Association of Body Mass Index and Serum Markers of Tissue Damage with Postoperative Pain. The Role of Lactate Dehydrogenase for Postoperative Pain Prediction. Issue 8 (17th December 2019)

• Record Type: Journal Article
• Authors: González-Callejas, Cristina; Aparicio, Virginia A; De Teresa, Carlos; Nestares, Teresa
• Is Part Of: Pain medicine. Volume 21:Issue 8(2020)
• Page Start: 1636
• Page End: 1643
• Publication Date: 2019-12-17
• Subjects: Inguinal Hernioplasty -- Surgery -- Analgesia -- Obesity -- Visual Analog Scale; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1093/pm/pnz325
• Languages: English
• ISSNs: 1526-2375

Abstract

Abstract: Objectives: i) To analyze the association of body mass index (BMI) and some serum tissue damage markers with postoperative pain. ii) To establish a biochemical marker cutoff point able to predict moderate to severe postoperative pain. Design: Cross-sectional study. Subjects: Ninety-six adult male patients from Southern Spain (55 ± 13 years old) who underwent an inguinal hernioplasty. Methods: Postoperative pain (eight hours after surgery) was assessed through a visual analog scale (VAS). Moderate to severe pain was defined as a VAS > 50 mm. BMI was calculated and medication, alcohol consumption, and smoking habit registered. Eight hours after surgery, some serum markers such as fibrinogen, lactate dehydrogenase (LDH), C-reactive protein, cortisol, creatine kinase, glutamic-pyruvic, glutamic oxaloacetic, and gamma-glutamyltransferase transaminases were determined by standard procedures. Results: After adjusting for potential confounders, BMI was not associated with postoperative pain ( P > 0.05). Serum fibrinogen was associated with greater postoperative pain (β = 0.333, P < 0.05). Serum LDH concentration was strongly associated with greater postoperative pain (β = 0.606, P < 0.001). Alcohol consumption was associated with higher postoperative pain (β = 0.212, P < 0.05). No associations were observed regarding age, tobacco consumption, and the rest of serum markers studied. Serum LDH concentration was able to discriminate between presence/absence of moderate to severe postoperative pain (receiver operating characteristic area under the curve = 0.655, P ≤ 0.01). An LDH concentration >204 IU/L was associated with a three-times increased odds ratio of moderate to severe postoperative pain. Conclusions: Contrary to expectations, greater BMI was not associated with higher postoperative pain. Notwithstanding, the assessment of serum LDH might provide useful information to predict moderate to severe postoperative pain.