Browse > Article
http://dx.doi.org/10.3344/kjp.2016.29.4.239

Chronic persistent post-surgical pain following staging laparotomy for carcinoma of ovary and its relationship to signal transduction genes  

Saxena, Ashok Kumar (Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital)
Chilkoti, Geetanjali T (Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital)
Chopra, Anand K (Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital)
Banerjee, Basu Dev (Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur Hospital)
Sharma, Tusha (Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur Hospital)
Publication Information
The Korean Journal of Pain / v.29, no.4, 2016 , pp. 239-248 More about this Journal
Abstract
Background: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. Methods: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included. Patients were excluded if had other causes of pain, cognitive dysfunction or chronic neurological disorders. Statistical analysis of pool data was done using SPSS version-17. For various scales like GPE, PDQ, NPSI, the visual analogue scale (VAS), global perceived effect (GPE), the pain DETECT questionnaire (PDQ), and neuropathic pain symptoms inventory (NPSI), one factor repaeted measure ANOVA applied with simple contrast with baseline as on post-operative day 1 (considered as reference and compared with subsequent time-interval), and the P values were adjusted according to "Bonferroni adjustments". In patients with CPPP, the ${\Delta}ct$ values of mRNA expressions of genes at the end of postoperative day 90 were compared with the baseline control values by one factor repeated ANOVA. P value < 0.005 significant. Results: The present study demonstrates 38.1% (8 out of 21 patients) incidence of CPPP. The functional status and quality of life as were observed to be significantly diminished in all patients with chronic pain. An up-regulation in the mRNA expression of signal transduction and a positive correlation was noted between the mRNA expression of signal transduction genes and VAS score in all patients with CPPP at the end of postoperative day 90. Conclusions: The reported incidence of CPPP in patients with carcinoma ovary was 38.1%. An up-regulation and positive correlation between mRNA expression of signal transduction genes and VAS score depicts its potential role in the pathogenesis of CPPP.
Keywords
Carcinoma ovary; Chronic pain; ERK; Neuropathic pain; PKA; PKC;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Poobalan AS, Bruce J, Smith WC, King PM, Krukowski ZH, Chambers WA. A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 2003; 19: 48-54.   DOI
2 Wallace MS, Wallace AM, Lee J, Dobke MK. Pain after breast surgery: a survey of 282 women. Pain 1996; 66: 195-205.   DOI
3 Gupta A, Gandhi K, Viscusi ER. Persistent postsurgical pain after abdominal surgery. Tech Reg Anesth Pain Manag 2011; 15: 140-6.   DOI
4 Obata H, Saito S, Fujita N, Fuse Y, Ishizaki K, Goto F. Epidural block with mepivacaine before surgery reduces long-term post-thoracotomy pain. Can J Anaesth 1999; 46: 1127-32.   DOI
5 Gottschalk A, Smith DS, Jobes DR, Kennedy SK, Lally SE, Noble VE, et al. Preemptive epidural analgesia and recovery from radical prostatectomy: a randomized controlled trial. JAMA 1998; 279: 1076-82.   DOI
6 Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth 2008; 101: 77-86.   DOI
7 Kehlet H, Rathmell JP. Persistent postsurgical pain: the path forward through better design of clinical studies. Anesthesiology 2010; 112: 514-5.   DOI
8 Pan PH, Coghill R, Houle TT, Seid MH, Lindel WM, Parker RL, et al. Multifactorial preoperative predictors for postcesarean section pain and analgesic requirement. Anesthesiology 2006; 104: 417-25.   DOI
9 Strulov L, Zimmer EZ, Granot M, Tamir A, Jakobi P, Lowenstein L. Pain catastrophizing, response to experimental heat stimuli, and post-cesarean section pain. J Pain 2007; 8: 273-9.   DOI
10 Nielsen PR, Norgaard L, Rasmussen LS, Kehlet H. Prediction of post-operative pain by an electrical pain stimulus. Acta Anaesthesiol Scand 2007; 51: 582-6.   DOI
11 de Andrade DC, Ferreira KA, Nishimura CM, Yeng LT, Batista AF, de Sa K, et al. Psychometric validation of the Portuguese version of the Neuropathic Pain Symptoms Inventory. Health Qual Life Outcomes 2011; 9: 107.   DOI
12 Freynhagen R, Baron R, Gockel U, Tolle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006; 22: 1911-20.   DOI
13 Bruce J, Poobalan AS, Smith WC, Chambers WA. Quantitative assessment of chronic postsurgical pain using the McGill Pain Questionnaire. Clin J Pain 2004; 20: 70-5.   DOI
14 Kurita GP, Sjogren P. Pain management in cancer survivorship. Acta Oncol 2015; 54: 629-34.   DOI
15 Foulkes T, Wood JN. Pain genes. PLoS Genet 2008; 4: e1000086.   DOI
16 Brandsborg B. Pain following hysterectomy: epidemiological and clinical aspects. Dan Med J 2012; 59: B4374.
17 Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006; 367: 1618-25.   DOI
18 Kehlet H, Edward RR, Buvanendran A. Persistent postoperative pain: pathogenic mechanism and preventive strategies. Seattle (WA), International Association for the Study of Pain/IASP Press. 2012, pp 133-46.
19 Mikkelsen T, Werner MU, Lassen B, Kehlet H. Pain and sensory dysfunction 6 to 12 months after inguinal herniotomy. Anesth Analg 2004; 99: 146-51.   DOI
20 Brandsborg B, Nikolajsen L, Kehlet H, Jensen TS. Chronic pain after hysterectomy. Acta Anaesthesiol Scand 2008; 52: 327-31.   DOI
21 Brandsborg B, Dueholm M, Nikolajsen L, Kehlet H, Jensen TS. A prospective study of risk factors for pain persisting 4 months after hysterectomy. Clin J Pain 2009; 25: 263-8.   DOI
22 Li G, Lu X, Zhang S, Zhou Q, Zhang L. mTOR and Erk1/2 signaling in the cerebrospinal fluid-contacting nucleus is involved in neuropathic pain. Neurochem Res 2015; 40: 1053-62.   DOI
23 Scholz J, Broom DC, Youn DH, Mills CD, Kohno T, Suter MR, et al. Blocking caspase activity prevents transsynaptic neuronal apoptosis and the loss of inhibition in lamina II of the dorsal horn after peripheral nerve injury. J Neurosci 2005; 25: 7317-23.   DOI
24 Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci 2004; 24: 10410-5.   DOI
25 Zhang X, Xiao HS. Gene array analysis to determine the components of neuropathic pain signaling. Curr Opin Mol Ther 2005; 7: 532-7.
26 Melemedjian OK, Khoutorsky A. Translational control of chronic pain. Prog Mol Biol Transl Sci 2015; 131: 185-213.
27 Brandsborg B, Nikolajsen L, Hansen CT, Kehlet H, Jensen TS. Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology 2007; 106: 1003-12.   DOI
28 Fu Y, Han J, Ishola T, Scerbo M, Adwanikar H, Ramsey C, et al. PKA and ERK, but not PKC, in the amygdala contribute to pain-related synaptic plasticity and behavior. Mol Pain 2008; 4: 26.
29 Bird GC, Lash LL, Han JS, Zou X, Willis WD, Neugebauer V. Protein kinase A-dependent enhanced NMDA receptor function in pain-related synaptic plasticity in rat amygdala neurones. J Physiol 2005; 564: 907-21.   DOI
30 Gao YJ, Ji RR. Activation of JNK pathway in persistent pain. Neurosci Lett 2008; 437: 180-3.   DOI
31 Macrae WA. Chronic pain after surgery. Br J Anaesth 2001; 87: 88-98.   DOI