Abstract
This study aims to evaluate the viability of a clinical model of remote ischemic preconditioning (RIPC) and its analgesic effects. It is a prospective study with twenty (20) patients randomly divided into two groups: control group and RIPC group. The opioid analgesics consumption in the postoperative period, the presence of secondary mechanical hyperalgesia, the scores of postoperative pain by visual analog scale, and the plasma levels interleukins (IL-6) were evaluated. The tourniquet applying after spinal anesthetic block was safe, producing no pain for all patients in the tourniquet group. The total dose of morphine consumption in 24 hours was significantly lower in RIPC group than in the control group (p = 0.0156). The intensity analysis of rest pain, pain during coughing and pain in deep breathing, showed that visual analogue scale (VAS) scores were significantly lower in RIPC group compared to the control group: p = 0.0087, 0.0119, and 0.0015, respectively. There were no differences between groups in the analysis of presence or absence of mechanical hyperalgesia (p = 0.0704) and in the serum levels of IL-6 dosage over time (p < 0.0001). This clinical model of remote ischemic preconditioning promoted satisfactory analgesia in patients undergoing conventional cholecystectomy, without changing serum levels of IL-6.
Highlights
Ischemic preconditioning (IPC) is defined as brief periods of ischemia, interspersed with reperfusion, prior to a sustained period of ischemia
This study aims to evaluate the analgesic activity of a clinical model of ischemic preconditioning on postoperative pain resulting from subcostal incision, as well as the influence of this technique in the cytokines levels in the postoperative period
There were no significant differences in the analysis of the variables: age, weight, duration of surgery, and ASA physical status between the two groups, as shown in Tables 1 and 2
Summary
Ischemic preconditioning (IPC) is defined as brief periods of ischemia, interspersed with reperfusion, prior to a sustained period of ischemia. This procedure is performed in order to prepare and protect the cell to the damage caused by a long period of ischemia [1]. It is a powerful innate mechanism of multiple organs protection which can be induced by transient occlusion of the blood flow of an organ. In addition to its protective effects in ischemia-reperfusion injury, there is a considerable amount of evidence indicating the effects of IPC in inflammatory conditions of nonischemic nature, probably through a systemic action [5]
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