Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain
Abstract Introduction: The objective of this study is to determine whether elevated circulating plasma catecholamine levels significantly impact opioid requirements during the first 24 hours postoperative period in individuals with acute surgical pain. Methods: We retrospectively reviewed 15 ele...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-01-01
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| Series: | Journal of Clinical and Translational Science |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866120005737/type/journal_article |
| _version_ | 1827995267449749504 |
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| author | Armando Uribe-Rivera Linda Rasubala Ana C. Machado-Perez Yan-Fang Ren Hans Malmström Adam Carinci |
| author_facet | Armando Uribe-Rivera Linda Rasubala Ana C. Machado-Perez Yan-Fang Ren Hans Malmström Adam Carinci |
| author_sort | Armando Uribe-Rivera |
| collection | DOAJ |
| description |
Abstract
Introduction:
The objective of this study is to determine whether elevated circulating plasma catecholamine levels significantly impact opioid requirements during the first 24 hours postoperative period in individuals with acute surgical pain.
Methods:
We retrospectively reviewed 15 electronic medical records (EMRs) from adults 18 years and older, with confirmed elevated plasma catecholamine levels (experimental) and 15 electronic health records (EHRs) from matched-controls for age, gender, race and type of surgery, with a follow up of 24 hours postoperatively.
Results:
The total morphine milligram equivalents (MMEs) requirements from the experimental group were not statistically different when compared with controls [44.1 (13 to 163) mg versus 47.5 (13 to 151) mg respectively; p 0.4965]. However, the intraoperative MMEs showed a significant difference, among the two groups; [(experimental) 32.5 (13. to 130) mg, (control) 15 (6.5 to 130) mg; p 0.0734]. The intraoperative dosage of midazolam showed a highly significant positive correlation to the total MMEs (p 0.0005). The subjects with both elevated plasma catecholamines and hypertension used significantly higher intraoperative MMEs compared to controls [34.1 (13 to 130) mg versus 15 (6.5 to 130) mg, respectively; p 0.0292)]. Those 51 years and younger, with elevated circulating levels of catecholamines, required significantly higher levels of both the postoperative MMEs [29.1 (0 to 45) mg versus 12 (0 to 71.5) mg; (p 0.0553)] and total MMEs [544.05 (13 to 81) mg versus 29.42 (13 to 92.5) mg; (p 0.00018), when compared to controls with history of nicotine and alcohol use.
Conclusion:
This preliminary study evaluated a biologic factor, which have promising clinical usefulness for predicting analgesic requirements that can drive clinical decisions on acute surgical pain.
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| first_indexed | 2024-04-10T04:53:57Z |
| format | Article |
| id | doaj.art-9e520eb49ef6471db47eb19306b24212 |
| institution | Directory Open Access Journal |
| issn | 2059-8661 |
| language | English |
| last_indexed | 2024-04-10T04:53:57Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj.art-9e520eb49ef6471db47eb19306b242122023-03-09T12:31:03ZengCambridge University PressJournal of Clinical and Translational Science2059-86612021-01-01510.1017/cts.2020.573Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical painArmando Uribe-Rivera0https://orcid.org/0000-0003-3969-0216Linda Rasubala1Ana C. Machado-Perez2Yan-Fang Ren3Hans Malmström4Adam Carinci5Howitt Urgent Dental Care Department, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USAHowitt Urgent Dental Care Department, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USAGeneral Dentistry Department, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USAHowitt Urgent Dental Care Department, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USAGeneral Dentistry Department, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USADepartment of Anesthesiology & Perioperative Medicine, University of Rochester Medical Center, Rochester, NY, USA Abstract Introduction: The objective of this study is to determine whether elevated circulating plasma catecholamine levels significantly impact opioid requirements during the first 24 hours postoperative period in individuals with acute surgical pain. Methods: We retrospectively reviewed 15 electronic medical records (EMRs) from adults 18 years and older, with confirmed elevated plasma catecholamine levels (experimental) and 15 electronic health records (EHRs) from matched-controls for age, gender, race and type of surgery, with a follow up of 24 hours postoperatively. Results: The total morphine milligram equivalents (MMEs) requirements from the experimental group were not statistically different when compared with controls [44.1 (13 to 163) mg versus 47.5 (13 to 151) mg respectively; p 0.4965]. However, the intraoperative MMEs showed a significant difference, among the two groups; [(experimental) 32.5 (13. to 130) mg, (control) 15 (6.5 to 130) mg; p 0.0734]. The intraoperative dosage of midazolam showed a highly significant positive correlation to the total MMEs (p 0.0005). The subjects with both elevated plasma catecholamines and hypertension used significantly higher intraoperative MMEs compared to controls [34.1 (13 to 130) mg versus 15 (6.5 to 130) mg, respectively; p 0.0292)]. Those 51 years and younger, with elevated circulating levels of catecholamines, required significantly higher levels of both the postoperative MMEs [29.1 (0 to 45) mg versus 12 (0 to 71.5) mg; (p 0.0553)] and total MMEs [544.05 (13 to 81) mg versus 29.42 (13 to 92.5) mg; (p 0.00018), when compared to controls with history of nicotine and alcohol use. Conclusion: This preliminary study evaluated a biologic factor, which have promising clinical usefulness for predicting analgesic requirements that can drive clinical decisions on acute surgical pain. https://www.cambridge.org/core/product/identifier/S2059866120005737/type/journal_articleOpioidsacute paincatecholaminesmorphine milligram equivalentspostoperative pain |
| spellingShingle | Armando Uribe-Rivera Linda Rasubala Ana C. Machado-Perez Yan-Fang Ren Hans Malmström Adam Carinci Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain Journal of Clinical and Translational Science Opioids acute pain catecholamines morphine milligram equivalents postoperative pain |
| title | Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain |
| title_full | Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain |
| title_fullStr | Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain |
| title_full_unstemmed | Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain |
| title_short | Preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain |
| title_sort | preliminary study of the impact of elevated circulating plasma levels of catecholamines on opioid requirements for acute surgical pain |
| topic | Opioids acute pain catecholamines morphine milligram equivalents postoperative pain |
| url | https://www.cambridge.org/core/product/identifier/S2059866120005737/type/journal_article |
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