Advertisement

Radiotelemetric and Symptomatic Evaluation of Pain in the Rat After Laparotomy: Long-Term Benefits of Perioperative Ropivacaine Care

  • Alexandre Charlet
    Affiliations
    Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, Unité Propre de Recherche 3212, Nociception and Pain Department, Strasbourg, France
    Search for articles by this author
  • Jean-Luc Rodeau
    Affiliations
    Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, Unité Propre de Recherche 3212, Nociception and Pain Department, Strasbourg, France
    Search for articles by this author
  • Pierrick Poisbeau
    Correspondence
    Address reprint requests to Prof. Pierrick Poisbeau, UPR 3212 CNRS, Départment Nociception et Douleur, 21 rue René Descartes, 67084 Strasbourg, France.
    Affiliations
    Centre National de la Recherche Scientifique, Institut des Neurosciences Cellulaires et Intégratives, Unité Propre de Recherche 3212, Nociception and Pain Department, Strasbourg, France

    Université de Strasbourg, Strasbourg, France
    Search for articles by this author
Published:September 15, 2010DOI:https://doi.org/10.1016/j.jpain.2010.07.005

      Abstract

      Effective relief of acute and long-term postoperative pain is of utmost importance to patients undergoing surgery. Here, we worked on a controlled procedure of abdominal surgery in the rat inducing persistent postoperative pain symptoms for up to 10 days and tested the efficacy of perioperative care with the local anesthetic ropivacaine. Laparotomy was likewise used to implant radiotelemetric probes by which electrocardiogram, body temperature, and locomotor activity were recorded in freely moving animals. We showed that postoperative pain symptoms (mechanical allodynia) measured in periphery of the scar were associated over time with persistent tachycardia, elevated heart rate variability, and loss of mobility. Furthermore, a single subcutaneous infiltration of the local anesthetic ropivacaine in the periphery of the abdominal incision was sufficient to prevent the appearance of allodynia and the associated cardiac and motor signs of pain, monitored by radiotelemetry. These beneficial effects were observed when the infiltration was performed in the perioperative period, but not later. This study on freely moving animals exhibiting long-lasting postoperative pain symptoms and altered autonomic/motor function illustrates well the importance of the timing of preemptive analgesia care with long-acting local anesthetics. Moreover, it emphasizes the utility of monitoring heart rate variability to quantify spontaneous expression of long-lasting postoperative pain.

      Perspective

      Speeding the recovery time after surgery using perioperative ropivacaine care is of significant clinical relevance because it might limit the risk of chronic pain and postoperative complications. In humans, chronobiological analysis of heart rate variability could also help quantify spontaneous pain expression with minimal emotional bias.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Arras M.
        • Rettich A.
        • Cinelli P.
        • Kasermann H.P.
        • Burki K.
        Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability.
        BMC Vet Res. 2007; 3: 16
        • Bamigboye A.A.
        • Justus H.G.
        Ropivacaine abdominal wound infiltration and peritoneal spraying at cesarean delivery for preemptive analgesia.
        Int J Gynaecol Obstet. 2008; 102: 160-164
        • Beaussier M.
        • El’Ayoubi H.
        • Schiffer E.
        • Rollin M.
        • Parc Y.
        • Mazoit J.X.
        • Azizi L.
        • Gervaz P.
        • Rohr S.
        • Biermann C.
        • Lienhart A.
        • Eledjam J.J.
        Continuous preperitoneal infusion of ropivacaine provides effective analgesia and accelerates recovery after colorectal surgery: A randomized, double-blind, placebo-controlled study.
        Anesthesiology. 2007; 107: 461-468
        • Blaha M.D.
        • Leon L.R.
        Effects of indomethacin and buprenorphine analgesia on the postoperative recovery of mice.
        J Am Assoc Lab Anim Sci. 2008; 47: 8-19
        • Brennan M.
        • Palaniswami M.
        • Kamen P.
        Do existing measures of Poincare plot geometry reflect nonlinear features of heart rate variability?.
        IEEE Trans Biomed Eng. 2001; 48: 1342-1347
        • Brennan T.J.
        • Vandermeulen E.P.
        • Gebhart G.F.
        Characterization of a rat model of incisional pain.
        Pain. 1996; 64: 493-501
        • Brennan T.J.
        • Zahn P.K.
        • Pogatzki-Zahn E.M.
        Mechanisms of incisional pain.
        Anesthesiol Clin North America. 2005; 23: 1-20
        • Chaplan S.R.
        • Bach F.W.
        • Pogrel J.W.
        • Chung J.M.
        • Yaksh T.L.
        Quantitative assessment of tactile allodynia in the rat paw.
        J Neurosci Methods. 1994; 53: 55-63
        • Coderre T.J.
        • Vaccarino A.L.
        • Melzack R.
        Central nervous system plasticity in the tonic pain response to subcutaneous formalin injection.
        Brain Res. 1990; 535: 155-158
        • Duarte A.M.
        • Pospisilova E.
        • Reilly E.
        • Mujenda F.
        • Hamaya Y.
        • Strichartz G.R.
        Reduction of postincisional allodynia by subcutaneous bupivacaine: Findings with a new model in the hairy skin of the rat.
        Anesthesiology. 2005; 103: 113-125
        • Ejlersen E.
        • Andersen H.B.
        • Eliasen K.
        • Mogensen T.
        A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain.
        Anesth Analg. 1992; 74: 495-498
        • Flatters S.J.
        Characterization of a model of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR).
        Pain. 2008; 135: 119-130
        • Goecke J.C.
        • Awad H.
        • Lawson J.C.
        • Boivin G.P.
        Evaluating postoperative analgesics in mice using telemetry.
        Comp Med. 2005; 55: 37-44
        • Gonzalez-Darder J.M.
        • Barbera J.
        • Abellan M.J.
        Effects of prior anaesthesia on autotomy following sciatic transection in rats.
        Pain. 1986; 24: 87-91
        • Gordon S.M.
        • Dionne R.A.
        • Brahim J.
        • Jabir F.
        • Dubner R.
        Blockade of peripheral neuronal barrage reduces postoperative pain.
        Pain. 1997; 70: 209-215
        • Hansen T.G.
        Ropivacaine: A pharmacological review.
        Expert Rev Neurother. 2004; 4: 781-791
        • Janig W.
        Systemic and specific autonomic reactions in pain: Efferent, afferent and endocrine components.
        Eur J Anaesthesiol. 1985; 2: 319-346
        • Janig W.
        The sympathetic nervous system in pain.
        Eur J Anaesthesiol Suppl. 1995; 10: 53-60
        • Jeanne M.
        • Logier R.
        • De Jonckheere J.
        • Tavernier B.
        Validation of a graphic measurement of heart rate variability to assess analgesia/nociception balance during general anesthesia.
        Conf Proc IEEE Eng Med Biol Soc. 2009; 1: 1840-1843
        • Jourdan D.
        • Ardid D.
        • Eschalier A.
        Automated behavioural analysis in animal pain studies.
        Pharmacol Res. 2001; 43: 103-110
        • Kehlet H.
        • Dahl J.B.
        Anaesthesia, surgery, and challenges in postoperative recovery.
        Lancet. 2003; 362: 1921-1928
        • Kramer K.
        • Kinter L.B.
        Evaluation and applications of radiotelemetry in small laboratory animals.
        Physiol Genomics. 2003; 13: 197-205
        • Le Bars D.
        • Gozariu M.
        • Cadden S.W.
        Animal models of nociception.
        Pharmacol Rev. 2001; 53: 597-652
        • Logier R.
        • Jeanne M.
        • Tavernier B.
        • De Jonckheere J.
        Pain/analgesia evaluation using heart rate variability analysis.
        Conf Proc IEEE Eng Med Biol Soc. 2006; 1: 4303-4306
        • Martin T.J.
        • Buechler N.L.
        • Kahn W.
        • Crews J.C.
        • Eisenach J.C.
        Effects of laparotomy on spontaneous exploratory activity and conditioned operant responding in the rat: A model for postoperative pain.
        Anesthesiology. 2004; 101: 191-203
        • Moiniche S.
        • Kehlet H.
        • Dahl J.B.
        A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: The role of timing of analgesia.
        Anesthesiology. 2002; 96: 725-741
        • Oberlander T.
        • Saul J.P.
        Methodological considerations for the use of heart rate variability as a measure of pain reactivity in vulnerable infants.
        Clin Perinatol. 2002; 29: 427-443
        • Oda A.
        • Ohashi H.
        • Komori S.
        • Iida H.
        • Dohi S.
        Characteristics of ropivacaine block of Na+ channels in rat dorsal root ganglion neurons.
        Anesth Analg. 2000; 91: 1213-1220
        • Oliveira N.E.
        • Lima Filho N.S.
        • Lima E.G.
        Vasquez EC: Effects of regional anesthesia with ropivacaine on arterial pressure and heart rate in healthy subjects.
        Eur J Oral Sci. 2006; 114: 27-32
        • Perkins F.M.
        • Kehlet H.
        Chronic pain as an outcome of surgery. A review of predictive factors.
        Anesthesiology. 2000; 93: 1123-1133
        • Piskorski J.
        • Guzik P.
        Geometry of the Poincare plot of RR intervals and its asymmetry in healthy adults.
        Physiol Meas. 2007; 28: 287-300
        • Pogatzki E.M.
        • Vandermeulen E.P.
        • Brennan T.J.
        Effect of plantar local anesthetic injection on dorsal horn neuron activity and pain behaviors caused by incision.
        Pain. 2002; 97: 151-161
        • Pogatzki E.M.
        • Zahn P.K.
        • Brennan T.J.
        Effect of pretreatment with intrathecal excitatory amino acid receptor antagonists on the development of pain behavior caused by plantar incision.
        Anesthesiology. 2000; 93: 489-496
        • Randic M.
        Plasticity of excitatory synaptic transmission in the spinal cord dorsal horn.
        Prog Brain Res. 1996; 113: 463-506
        • Rietmann T.R.
        • Stauffacher M.
        • Bernasconi P.
        • Auer J.A.
        • Weishaupt M.A.
        The association between heart rate, heart rate variability, endocrine and behavioural pain measures in horses suffering from laminitis.
        J Vet Med A Physiol Pathol Clin Med. 2004; 51: 218-225
        • Rooney B.A.
        • Crown E.D.
        • Hulsebosch C.E.
        • McAdoo D.J.
        Preemptive analgesia with lidocaine prevents Failed Back Surgery Syndrome.
        Exp Neurol. 2007; 204: 589-596
        • Sandkuhler J.
        • Liu X.
        Induction of long-term potentiation at spinal synapses by noxious stimulation or nerve injury.
        Eur J Neurosci. 1998; 10: 2476-2480
        • Scholz J.
        • Woolf C.J.
        Can we conquer pain?.
        Nat Neurosci. 2002; : 1062-1067
        • Sharp J.
        • Zammit T.
        • Azar T.
        • Lawson D.
        Recovery of male rats from major abdominal surgery after treatment with various analgesics.
        Contemp Top Lab Anim Sci. 2003; 42: 22-27
        • Simpson D.
        • Curran M.P.
        • Oldfield V.
        • Keating G.M.
        Ropivacaine: A review of its use in regional anaesthesia and acute pain management.
        Drugs. 2005; 65: 2675-2717
        • Sisk A.L.
        • Dionne R.A.
        • Wirdzek P.R.
        Evaluation of etidocaine hydrochloride for local anesthesia and postoperative pain control in oral surgery.
        J Oral Maxillofac Surg. 1984; 42: 84-88
        • Tverskoy M.
        • Cozacov C.
        • Ayache M.
        • Bradley Jr., E.L.
        • Kissin I.
        Postoperative pain after inguinal herniorrhaphy with different types of anesthesia.
        Anesth Analg. 1990; 70: 29-35
        • Waxman S.G.
        • Dib-Hajj S.
        • Cummins T.R.
        • Black J.A.
        Sodium channels and pain.
        Proc Natl Acad Sci U S A. 1999; 96: 7635-7639
        • White P.F.
        The changing role of non-opioid analgesic techniques in the management of postoperative pain.
        Anesth Analg. 2005; 101: S5-22
        • Wilder-Smith O.H.
        • Arendt-Nielsen L.
        Postoperative hyperalgesia: Its clinical importance and relevance.
        Anesthesiology. 2006; 104: 601-607
        • Woolf C.J.
        Evidence for a central component of post-injury pain hypersensitivity.
        Nature. 1983; 306: 686-688
        • Woolf C.J.
        • Salter M.W.
        Neuronal plasticity: Increasing the gain in pain.
        Science. 2000; 288: 1765-1769
        • Yashpal K.
        • Katz J.
        • Coderre T.J.
        Effects of preemptive or postinjury intrathecal local anesthesia on persistent nociceptive responses in rats. Confounding influences of peripheral inflammation and the general anesthetic regimen.
        Anesthesiology. 1996; 84: 1119-1128