The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial

Abstract Background In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2...

Full description

Bibliographic Details
Main Authors: Muzaffer Gencer, Ayşe Yeşim Göçmen
Format: Article
Language:English
Published: BMC 2020-09-01
Series:BMC Anesthesiology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12871-020-01138-z
_version_ 1818547855966601216
author Muzaffer Gencer
Ayşe Yeşim Göçmen
author_facet Muzaffer Gencer
Ayşe Yeşim Göçmen
author_sort Muzaffer Gencer
collection DOAJ
description Abstract Background In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n = 60) was patients given tramadol (1–2 mg/kg) for post-operative analgesia, and the second group (control group) (n = 60) was initially prescribed only fentanyl (1 μg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results Demographic data and peri-operative variables were similar in both study group (p < 0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94 ± 15.34 pg/mL (max:489.92 ± 22.36 pg/mL, min: 94.56 ± 11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p < 0.05), 1st (p < 0.05) and 3rd hours (p < 0.05).The VAS scores were lower in the tramadol group compared to the control group (p < 0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p < 0.05) for arrival at the recovery room and 1st hour. Patients in the tramadol group needed a second pain killer much later than patients in the control group. Conclusions Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration This trial was registered retrospectively (The ACTRN: ACTRN12619001652167 , registration date: 26/11/2019).
first_indexed 2024-12-12T08:12:15Z
format Article
id doaj.art-f7a19f8effa2448990b8ccbab1c90a83
institution Directory Open Access Journal
issn 1471-2253
language English
last_indexed 2024-12-12T08:12:15Z
publishDate 2020-09-01
publisher BMC
record_format Article
series BMC Anesthesiology
spelling doaj.art-f7a19f8effa2448990b8ccbab1c90a832022-12-22T00:31:45ZengBMCBMC Anesthesiology1471-22532020-09-012011810.1186/s12871-020-01138-zThe relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trialMuzaffer Gencer0Ayşe Yeşim Göçmen1Department of Anesthesia, Istinye University Medical FacultyDepartment of Biochemistry, Bozok University Medical FacultyAbstract Background In this study, the μ-Opioid receptor activity was assessed pre-operatively for its association with postoperative pain level and second analgesic requirement in patients undergoing septoplasty. Methods In our prospective study, 120 adult patients underwent septoplasty from June 2015 to January 2019 were randomly divided into 2 pre-operative groups. The first group (n = 60) was patients given tramadol (1–2 mg/kg) for post-operative analgesia, and the second group (control group) (n = 60) was initially prescribed only fentanyl (1 μg/ kg-i.v.) in the induction. Acetaminophen with codeine analgesic 325/30 mg (p.o.) was used as an rescue painkiller in the post-operative period. The μ-Opioid receptor activity was investigated in pre-operative blood samples and compared to post-operative pain level and time required for second round of analgesic administration. The visual analogue score (VAS) was used to evaluate the post-operative pain degree (0 no pain; 10 worst pain). The patients’ post-operative VAS scores were evaluated upon arrival to recovery room, and at the 1st, 3rd, 7th, 10th, and 24th hour post-operative period. Results Demographic data and peri-operative variables were similar in both study group (p < 0.05).There was no significant difference between the receptor levels in both groups and the mean receptor level was 200.94 ± 15.34 pg/mL (max:489.92 ± 22.36 pg/mL, min: 94.56 ± 11.23 pg/mL).In patients who used tramadol as the levels of μ-Opioid receptors increased, VAS scores of patients and second analgesic use decreased in post-operative period.The VAS scores in patients with higher receptor levels were lower in the recovery room (p < 0.05), 1st (p < 0.05) and 3rd hours (p < 0.05).The VAS scores were lower in the tramadol group compared to the control group (p < 0.05).Number of secondary analgesic requirement was significantly lower in patients of the tramadol group with higher receptor levels compared to the ones with lower receptor (p < 0.05) for arrival at the recovery room and 1st hour. Patients in the tramadol group needed a second pain killer much later than patients in the control group. Conclusions Our study demonstrates that patients with higher μOR levels have a higher efficacy of opioid analgesic agents and an lesser need for additional analgesic agents. Trial registration This trial was registered retrospectively (The ACTRN: ACTRN12619001652167 , registration date: 26/11/2019).http://link.springer.com/article/10.1186/s12871-020-01138-zAnalgesic agentμ-Opioid receptor (μORs)SeptoplastyTramadol
spellingShingle Muzaffer Gencer
Ayşe Yeşim Göçmen
The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial
BMC Anesthesiology
Analgesic agent
μ-Opioid receptor (μORs)
Septoplasty
Tramadol
title The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial
title_full The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial
title_fullStr The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial
title_full_unstemmed The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial
title_short The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial
title_sort relationship between the level of μ opioid receptor μors and postoperative analgesic use in patients undergoing septoplasty a prospective randomized controlled trial
topic Analgesic agent
μ-Opioid receptor (μORs)
Septoplasty
Tramadol
url http://link.springer.com/article/10.1186/s12871-020-01138-z
work_keys_str_mv AT muzaffergencer therelationshipbetweenthelevelofmopioidreceptormorsandpostoperativeanalgesicuseinpatientsundergoingseptoplastyaprospectiverandomizedcontrolledtrial
AT ayseyesimgocmen therelationshipbetweenthelevelofmopioidreceptormorsandpostoperativeanalgesicuseinpatientsundergoingseptoplastyaprospectiverandomizedcontrolledtrial
AT muzaffergencer relationshipbetweenthelevelofmopioidreceptormorsandpostoperativeanalgesicuseinpatientsundergoingseptoplastyaprospectiverandomizedcontrolledtrial
AT ayseyesimgocmen relationshipbetweenthelevelofmopioidreceptormorsandpostoperativeanalgesicuseinpatientsundergoingseptoplastyaprospectiverandomizedcontrolledtrial