Postoperative ‘minor’ complications

Myles, Paul S.; Hunt, Jennifer O.; Moloney, John

doi:10.1111/j.1365-2044.1997.89-az0091.x

Cited by 86 publications

(30 citation statements)

References 29 publications

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“…Direct questioning is known to increase the number of events reported by patients, which may explain the high incidence of PH in our study [44]. According to Myles et al there may be a gender difference in the ability to report postoperative symptoms, and that women may find it easier to report symptoms to a nurse than do men [45]. If this indeed was the case in the present study remains unclear.…”

Section: Discussionmentioning

confidence: 64%

Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study

2014

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BackgroundPostoperative sore throat and hoarseness are common minor complications following airway manipulation. This study was primarily done to determine gender differences in the incidence of these symptoms and the location of POST after laryngeal mask airway (LMA) and endotracheal tube (ETT).MethodsA total of 112 men and 185 women were included during a four month period. All patients were evaluated postoperatively and after 24 hours about the occurrence of sore throat, its location and hoarseness. If the patients had any symptom, they were followed-up at 48, 72 and 96 hours until the symptoms resolved.ResultsThere was no significant gender difference in postoperative sore throat (POST) and postoperative hoarseness (PH) when analyzing both airway devices together. The incidence of sore throat and hoarseness were higher postoperatively after an ETT than an LMA (32% vs. 19%, p = 0.012) and 57% vs. 33% (p < 0.001) respectively. Significantly more women than men had POST after an LMA (26% vs. 6%, p = 0.004). No significant gender difference was found in either POST or PH after an ETT or in the incidence of PH after an LMA. More patients located their pain below the larynx after an ETT vs. an LMA (24% vs. 4%). Pain above the larynx was more common after an LMA than an ETT (52% vs. 37%).ConclusionsIn a clinical setting where women are intubated with a smaller size ETT than men, there were no significant differences in POST or PH between genders. Additionally, more women than men have POST when an LMA is used. Awareness of POST and PH may help streamline patients in whom the best airway device could be used during anesthesia and surgery.

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Section: Discussionmentioning

confidence: 64%

Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study

2014

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“…Opioids (such as morphine and fentanyl) act by binding to neuronal mu-opioid receptors (MORs) to inhibit pain. However, opioids also induce respiratory depression, gut immotility, nausea, dysphoria, headache, and vomiting, with women more likely than men to experience many of these negative side effects (Myles et al, 1997; Cepeda et al, 2003; Fillingim et al, 2005; Comer et al, 2010). Long-term opiate use also results in the development of tolerance, leading to a reduction in opioid potency that is typically countered with dose escalation (Trescot et al, 2006; Trescot et al, 2008).…”

Section: Opioid Analgesiamentioning

confidence: 99%

Impact of sex on pain and opioid analgesia: a review

Fullerton

Doyle

Murphy

2018

Current Opinion in Behavioral Sciences

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Chronic pain is a debilitating condition that impacts tens of millions each year, resulting in lost wages for workers and exacting considerable costs in health care and rehabilitation. A thorough understanding of the neural mechanisms underlying pain and analgesia is critical to facilitate the development of therapeutic strategies and personalized medicine. Clinical and epidemiological studies report that women experience greater levels of pain than men and have higher rates of pain-related disorders. Studies in both rodents and humans report sex differences in the anatomical and physiologic properties of the descending antinociceptive circuit, mu opioid receptor (MOR) expression and binding, morphine metabolism, and immune system activation, all of which likely contribute to the observed sex differences in pain and opioid analgesia. Although more research is needed to elucidate the underlying mechanisms, these sex differences present potential therapeutic targets to optimize pain management strategies for both sexes.

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“…Clinical studies examining sex differences in analgesia are more varied, with reports of decreased analgesic efficacy of morphine in females (Cepeda and Carr 2003; Mehlisch 2003; Miller and Ernst 2004), as well as lower analgesia in males (Niesters et al 2010; Sarton et al 2000) and no sex difference at all (Fillingim et al 2009). Despite discrepancies in absolute analgesia with morphine administration, women consistently experience a greater preponderance of the negative side effects associated with morphine consumption, including nausea, dysphoria, headache, and vomiting (Cepeda et al 2003; Comer et al 2010; Fillingim et al 2005; Myles et al 1997). Thus, development of novel non-opioid based treatment strategies, or adjuvants to morphine that can improve analgesic quality in females, is clearly warranted.…”

mentioning

confidence: 99%

Sex differences in innate immunity and its impact on opioid pharmacology

Doyle

Murphy

2016

J of Neuroscience Research

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Morphine has been and continues to be one of the most potent and widely used drugs for the treatment of pain. Clinical and animal models investigating sex differences in pain and analgesia demonstrate that morphine is a more potent analgesic in males than in females. In addition to binding to the neuronal mu opioid receptor, morphine binds to the innate immune receptor toll-like receptor 4 (TLR4), located on glial cells. Activation of glial TLR4 initiates a neuroinflammatory response that directly opposes morphine analgesia. Females of many species have a more active immune system than males; however, few studies have investigated glial cells as a potential mechanism driving sexually dimorphic responses to morphine. This review illustrates the involvement of glial cells in key processes underlying observed sex differences in morphine analgesia, and suggests that targeting glia may improve current treatment strategies for pain.

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Postoperative ‘minor’ complications

Cited by 86 publications

References 29 publications

Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study

Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study

Impact of sex on pain and opioid analgesia: a review

Sex differences in innate immunity and its impact on opioid pharmacology

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