leptin and Pain--Postoperative

This study aimed to investigate the preoperative level of serum leptin in cesarean section (C-section) patients with and without acute labor pain and its association with postoperative analgesic consumption and preoperative pain threshold.. Preoperative leptin levels, preoperative pain threshold, postoperative analgesic consumption in the first 24 h, and postoperative pain severity (visual analog scale (VAS) scores at 1, 2, 4, 6, 12, and 24 h postoperatively) in C-section patients with labor pain (emergency C-section; n = 21) and without labor pain (elective C-section; n = 25) were compared.. There were no significant differences between the groups regarding the demographic characteristics. Leptin levels, postoperative VAS scores, and analgesic consumption were significantly higher in the group with labor pain, while the preoperative pain threshold was lower. Serum leptin levels correlated negatively with pain threshold and positively with postoperative analgesic consumption. Multiple linear regression analyses in our study revealed that the preoperative leptin levels and having an emergency C-section independently affected the postoperative analgesic consumption and preoperative pain threshold, whereas their combined effects on these parameters were statistically not significant.. Preoperative levels of serum leptin were higher in C-section patients with labor pain than in those without labor pain, and increased serum leptin levels were associated with decreased preoperative pain threshold and increased postoperative analgesic consumption in our study population. Postoperative analgesic requirements may vary among patients, and their requirements might be predicted using preoperative indicators. Serum levels of leptin might be one such indicator and this warrants further studies with larger sample sizes.

Topics: Adult; Analgesics, Opioid; Cesarean Section; Female; Humans; Labor Pain; Leptin; Pain Measurement; Pain Threshold; Pain, Postoperative; Pregnancy; Young Adult

Identifying drivers of pain that can serve as novel drug targets is important for improving perioperative analgesia. Total knee arthroplasty (TKA) is associated with significant postoperative pain. Cytokines contribute to the pathophysiology of osteoarthritis (OA) and associated pain. However, the influence of perioperative cytokine levels after TKA surgery upon postoperative pain remains unexplored.. We designed a prospective observational study to profile three proinflammatory cytokines, interleukin-6 (IL-6), tumor necrosis factor α (TNFα), and leptin in serum, synovial, and cerebrospinal fluid of TKA patients perioperatively to determine associations between cytokine levels and pain. We characterized time-trajectories in cytokines pre- and post-surgery and explored their relationships to pain across gender.. Preoperative pain, measured by functional pain disability scores (PDQ), was predictive of postoperative pain. There were no gender differences in severity of preoperative pain or acute postoperative pain. Serum IL-6, serum leptin, and synovial fluid leptin were positively correlated with body mass index and preoperative pain severity. Stratification of patients by gender revealed strong correlations between serum IL-6, leptin, and PDQ only in females, suggesting that females may be more sensitive to the nociceptive actions of these cytokines. Although serum IL-6 increased dramatically (and TNFα increased modestly) four hours after surgery and remained elevated at 72h; they were not associated with the severity of acute postoperative pain.. Our data suggest that while preoperative chronic pain is predictive of the severity of acute postoperative pain in TKA patients, the pre- and post-operative inflammatory status does not predict postoperative pain.

Topics: Aged; Arthralgia; Arthroplasty, Replacement, Knee; Cerebrospinal Fluid; Female; Humans; Interleukin-6; Leptin; Male; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Pain, Postoperative; Prospective Studies; Synovial Fluid; Tumor Necrosis Factor-alpha

The prevalence of unrelieved pain following total knee arthroplasty (TKA) is substantial.. We asked if cytokine markers of inflammation in preoperative serum or knee synovial fluid (SF) would predict pain 2 years following TKA.. Demographic data and functional outcomes were recorded at baseline and 2 years with the WOMAC index. Serum and SF tissue samples were collected at the time of surgery. Linear regression modeling was used to determine the relationship between SF/serum inflammatory markers and a lesser improvement in self reported pain at two years follow-up.. Of our 28 patient cohort, significant correlations between serum and SF levels were found for IL-1β (p<0.002), MIP-1β (p<0.001), adiponectin (p<0.001) and leptin (p<0.001). Adjusted analysis showed that greater SF concentrations of TNF-α, MMP-13 and IL-6 were independent predictors of less pain improvement at two years follow-up (p<0.05).. Those patients, having ongoing pain despite no clinical or radiological cause, may have an inflammatory profile characterizing a predisposition to ongoing pain after TKA.. Prognosis study, Level 2.

Topics: Adiponectin; Aged; Arthroplasty, Replacement, Knee; Cohort Studies; Female; Follow-Up Studies; Humans; Inflammation Mediators; Interleukin-6; Leptin; Linear Models; Male; Matrix Metalloproteinase 1; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Pain, Intractable; Pain, Postoperative; Predictive Value of Tests; Risk Assessment; Severity of Illness Index; Synovial Fluid; Time Factors