Hyperalgesia in early postoperative period in children operated on for oncological pathology is accompanied by an increase of TOLL-like receptors (TLP-4)

Abstract

Introduction. The aim of our study was to determine whether the application early in the postoperative phase of fentanyl infusion solution to the emergence of the state of hyperalgesia in children with cancer pathology and study level TOLL-these receptors in the early postoperative period.Material and method. In 18 children operated on for tumors of abdominal cavity (average age 14,6 ± 2,4 years), who were in early postoperative period, was performed 20 measurements of mechanical pain threshold using a set of 10 von Frey monofilaments (VFMs) (Touch-Test Sensory Evaluator, North Coast Medical Inc., CA, USA). Pain threshold was measured on the area around the postoperative wound. Levels of toll-like receptors TLR-4 in blood serum were determined by ELISA method according to the set “Human TLR4 ELISA Kit” (NeoBiolab, CША).Results. Using o high doses of fentanyl (2800-4200 mcg/day), for anesthesia in the early postoperative period in children operated on for tumors of abdominal cavity, can lead to the hyperalgesia. The hyperalgesia in early postoperative period was represented by increased levels of TLR4 in blood of the children operated on for tumors of abdominal cavity. For example, on the 3rd day of hyperalgesia development blood level of TLR4 was 14,2±2,4, ng/ml, on the 5th day of hyperalgesia development 12,1±1,6, ng/ml, that was noticeably higher than the preoperation – 5,2 ±1,4, ng/ml.Further studies are required for optimization and choosing of schemes of adequate method of anesthesia in children with using of opioid analgesics and anesthetics of other groups.