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
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Article info
Publication history
Published online: September 15, 2010
Accepted:
July 10,
2010
Received in revised form:
June 22,
2010
Received:
April 12,
2010
Footnotes
Supported by the following French institutions: Centre National de la Recherche Scientifique, Université de Strasbourg, Action Concertée Incitative jeunes chercheurs. P.P. is a junior member of the Institut Universitaire de France, which supports the project.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
