Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution

Postoperative pain is the most important factor od so called "tumor promotive effect of surgery" ie. of endocrine-metabolic changes having the consequence drop in immune, antiinfective and antitumor defense. Due to presence of organic involutive changes, old people (≥ 65 years), often have...

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Main Authors: Jovanović Nikola Č., Džodić Radan R., Čelebić Aleksandar, Žegarac Milan, Đurišić Igor, Stojiljković Dejan
Format: Article
Language:English
Published: Serbian Medical Society 2003-01-01
Series:Srpski Arhiv za Celokupno Lekarstvo
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0370-8179/2003/0370-81790302052J.pdf
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author Jovanović Nikola Č.
Džodić Radan R.
Čelebić Aleksandar
Žegarac Milan
Đurišić Igor
Stojiljković Dejan
author_facet Jovanović Nikola Č.
Džodić Radan R.
Čelebić Aleksandar
Žegarac Milan
Đurišić Igor
Stojiljković Dejan
author_sort Jovanović Nikola Č.
collection DOAJ
description Postoperative pain is the most important factor od so called "tumor promotive effect of surgery" ie. of endocrine-metabolic changes having the consequence drop in immune, antiinfective and antitumor defense. Due to presence of organic involutive changes, old people (≥ 65 years), often have serious side effects during application of usual analgetics. Since hypertonic glucose (33%) given i.v. or per os, works analgesically in small children there is assumption that it can be used in treatment of postoperative pain in old oncology patients. We tested the hypothesis that postoperative pain in old oncology patients can be treated with i.v. application of 50% of glucose solution. 37 oncology patients over 65 years, 26 females and 11 males, operated for breast cancer and soft tissue cancer, werw investigated. Average age of the patients was 72±4 years. 50% Glucose solution was given in two boluses of 20 ml each: the first bolus was given to all patients at the end of anesthesia and the other bolus was given individually after appearance of post-operative pain. Pain intensity (in coefficients of the visual analogue scale VAK = 1-100) and its characteristics were tested by oral testing of operated patients: after weaking from anesthesia, after the first appearance of the pain and 15 minutes after giving of the second glucose bolus. None patient had pain weaking from anesthesia. All tested patients experienced pain during the first 70 minutes and it could be categorized as very strong pain (=82 VAK). The pain was decreased with another glucose bolus by approximately (=56% VAK) so it was classifies in category of bearable pains (=36 VAK). In 9 patients (24,3%) the pain had neuropatic component (filing of "burning") which could not be eliminated by hypertonic glucose but only with application of tramadol. Activation of the central cholinergic transmission is the most significant mechanism of analgesic glucose effect, but, probably there is another one facilitation of entrence of formerly given analgesics in the brain cells. As energetic supstrate, entering all organism cells, glucose could make easier intracell breakthrough of any other analgesic drug, of the peripheral or central action, and final antipain effect could be potential or additional one. It was concluded that 40 ml of 50% glucose solution given in two identical boluses, has good analgesic effect in treatment of postoperative pain in old oncology patients: the pain was not completely eliminated, but it was significantly decreased and became tolerable. Hypertonic glucose neiter eliminates, nor decreases neuropatic component of the pain, so, when the pain appears the therapy should.
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spelling doaj.art-3a1adee6046c43d7b5bcd01b35c4bcbe2022-12-21T23:24:13ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792003-01-011311-2525410.2298/SARH0302052JTreatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solutionJovanović Nikola Č.Džodić Radan R.Čelebić AleksandarŽegarac MilanĐurišić IgorStojiljković DejanPostoperative pain is the most important factor od so called "tumor promotive effect of surgery" ie. of endocrine-metabolic changes having the consequence drop in immune, antiinfective and antitumor defense. Due to presence of organic involutive changes, old people (≥ 65 years), often have serious side effects during application of usual analgetics. Since hypertonic glucose (33%) given i.v. or per os, works analgesically in small children there is assumption that it can be used in treatment of postoperative pain in old oncology patients. We tested the hypothesis that postoperative pain in old oncology patients can be treated with i.v. application of 50% of glucose solution. 37 oncology patients over 65 years, 26 females and 11 males, operated for breast cancer and soft tissue cancer, werw investigated. Average age of the patients was 72±4 years. 50% Glucose solution was given in two boluses of 20 ml each: the first bolus was given to all patients at the end of anesthesia and the other bolus was given individually after appearance of post-operative pain. Pain intensity (in coefficients of the visual analogue scale VAK = 1-100) and its characteristics were tested by oral testing of operated patients: after weaking from anesthesia, after the first appearance of the pain and 15 minutes after giving of the second glucose bolus. None patient had pain weaking from anesthesia. All tested patients experienced pain during the first 70 minutes and it could be categorized as very strong pain (=82 VAK). The pain was decreased with another glucose bolus by approximately (=56% VAK) so it was classifies in category of bearable pains (=36 VAK). In 9 patients (24,3%) the pain had neuropatic component (filing of "burning") which could not be eliminated by hypertonic glucose but only with application of tramadol. Activation of the central cholinergic transmission is the most significant mechanism of analgesic glucose effect, but, probably there is another one facilitation of entrence of formerly given analgesics in the brain cells. As energetic supstrate, entering all organism cells, glucose could make easier intracell breakthrough of any other analgesic drug, of the peripheral or central action, and final antipain effect could be potential or additional one. It was concluded that 40 ml of 50% glucose solution given in two identical boluses, has good analgesic effect in treatment of postoperative pain in old oncology patients: the pain was not completely eliminated, but it was significantly decreased and became tolerable. Hypertonic glucose neiter eliminates, nor decreases neuropatic component of the pain, so, when the pain appears the therapy should.http://www.doiserbia.nb.rs/img/doi/0370-8179/2003/0370-81790302052J.pdfglucosepostoperative painold peopleoncology patients
spellingShingle Jovanović Nikola Č.
Džodić Radan R.
Čelebić Aleksandar
Žegarac Milan
Đurišić Igor
Stojiljković Dejan
Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
Srpski Arhiv za Celokupno Lekarstvo
glucose
postoperative pain
old people
oncology patients
title Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
title_full Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
title_fullStr Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
title_full_unstemmed Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
title_short Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
title_sort treatment of post operative pain in old oncology patients with intravenous application of 50 glucose solution
topic glucose
postoperative pain
old people
oncology patients
url http://www.doiserbia.nb.rs/img/doi/0370-8179/2003/0370-81790302052J.pdf
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