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Spine Deform. 2017 Sep;5(5):325-333. doi: 10.1016/j.jspd.2017.03.012.

Preoperative Norepinephrine Levels in Cerebrospinal Fluid and Plasma Correlate With Pain Intensity After Pediatric Spine Surgery.

Author information

1
Department of Anesthesia, McGill University, 845 Sherbrooke St W, Montreal, Quebec H3A 0G4, Canada; Research Institute of the McGill University Health Centre, 2155 Guy St, Montreal, Quebec H3H 2L9, Canada; Alan Edwards Centre for Research on Pain, Suite 3100, Genome Building, 740 Dr. Penfield Avenue, Montreal, Quebec H3A 0G1, Canada; Shriners Hospital for Children-Canada, 1003 Decarie Blvd, Montreal, Quebec H4A 0A9, Canada. Electronic address: catherine.ferland@mcgill.ca.
2
Department of Pharmacology and Physiology, Université de Sherbrooke, Administration, 2500 Boulevard de l'Université, Sherbrooke, Quebec J1K 2R1, Canada.
3
Shriners Hospital for Children-Canada, 1003 Decarie Blvd, Montreal, Quebec H4A 0A9, Canada; Department of Surgery, McGill University, 845 Sherbrooke St W, Montreal, Quebec H3A 0G4, Canada.
4
Department of Anesthesia, McGill University, 845 Sherbrooke St W, Montreal, Quebec H3A 0G4, Canada; Alan Edwards Centre for Research on Pain, Suite 3100, Genome Building, 740 Dr. Penfield Avenue, Montreal, Quebec H3A 0G1, Canada.
5
Dép. des sciences de la santé, Université du Québec en Abitibi Témiscamingue, 445 Boulevard de l'Université, Rouyn-Noranda, Quebec J9X 5E4, Canada.
6
Alan Edwards Centre for Research on Pain, Suite 3100, Genome Building, 740 Dr. Penfield Avenue, Montreal, Quebec H3A 0G1, Canada; Department of Surgery, Université de Sherbrooke, Administration, 2500 Boulevard de l'Université, Sherbrooke, Quebec J1K 2R1, Canada; Centre de recherche du CHUS, aile 9, porte 6, 3001 12e Avenue N, Sherbrooke, Quebec J1H 5N4, Canada.
7
Department of Pharmacology and Physiology, Université de Sherbrooke, Administration, 2500 Boulevard de l'Université, Sherbrooke, Quebec J1K 2R1, Canada; Centre de recherche du CHUS, aile 9, porte 6, 3001 12e Avenue N, Sherbrooke, Quebec J1H 5N4, Canada.
8
Alan Edwards Centre for Research on Pain, Suite 3100, Genome Building, 740 Dr. Penfield Avenue, Montreal, Quebec H3A 0G1, Canada; Shriners Hospital for Children-Canada, 1003 Decarie Blvd, Montreal, Quebec H4A 0A9, Canada; Department of Surgery, McGill University, 845 Sherbrooke St W, Montreal, Quebec H3A 0G4, Canada.

Abstract

PURPOSE:

Catecholamines were found to be involved in descending pain modulation and associated with perioperative pain. The purpose of the present study was to investigate the relationship between preoperative concentrations of catecholamines and postoperative pain intensity of pediatric patients.

METHODS:

Fifty adolescents with idiopathic scoliosis scheduled for elective spinal fusion surgery were enrolled in this prospective cohort study. Preoperative plasma and cerebrospinal fluid (CSF) samples were collected and analyzed by mass spectrometry. Pain intensity was assessed during the acute postoperative period and in the intermediate period.

RESULTS:

Preoperative plasma concentrations of norepinephrine (NE) and normetanephrine (NME), as well as the CSF concentration of NE, were significantly correlated with the presence of pain six weeks after surgery (r = 0.48, 0.50, and 0.50, respectively; p < .002). We also found that preoperative NE levels in CSF were significantly higher in patients reporting moderate to severe pain intensity than in patients with mild pain during the first day following surgery (0.268 ± 0.29 ng/mL vs. 0.121 ± 0.074 ng/mL, p = .01), as well as between patients reporting pain and painless patients at 6 weeks postsurgery (0.274 ± 0.282 ng/mL vs. 0.103 ± 0.046 ng/mL respectively, U = 69.5, p = .002).

CONCLUSIONS:

These results support the potential role of catecholamine levels in predicting postoperative pain intensity.

KEYWORDS:

Adolescent idiopathic scoliosis; Catecholamines; Cerebrospinal fluid; Perioperative pain; Plasma

PMID:
28882350
DOI:
10.1016/j.jspd.2017.03.012
[Indexed for MEDLINE]

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