. 5. Science Service Center, Kuopio University Hospital, Kuopio, Finland.
Abstract
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. PATIENTS AND METHODS: This study assessed three LP biomarkers; CAT, MDA and 4-HNE and compared the plasma levels to the patient satisfaction 24 h postoperatively (SFS24; 0=fully unsatisfied; 10=fully satisfied); the overall pain at rest (NRSr) and when pressing the wound at 20 Newton force (NRSp) 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. RESULTS: The RSB analgesia enhanced significantly the SFS24 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). CONCLUSION: The present study confirms the applicability of the plasma biomarker 4-HNE to cast further light on the postoperative pain in midline laparotomy patients. Copyright
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. PATIENTS AND METHODS: This study assessed three LP biomarkers; CAT, MDA and 4-HNE and compared the plasma levels to the patient satisfaction 24 h postoperatively (SFS24; 0=fully unsatisfied; 10=fully satisfied); the overall pain at rest (NRSr) and when pressing the wound at 20 Newton force (NRSp) 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. RESULTS: The RSB analgesia enhanced significantly the SFS24 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). CONCLUSION: The present study confirms the applicability of the plasma biomarker 4-HNE to cast further light on the postoperative pain in midline laparotomy patients. Copyright
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