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Postoperative pain reduction by pre-emptive N-acetylcysteine : an exploratory randomized controlled clinical trial. / Mulkens, Chantal Elise; Staatsen, Marieke; van Genugten, Lucie et al.

In: Regional anesthesia and pain medicine, Vol. 46, No. 11, 01.11.2021, p. 960-964.

Research output: Contribution to journal › Article › Academic › peer-review

Harvard

Mulkens, CE, Staatsen, M, van Genugten, L, Snoeker, BAM, Vissers, KCP, Bruhn, JR & Bucx, MJL 2021, 'Postoperative pain reduction by pre-emptive N-acetylcysteine: an exploratory randomized controlled clinical trial', Regional anesthesia and pain medicine, vol. 46, no. 11, pp. 960-964. https://doi.org/10.1136/rapm-2021-102884

APA

Mulkens, C. E., Staatsen, M., van Genugten, L., Snoeker, B. A. M., Vissers, K. C. P., Bruhn, J. R., & Bucx, M. J. L. (2021). Postoperative pain reduction by pre-emptive N-acetylcysteine: an exploratory randomized controlled clinical trial. Regional anesthesia and pain medicine, 46(11), 960-964. https://doi.org/10.1136/rapm-2021-102884

Vancouver

Mulkens CE, Staatsen M, van Genugten L, Snoeker BAM, Vissers KCP, Bruhn JR et al. Postoperative pain reduction by pre-emptive N-acetylcysteine: an exploratory randomized controlled clinical trial. Regional anesthesia and pain medicine. 2021 Nov 1;46(11):960-964. doi: 10.1136/rapm-2021-102884

Author

Mulkens, Chantal Elise ; Staatsen, Marieke ; van Genugten, Lucie et al. / Postoperative pain reduction by pre-emptive N-acetylcysteine : an exploratory randomized controlled clinical trial. In: Regional anesthesia and pain medicine. 2021 ; Vol. 46, No. 11. pp. 960-964.

BibTeX

@article{c97391d4fb0f403c961df19a18ceb9ac,
title = "Postoperative pain reduction by pre-emptive N-acetylcysteine: an exploratory randomized controlled clinical trial",
abstract = "BACKGROUND: A new potential target for multimodal pain management is the group-II metabotropic glutamate receptor subtypes, which can be activated by N-acetylcysteine. We investigated whether pre-emptive administration of N-acetylcysteine leads to a reduction in postoperative pain after laparoscopic inguinal hernia repair. METHODS: Sixty American Society of Anesthesiologists I-II patients scheduled for elective inguinal hernia repair were randomized to receive either N-acetylcysteine (150 mg/kg) or placebo intravenously 1 hour before surgery. The primary outcome was the visual analogue score during movement in the morning (approximately 24 hours) after surgery. Among secondary outcomes were postoperative opioid consumption and safety of intravenous N-acetylcysteine. RESULTS: In total, 23 patients were analyzed per group. Pain scores were similar at all timepoints with a 24 hours median score of 34 (IQR of 19.0 to 42.5) in the N-acetylcysteine group and a median score of 26 (16.0 to 50.0) in the placebo group. The percentage of patients using opioids after surgery was 22% versus 39% day 1 (p=0.63); 9% versus 26% day 2 (p=0.14); 9% versus 17% day 3 (p=0.35) in the N-acetylcysteine group compared with placebo group. Side effects resembling anaphylactoid reactions in response to the administration of N-acetylcysteine were present in more than half of the patients. CONCLUSIONS: Without finding important differences between N-acetylcysteine and placebo group in pain scores postoperatively, but with a high percentage of bothersome side effects for the N-acetylcysteine group, we would not recommend the use of pre-emptive intravenous N-acetylcysteine to reduce postoperative pain in laparoscopic inguinal hernia repair patients based on this study. TRIAL REGISTRATION NUMBER: NCT03354572.",
keywords = "ambulatory care, analgesia, pain, postoperative",
author = "Mulkens, {Chantal Elise} and Marieke Staatsen and {van Genugten}, Lucie and Snoeker, {Barbara A. M.} and Vissers, {Kris C. P.} and Bruhn, {J. rgen} and Bucx, {Martin J. L.}",
note = "Publisher Copyright: {\textcopyright} American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = nov,
day = "1",
doi = "10.1136/rapm-2021-102884",
language = "English",
volume = "46",
pages = "960--964",
journal = "Regional anesthesia and pain medicine",
issn = "1098-7339",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

RIS

TY - JOUR

T1 - Postoperative pain reduction by pre-emptive N-acetylcysteine

T2 - an exploratory randomized controlled clinical trial

AU - Mulkens, Chantal Elise

AU - Staatsen, Marieke

AU - van Genugten, Lucie

AU - Snoeker, Barbara A. M.

AU - Vissers, Kris C. P.

AU - Bruhn, J. rgen

AU - Bucx, Martin J. L.

N1 - Publisher Copyright: © American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/11/1

Y1 - 2021/11/1

N2 - BACKGROUND: A new potential target for multimodal pain management is the group-II metabotropic glutamate receptor subtypes, which can be activated by N-acetylcysteine. We investigated whether pre-emptive administration of N-acetylcysteine leads to a reduction in postoperative pain after laparoscopic inguinal hernia repair. METHODS: Sixty American Society of Anesthesiologists I-II patients scheduled for elective inguinal hernia repair were randomized to receive either N-acetylcysteine (150 mg/kg) or placebo intravenously 1 hour before surgery. The primary outcome was the visual analogue score during movement in the morning (approximately 24 hours) after surgery. Among secondary outcomes were postoperative opioid consumption and safety of intravenous N-acetylcysteine. RESULTS: In total, 23 patients were analyzed per group. Pain scores were similar at all timepoints with a 24 hours median score of 34 (IQR of 19.0 to 42.5) in the N-acetylcysteine group and a median score of 26 (16.0 to 50.0) in the placebo group. The percentage of patients using opioids after surgery was 22% versus 39% day 1 (p=0.63); 9% versus 26% day 2 (p=0.14); 9% versus 17% day 3 (p=0.35) in the N-acetylcysteine group compared with placebo group. Side effects resembling anaphylactoid reactions in response to the administration of N-acetylcysteine were present in more than half of the patients. CONCLUSIONS: Without finding important differences between N-acetylcysteine and placebo group in pain scores postoperatively, but with a high percentage of bothersome side effects for the N-acetylcysteine group, we would not recommend the use of pre-emptive intravenous N-acetylcysteine to reduce postoperative pain in laparoscopic inguinal hernia repair patients based on this study. TRIAL REGISTRATION NUMBER: NCT03354572.

AB - BACKGROUND: A new potential target for multimodal pain management is the group-II metabotropic glutamate receptor subtypes, which can be activated by N-acetylcysteine. We investigated whether pre-emptive administration of N-acetylcysteine leads to a reduction in postoperative pain after laparoscopic inguinal hernia repair. METHODS: Sixty American Society of Anesthesiologists I-II patients scheduled for elective inguinal hernia repair were randomized to receive either N-acetylcysteine (150 mg/kg) or placebo intravenously 1 hour before surgery. The primary outcome was the visual analogue score during movement in the morning (approximately 24 hours) after surgery. Among secondary outcomes were postoperative opioid consumption and safety of intravenous N-acetylcysteine. RESULTS: In total, 23 patients were analyzed per group. Pain scores were similar at all timepoints with a 24 hours median score of 34 (IQR of 19.0 to 42.5) in the N-acetylcysteine group and a median score of 26 (16.0 to 50.0) in the placebo group. The percentage of patients using opioids after surgery was 22% versus 39% day 1 (p=0.63); 9% versus 26% day 2 (p=0.14); 9% versus 17% day 3 (p=0.35) in the N-acetylcysteine group compared with placebo group. Side effects resembling anaphylactoid reactions in response to the administration of N-acetylcysteine were present in more than half of the patients. CONCLUSIONS: Without finding important differences between N-acetylcysteine and placebo group in pain scores postoperatively, but with a high percentage of bothersome side effects for the N-acetylcysteine group, we would not recommend the use of pre-emptive intravenous N-acetylcysteine to reduce postoperative pain in laparoscopic inguinal hernia repair patients based on this study. TRIAL REGISTRATION NUMBER: NCT03354572.

KW - ambulatory care

KW - analgesia

KW - pain

KW - postoperative

UR - http://www.scopus.com/inward/record.url?scp=85120508275&partnerID=8YFLogxK

U2 - 10.1136/rapm-2021-102884

DO - 10.1136/rapm-2021-102884

M3 - Article

C2 - 34446544

VL - 46

SP - 960

EP - 964

JO - Regional anesthesia and pain medicine

JF - Regional anesthesia and pain medicine

SN - 1098-7339

IS - 11

ER -

ID: 20729596