Allopurinol attenuates postoperative pain and modulates the purinergic system in patients undergoing abdominal hysterectomy: a randomized controlled trial

Schmidt, André; Oliveira, Enderson D de; Fagundes, Aécio C.; Hansel, Gisele; Pedrini, Renata Ortiz; Valdameri, Aline; Martinelli, Eduarda Schütz; Schmidt, Sérgio Renato Guimarães; Andrade, Cristiano Feijó; Lara, Diogo R.; Souza, Diogo Onofre Gomes de

doi:10.1007/s00540-021-02983-z

Cited by 3 publications

(4 citation statements)

References 33 publications

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“…Reimaging acute pain management also means repurposing established agents. Allopurinol, a xanthine oxidase inhibitor used in gout treatment, was compared to placebo in a study of postoperative pain following abdominal hysterectomy [ 42 ]. Fifty-four patients were randomized to receive 300 mg oral allopurinol or placebo the night before surgery and one hour immediately before the operation.…”

Section: Reviewmentioning

confidence: 99%

“…Fifty-four patients were randomized to receive 300 mg oral allopurinol or placebo the night before surgery and one hour immediately before the operation. Allopurinol was shown to significantly reduce postoperative pain by 40% two hours after surgery; anxiety scores after surgery were similar between groups [ 42 ]. Thus, the purinergic system may be a potential new drug target for analgesics treating acute pain.…”

Section: Reviewmentioning

confidence: 99%

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Reimagining How We Treat Acute Pain: A Narrative Review

Castromán¹,

Quiroga²,

Rojals³

et al. 2022

Cureus

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Acute pain may be influenced by biopsychosocial factors. Conditioned pain modulation, distraction, peripheral nerve stimulation, and cryoneurolysis may be helpful in its treatment. New developments in opioids, such as opioids with bifunctional targets and oliceridine, may be particularly suited for acute pain care. Allosteric modulators can enhance receptor subtype selectivity, offering analgesia with fewer and/or less severe side effects. Neuroinflammation in acute pain is caused by direct insult to the central nervous system and is distinct from neuroinflammation in degenerative disorders. Pharmacologic agents targeting the neuroinflammatory process are limited at this time. Postoperative pain is a prevalent form of acute pain and must be recognized as a global public health challenge. This type of pain may be severe, impede rehabilitation, and is often under-treated. A subset of surgical patients develops chronic postsurgical pain. Acute pain is not just temporally limited pain that often resolves on its own. It is an important subject for further research as acute pain may transition into more damaging and debilitating chronic pain. Reimagining how we treat acute pain will help us better address this urgent unmet medical need.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Reimagining How We Treat Acute Pain: A Narrative Review

Castromán¹,

Quiroga²,

Rojals³

et al. 2022

Cureus

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“…Цікавим є досвід доопераційного використання алопуринолу для зменшення інтенсивності болю після гістеректомії. Доведено зменшення рівня болю протягом 2 год після втручання [25]. Це свідчить про участь пуринергічних речовин у формуванні больового синдрому та модулюючий вплив алопуринолу на інтенсивність болю.…”

Section: огляд літературиunclassified

Abdominal hysterectomy and postoperative quality of recovery: emphasis on pain relief

Лахно

Korovai

Zheleznyakov

et al. 2022

PMJUA

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Hysterectomy is a widespread surgical intervention in gynecological practice. Open abdominal hysterectomy is accompanied by a significant algogenic afferent impulse from the site of surgical intervention. Therefore, the search for effective methods of combating postoperative pain is quite urgent. The article analyzes modern approaches to the preventive (preoperative) use of non-narcotic drugs for reliable pain control. Literature data suggest that the combined use of paracetamol, dexketoprofen, nalbuphin, as well as ropivacaine or bupivacaine allows to implement the concept of multimodal analgesia and optimize the recovery process after surgery. The clinical case is given as an example of the use of the specified Step-UP-analgesia of the postoperative period in an overweight patient with varicose veins of the lower extremities and severe history of septic shock. The review of literature and the experience of the authors testify to the considerable potential of multimodal anesthesia following abdominal hysterectomy.

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“…A randomised controlled trial evaluating the effect of anaesthetic regimen during vaginal surgery on operative outcomes, patient-reported outcomes, and length of hospital stay found no statistically significant differences between groups in terms of pain, nausea, quality of life, functional outcomes, length of stay in the postoperative intensive care unit, as well as the use of analgesia after surgery. 27,[43][44][45] According to Hryshchenko MH and Lakhno IV, the issue of choosing drugs for multimodal analgesia remains quite relevant today, as the quality of recovery after surgery depends on the level of pain. 3 Literature data suggest that the combined use of paracetamol, dexketoprofen, nalbuphine, and ropivacaine or bupivacaine allows to implement the concept of multimodal analgesia and optimise the recovery process after surgery.…”

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confidence: 99%

Perioperative managment for gynecological surgery in accelerated rehabilitation programme

Proshchenko,

Govsieiev,

Vasyliuk

et al. 2023

HJOG

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The Enhanced Recovery After Surgery (ERAS), or Fast Track Surgery, aims to minimise the physiological stress of surgery and optimise patient rehabilitation. However, data on surgical interventions in obstetrics and gynaecology are limited. The aim of the study was to analyse the use of elements of the ERAS programme in gynaecologic surgery clinics and to assess the benefits of this approach. Analytical processing was carried out on systematic reviews and meta-analyses, articles and scientific reports published before June 2023, found and available through the PubMed, EMBASE, Cochrane Central Register of Controlled Trials databases. The data were obtained from relevant published studies, including changes in quality of life, postoperative pain, use of opioids or anaesthesia, postoperative nausea and vomiting, rate of readmission, cost of hospitalisation, and clinically significant increase in patient satisfaction. The ERAS programme is a multimodal and multidisciplinary programme aimed at optimising perioperative treatment and improving postoperative outcomes in operative gynaecology by minimising the patient’s stress response, promoting functional recovery and achieving rapid recovery, where the patient is in the field of view of a number of specialists. The presented publications demonstrate that this concept of FTS is a fundamentally new approach to the surgical treatment of gynaecological patients and covers all stages of perioperative therapy: preoperative, intraoperative and postoperative. Conclusions. The initial stage of the surgeon’s and anaesthetist’s acquaintance with the patient is very important, as communication and rational presentation of information using illustrative and video material helps the patient understand the disease, consciously choose the proposed method of treatment, reduces anxiety, increases the role of the surgical team in treatment and satisfaction with its outcome, reduces the risk of dissatisfaction from false expectations (duration of the perioperative period, pain, changes in nutrition and mobility, sutures, etc.). The introduction of evidence-based medicine into the practice of operative gynaecology restructures classical approaches and principles of patient treatment, raises awareness of doctors and heads of surgical departments, and also contributes to the improvement of the outcome of operations.

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Allopurinol attenuates postoperative pain and modulates the purinergic system in patients undergoing abdominal hysterectomy: a randomized controlled trial

Cited by 3 publications

References 33 publications

Reimagining How We Treat Acute Pain: A Narrative Review

Reimagining How We Treat Acute Pain: A Narrative Review

Abdominal hysterectomy and postoperative quality of recovery: emphasis on pain relief

Perioperative managment for gynecological surgery in accelerated rehabilitation programme

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