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. 2017 Jun 8;8(31):51869-51877.
doi: 10.18632/oncotarget.18417. eCollection 2017 Aug 1.

The effect of intraperitoneal chemotherapy on early pain hyperalgesia in patients following elective laparoscopic transabdominal resection of rectal cancer

Min Liang  1   2 , Chang-Ying Li  2 , Chun-Guang Ren  2 , Zong-Wang Zhang  2 , Zhi-Jian Fu  1
Affiliations

The effect of intraperitoneal chemotherapy on early pain hyperalgesia in patients following elective laparoscopic transabdominal resection of rectal cancer

Min Liang et al. Oncotarget. .

Abstract

Background: Chemotherapy has been associated with hyperalgesia. This prospective study was designed to investigate the effect of intraperitoneal chemotherapy with lobaplatin on post-operative pain intensity and sufentanil requirements after laparoscopic transabdominal resection of rectal cancer.

Methods: Eighty subjects (40 subjects treated with intraperitoneal chemotherapy and 40 subjects without chemotherapy treatment) scheduled for laparoscopic transabdominal resection of rectal cancer were included in this study. All subjects received standardized anesthetic and patient-controlled analgesia using sufentanil for 72 h post-surgery, as the only analgesics. Pain intensity scores, cumulative sufentanil requirements and side effects were recorded until 72 h post-surgery.

Results: Following intraperitoneal chemotherapy, patients had a significantly higher total post-operative sufentanil requirement (193 μg vs. 142 μg; P = 0.008), significantly higher verbal rating scale post-surgery pain intensity scores at rest and with coughing (P < 0.05), and a significantly worse functional activity score (P < 0.05) over 72 h, compared with those without intraperitoneal chemotherapy. There were no post-operative differences in the incidence of side-effects (post-operative nausea [P = 0.189], vomiting [P = 0.311], pruritus [P = 0.263], respiratory depression [P = 1.000], and dizziness [P = 0.712]) between the two groups.

Conclusion: Intraperitoneal chemotherapy is associated with significantly increased post-operative sufentanil requirements and pain intensity, suggesting chemotherapy-associated hyperalgesia.

Keywords: chemotherapy; colorectal cancer; hyperalgesia; lobaplatin; sufentanil.

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Conflict of interest statement

CONFLICT OF INTEREST The authors declared that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1. Patient flow chart
Group C = control group; Group L = treated group. PCA, patient-controlled analgesia.
Figure 2
Figure 2. Sufentanil dosage during 72 h after surgery in Group C and Group L
Continuous variables are presented as mean ± standard deviation. Group C = control group; Group L = treated group; *P < 0.05 vs Group C, **P < 0.01 vs Group C.
Figure 3
Figure 3. Pain score (NRS) at rest during 72 h after surgery in Group C and Group L
Variables are presented as median (interquartile range). Group C = control group; Group L = treated group; *P < 0.05 vs Group C, **P < 0.01 vs Group C. NRS = numerical rating scale.
Figure 4
Figure 4. Pain score (NRS) with coughing during 72 h after surgery in Group C and Group L
Variables are presented as median (interquartile range). Group C = control group; Group L = treated group; *P < 0.05 vs Group C, **P < 0.01 vs Group C. NRS = numerical rating scale.
See this image and copyright information in PMC

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