Analgesic therapy improves arterial endothelial function following non‑cardiovascular surgery: A randomized, placebo‑controlled trial

Wu,Meng‑Jun; Yang,Meng‑Chang; Ran,Long‑Qing; Wei,Su‑Mei; Zhou,Wen‑Lai; Gou,Yong‑Sheng; Yu,Hai

doi:10.3892/etm.2017.5139

Analgesic therapy improves arterial endothelial function following non‑cardiovascular surgery: A randomized, placebo‑controlled trial

Authors:
- Meng‑Jun Wu
- Meng‑Chang Yang
- Long‑Qing Ran
- Su‑Mei Wei
- Wen‑Lai Zhou
- Yong‑Sheng Gou
- Hai Yu
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Affiliations: Department of Anesthesiology, Chengdu Women and Children's Central Hospital, Chongqing Medical University, Chengdu, Sichuan 610041, P.R. China, Department of Anesthesiology, Sichuan Provincial People's Hospital, Chengdu, Sichuan 610041, P.R. China, Department of Obstetrics, Chengdu Women and Children's Central Hospital, Chongqing Medical University, Chengdu, Sichuan 610041, P.R. China, Department of Intensive Care Unit, Dazhou Central Hospital, Dazhou, Sichuan 635000, P.R. China, Department of Orthopedics, Shuangliu First People's Hospital, Chengdu, Sichuan 610200, P.R. China, Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
Published online on: September 19, 2017 https://doi.org/10.3892/etm.2017.5139
Pages: 4767-4772
Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pain subsequent to non‑cardiac surgery may affect the endothelial function, which in turn contributes to myocardial injury (MI). The present study examined whether effective pain control is able to improve the postoperative endothelial function. Patients (n=160) undergoing laparoscopic cholecystectomy were randomly assigned into two groups, treated with tramadol analgesic or saline (placebo) following surgery. On preoperative day 1 (baseline) and postoperatively at 2 h, 1 day and 5 days, pain was assessed on a visual analogue scale (VAS), and B‑mode ultrasound was used to measure brachial endothelium‑dependent flow‑mediated dilation (FMD) and nitroglycerin‑induced dilation. At 2 h postoperatively, the FMD in the two groups was significantly lower compared with that at the other three time points (P≤0.005), while VAS was significantly higher (P<0.05). Patients in the tramadol group presented significantly reduced VAS values in comparison with those in the placebo group at 2 h and 1 day postoperatively (P=0.013 and 0.031, respectively), as well as significantly higher FMD at 2 h (6.7±1.5 vs. 6.0±1.7%; P=0.001) and 1 day postoperatively (7.3±1.3 vs. 6.9±1.4%; P=0.03). A VAS score of <5 was independently associated with postoperative FMD of ≥7 (odds ratio, 2.5; 95% confidence interval, 1.0‑6.0; P=0.047). Backward multivariate linear regression also demonstrated that FMD was independently correlated with age and VAS score (B=‑1.403, P=0.011; B=‑0.579, P=0.003). The response to nitroglycerin‑induced dilation remained stable in all patients at baseline and at all postoperative time points. In conclusion, analgesic treatment may improve the arterial endothelial function following non‑cardiac surgery, which may help prevent postoperative MI.

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