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Perioperative opioid consumption is enhanced in patients with Crohn's disease

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Wehrfritz, A.; Munster, T.; Troester, A.; Griessinger, N.; Koppert, W.

European Journal of Anaesthesiology (EJA): June 2006 - Volume 23 - Issue - p 227
Acute and Chronic Pain Management
Free

Department of Anaesthesiology, University Hospital of Erlangen, Germany

Background and Goal of Study: The aim of this retrospective study was to compare intra- and postoperative consumption of analgesics between patients undergoing hemicolectomy (HE), sigmoidectomy (SE), and abdominal surgery due to Crohn's disease (CD).

Materials and Methods: In a retrospective review of medical charts we analyzed all patients with the above designed procedure in the years 2001-2004. Intraoperative opioid consumption (fentanyl or alfentanil) and postoperative demand of analgesics (morphine, non-opioid analgesics) were compared among patients with CD, HE and SE. Doses of analgesics were normalized by weight. Postoperative demand for morphine was assessed using patient controlled analgesia.

Results and Discussions: Patients with CD where significantly younger (35 ± 12 vs. 67 ± 13 and 57 ± 13, mean ± SD) than patients with HE and SE. There was no difference in gender and postoperative consumption of non-opioid analgesics among the groups. Intraoperative opioid consumption and postoperative demand for morphine (Figures A and B, respectively, *p < 0.05 Bonferroni corrected t-tests) were significantly different in patients with CD vs. patients with HE or SE.

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Conclusions: Patients with CD showed a higher demand for opioids during surgery and for morphine in the postoperative period than patients with SE or HE. Since patients with CD were significantly younger, age-related effects must be considered. However, further research is warranted to determine the underlying mechanism of this observation. Since CD is known to have several underlying genetic mutations (e.g. NOD2, CARD15) with an overexpression of inflammatory proteins, the enhanced pain sensitivity might be related to this fact.

© 2006 European Society of Anaesthesiology