Cargando…

Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements

BACKGROUND: The predictive value of an individual’s attitude towards painful situations and the status of his immune system for postoperative analgesic requirements are not well understood. These may help the clinician to anticipate individual patient’s needs. METHODS: Sixty patients, who underwent...

Descripción completa

Detalles Bibliográficos
Autores principales: Daoudia, Myriam, Decruynaere, Céline, Le Polain de Waroux, Bernard, Thonnard, Jean-Louis, Plaghki, Léon, Forget, Patrice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681155/
https://www.ncbi.nlm.nih.gov/pubmed/26674471
http://dx.doi.org/10.1186/s12871-015-0167-9
_version_ 1782405710022180864
author Daoudia, Myriam
Decruynaere, Céline
Le Polain de Waroux, Bernard
Thonnard, Jean-Louis
Plaghki, Léon
Forget, Patrice
author_facet Daoudia, Myriam
Decruynaere, Céline
Le Polain de Waroux, Bernard
Thonnard, Jean-Louis
Plaghki, Léon
Forget, Patrice
author_sort Daoudia, Myriam
collection PubMed
description BACKGROUND: The predictive value of an individual’s attitude towards painful situations and the status of his immune system for postoperative analgesic requirements are not well understood. These may help the clinician to anticipate individual patient’s needs. METHODS: Sixty patients, who underwent a laparoscopic cholecystectomy under standardised general anaesthesia, were included. The total analgesic requirements during the first 48 h were the primary endpoint (unitary dosage, UD). The individual’s attitude towards imaginary painful situations was measured with the Situational Pain Scale (SPS). The emotional status was assessed by the Hospital Anxiety and Depression Scale (HADS) and the inflammatory status by the neutrophil-to-lymphocyte ratio (NLR). RESULTS: Univariate analyses revealed a significant association between UD and SPS, HADS and NLR. A negative relationship between SPS and NLR (NLR = 0.820–0.180*SPS;R(2) = 0.211;P < 0.001) and a positive relationship between SPS and HADS (HADS = 14.8 + 1.63*SPS; R(2) = 0.159;P = 0.002) were observed. A multiple linear regression analysis showed that the contribution of NLR to the UD was the most effective. A mediation analysis showed a complete mediation of the effect of SPS on UD (R(2) = 0.103;P = 0.012), by the NLR (SPS on NLR: R(2) = 0.211;P = <0.001), the HADS (SPS on HADS: R(2) = 0.159;P = 0.002). The variance in UD explained by the SPS was indirect and amounts to 46 % through NLR and to 34 % through HADS. CONCLUSIONS: In this series, preoperative pain-related attitudes (SPS) were associated with the postoperative analgesic requirements (UD) after a cholecystectomy. Eighty per cent of this effect was mediated by the HADS and the NLR. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12871-015-0167-9) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4681155
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-46811552015-12-17 Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements Daoudia, Myriam Decruynaere, Céline Le Polain de Waroux, Bernard Thonnard, Jean-Louis Plaghki, Léon Forget, Patrice BMC Anesthesiol Research Article BACKGROUND: The predictive value of an individual’s attitude towards painful situations and the status of his immune system for postoperative analgesic requirements are not well understood. These may help the clinician to anticipate individual patient’s needs. METHODS: Sixty patients, who underwent a laparoscopic cholecystectomy under standardised general anaesthesia, were included. The total analgesic requirements during the first 48 h were the primary endpoint (unitary dosage, UD). The individual’s attitude towards imaginary painful situations was measured with the Situational Pain Scale (SPS). The emotional status was assessed by the Hospital Anxiety and Depression Scale (HADS) and the inflammatory status by the neutrophil-to-lymphocyte ratio (NLR). RESULTS: Univariate analyses revealed a significant association between UD and SPS, HADS and NLR. A negative relationship between SPS and NLR (NLR = 0.820–0.180*SPS;R(2) = 0.211;P < 0.001) and a positive relationship between SPS and HADS (HADS = 14.8 + 1.63*SPS; R(2) = 0.159;P = 0.002) were observed. A multiple linear regression analysis showed that the contribution of NLR to the UD was the most effective. A mediation analysis showed a complete mediation of the effect of SPS on UD (R(2) = 0.103;P = 0.012), by the NLR (SPS on NLR: R(2) = 0.211;P = <0.001), the HADS (SPS on HADS: R(2) = 0.159;P = 0.002). The variance in UD explained by the SPS was indirect and amounts to 46 % through NLR and to 34 % through HADS. CONCLUSIONS: In this series, preoperative pain-related attitudes (SPS) were associated with the postoperative analgesic requirements (UD) after a cholecystectomy. Eighty per cent of this effect was mediated by the HADS and the NLR. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12871-015-0167-9) contains supplementary material, which is available to authorized users. BioMed Central 2015-12-16 /pmc/articles/PMC4681155/ /pubmed/26674471 http://dx.doi.org/10.1186/s12871-015-0167-9 Text en © Daoudia et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Daoudia, Myriam
Decruynaere, Céline
Le Polain de Waroux, Bernard
Thonnard, Jean-Louis
Plaghki, Léon
Forget, Patrice
Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
title Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
title_full Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
title_fullStr Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
title_full_unstemmed Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
title_short Biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
title_sort biological inflammatory markers mediate the effect of preoperative pain-related behaviours on postoperative analgesics requirements
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681155/
https://www.ncbi.nlm.nih.gov/pubmed/26674471
http://dx.doi.org/10.1186/s12871-015-0167-9
work_keys_str_mv AT daoudiamyriam biologicalinflammatorymarkersmediatetheeffectofpreoperativepainrelatedbehavioursonpostoperativeanalgesicsrequirements
AT decruynaereceline biologicalinflammatorymarkersmediatetheeffectofpreoperativepainrelatedbehavioursonpostoperativeanalgesicsrequirements
AT lepolaindewarouxbernard biologicalinflammatorymarkersmediatetheeffectofpreoperativepainrelatedbehavioursonpostoperativeanalgesicsrequirements
AT thonnardjeanlouis biologicalinflammatorymarkersmediatetheeffectofpreoperativepainrelatedbehavioursonpostoperativeanalgesicsrequirements
AT plaghkileon biologicalinflammatorymarkersmediatetheeffectofpreoperativepainrelatedbehavioursonpostoperativeanalgesicsrequirements
AT forgetpatrice biologicalinflammatorymarkersmediatetheeffectofpreoperativepainrelatedbehavioursonpostoperativeanalgesicsrequirements