Medizinische Universität Graz - Research portal

Go directly to the nagivation.
Go directly to the content.

Navigation/Search

Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Kager, I; Mousa, SA; Sieper, J; Stein, C; Pipam, W; Likar, R.
Blockade of intra-articular adrenergic receptors increases analgesic demands for pain relief after knee surgery.
Rheumatol Int. 2011; 31(10): 1299-306. Doi: 10.1007/s00296-010-1489-z
Web of Science PubMed FullText FullText_MUG

Leading authors Med Uni Graz: Likar Rudolf
Altmetrics:
Dimensions Citations:
Plum Analytics:
Scite (citation analytics):
Abstract:: Activation of opioid receptors on peripheral sensory nerve terminals by opioid peptides that are produced and released from immune cells can result in inhibition of inflammatory pain. This study tests the hypothesis that postoperative pain is attenuated endogenously through a local sympathetic neurotransmitter-activated release of opioids in patients undergoing knee surgery. We examined the expression of opioid peptides and adrenergic receptors in cells infiltrating inflamed synovial tissue and we hypothesized that intra-articular (i.a.) administration of the adrenergic receptor antagonist labetalol will increase postoperative analgesic consumption and/or pain intensity in these patients. In a double-blind, randomized manner, 75 patients undergoing therapeutic knee arthroscopy received i.a. placebo (20 ml saline) or labetalol (2.5 or 5 mg in 20 ml saline) at the end of surgery. Postoperative pain intensity was assessed by visual analog and verbal rating scales at rest and on exertion, and by the consumption of morphine via patient-controlled analgesia. Synovial biopsies were taken during the operation for double-immunofluorescence confocal microscopy studies. Alpha(1)- and beta(2)-adrenergic receptors were co-expressed in opioid peptide-containing cells. No significant difference was seen in pain scores, but patients receiving 2.5 mg labetalol requested significantly higher amounts of morphine. These findings are consistent with the notion that surgical stress induces sympathetically activated release of endogenous opioids from inflammatory cells and subsequent analgesia via activation of peripheral opioid receptors.
Find related publications in this database (using NLM MeSH Indexing): Adrenergic alpha-1 Receptor Antagonists - administration & dosage, adverse effects; Adrenergic beta-Antagonists - administration & dosage, adverse effects; Adult - administration & dosage; Aged - administration & dosage; Aged, 80 and over - administration & dosage; Analgesics - administration & dosage; Female - administration & dosage; Humans - administration & dosage; Injections, Intra-Articular - methods; Knee Injuries - metabolism, surgery; Labetalol - administration & dosage, adverse effects; Male - administration & dosage; Middle Aged - administration & dosage; Pain, Postoperative - drug therapy, metabolism; Young Adult - administration & dosage
Find related publications in this database (Keywords): Inflammation; Pain; Opioid receptors; Peripheral; Adrenergic receptors