Interleukin balance and early recovery from anesthesia in elderly surgical patients exposed to β-adrenergic antagonism

Shyong, Eileen Q.; Lucchinetti, Eliana; Tagliente, Thomas M.; Hossain, Tanzib; Silverstein, Jeffrey H.; Zaugg, Michael

doi:10.1016/s0952-8180(03)00033-3

Cited by 11 publications

(7 citation statements)

References 29 publications

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“…Zaugg and colleagues found that the administration of a b-antagonist appeared to exert no influence upon pro-inflammatory or inflammatory interleukin profiles. 29 Such a result was interpreted to imply that the beneficial impact of a b-antagonist upon anaesthesia and postoperative pain management is not necessarily attributable to the influential suppression effect of stress hormone or proinflammatory cytokines.…”

Section: Discussionmentioning

confidence: 99%

Role of β-blockade in anaesthesia and postoperative pain management after hysterectomy

Chia

Chan

et al. 2004

British Journal of Anaesthesia

127

111

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Section: Discussionmentioning

confidence: 99%

Role of β-blockade in anaesthesia and postoperative pain management after hysterectomy

Chia

Chan

et al. 2004

British Journal of Anaesthesia

127

111

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“…Participants presented illustrations of the concept of vulnerability and multisystem decline using data from clinical observations and clinical studies. First, the pathophysiological stressors of surgery and anesthesia, which activate stress response pathways, may trigger complications frequently seen in frail older adults 13 . Physiological systems hypothesized to play a role in this vulnerability include the central nervous system (CNS), the sympathetic nervous system (SNS), endocrine system responses from the pituitary gland and the adrenal gland, and innate immune system responses.…”

Section: Clinical Illustrations Of Multisystemic Decline and Vulnerabmentioning

confidence: 99%

“…First, the pathophysiological stressors of surgery and anesthesia, which activate stress response pathways, may trigger complications fre- quently seen in frail older adults. 13 Physiological systems hypothesized to play a role in this vulnerability include the central nervous system (CNS), the sympathetic nervous system (SNS), endocrine system responses from the pituitary gland and the adrenal gland, and innate immune system responses. It was hypothesized that a frail individual who already has compromised regulation within and across these systems may have more difficulty than others in tolerating surgical stress.…”

Section: Clinical Illustrations Of Multisystemic Decline and Vulnerabmentioning

confidence: 99%

Research Agenda for Frailty in Older Adults: Toward a Better Understanding of Physiology and Etiology: Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults

Walston

Hadley

Ferrucci

et al. 2006

J American Geriatrics Society

1,338

887

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Evolving definitions of frailty, and improved understanding of molecular and physiological declines in multiple systems that may increase vulnerability in frail, older adults has encouraged investigators from many disciplines to contribute to this emerging field of research. This article reports on the results of the 2004 American Geriatrics Society/National Institute on Aging conference on a Research Agenda on Frailty in Older Adults, which brought together a diverse group of clinical and basic scientists to encourage further investigation in this area. This conference was primarily focused on physical and physiological aspects of frailty. Although social and psychological aspects of frailty are critically important and merit future research, these topics were largely beyond the scope of this meeting. Included in this article are sections on the evolving conceptualization and definitions of frailty; physiological underpinnings of frailty, including the potential contributions of inflammatory, endocrine, skeletal muscle, and neurologic system changes; potential molecular and genetic contributors; proposed animal models; and integrative, system biology approaches that may help to facilitate future frailty research. In addition, several specific recommendations as to future directions were developed from suggestions put forth by participants, including recommendations on definition and phenotype development, methodological development to perform clinical studies of individual-system and multiple-system vulnerability to stressors, development of animal and cellular models, application of population-based studies to frailty research, and the development of large collaborative networks in which populations and resources can be shared. This meeting and subsequent article were not meant to be a comprehensive review of frailty research; instead, they were and are meant to provide a more-targeted research agenda-setting process.

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“…The most applicable data came from a report of pain scores after median thoracotomy among patients randomized to a beta-antagonist vs. placebo. 37 Based on these data, and our use of repeated measures within each subject, we felt that randomization group sizes of n = 20 (total n = 40) would be sufficient to assess study feasibility and to generate useful estimates of potential propranolol efficacy.…”

Section: Methodsmentioning

confidence: 99%

Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury

Orrey

Halawa

Bortsov

et al. 2015

The Clinical Journal of Pain

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Background Results of previous studies suggest that β-adrenoreceptor activation may augment pain, and that β-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high activity haplotype. Methods Consenting patients admitted for thermal burn injury at participating burn centers were genotyped; those who were not high activity COMT homozygotes were randomized to propranolol 240mg/day or placebo. Primary outcomes were study feasibility (consent rate, protocol completion rate) and pain scores on study days 5-19. Secondary outcomes assessed pain and posttraumatic stress disorder (PTSD) symptoms 6 weeks post-injury. Results Seventy-seven (61/79) percent of eligible patients were consented and genotyped, and 77% (47/61) were genotype-eligible and randomized. Ninety-one percent (43/47) tolerated study drug and completed primary outcome assessments. In intention to treat and per protocol analyses, patients randomized to propranolol had worse pain scores on study days 5-19. Conclusions Genotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury.

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Interleukin balance and early recovery from anesthesia in elderly surgical patients exposed to β-adrenergic antagonism

Cited by 11 publications

References 29 publications

Role of β-blockade in anaesthesia and postoperative pain management after hysterectomy

Role of β-blockade in anaesthesia and postoperative pain management after hysterectomy

Research Agenda for Frailty in Older Adults: Toward a Better Understanding of Physiology and Etiology: Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults

Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury

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