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Anesth Analg 2003;96:481-486
© 2003 International Anesthesia Research Society

ANESTHETIC PHARMACOLOGY

Release of ß-Endorphin Immunoreactive Material Under Perioperative Conditions into Blood or Cerebrospinal Fluid: Significance for Postoperative Pain?

Reginald Matejec*, Ralph Ruwoldt*, Rolf-Hasso Bödeker{dagger}, Gunter Hempelmann*, and Hansjörg Teschemacher{ddagger}

*Department of Anaesthesiology and Intensive Care Medicine, {dagger}Institute of Medical Informatics, and {ddagger}Rudolf-Buchheim-Institute for Pharmacology, Justus-Liebig-University, Giessen, Germany

Address correspondence and reprint requests to Dr. med. Dr. rer. nat. Reginald Matejec, Department of Anaesthesiology and Intensive Care Medicine, Rudolf-Buchheim-Str. 7, D-35392 Giessen, Germany. Address e-mail to reginald.matejec{at}chiru.med.uni-giessen.de

The function of ß-endorphin immunoreactive material (IRM) released under perioperative conditions remains to be clarified. In 17 patients undergoing orthopedic surgery, we determined ß-endorphin IRM in venous blood plasma and in cerebrospinal fluid (CSF) before surgery (tA); after termination of surgery and general anesthesia, but still under spinal anesthesia (tB); on occurrence of postoperative pain (tC); and 1 day after the operation (tD). Pain severity was rated by the patients by using a visual analog scale. Patients felt postoperative pain (tC), but they felt no pain at times tA, tB, and tD. ß-Endorphin IRM plasma levels before surgery (tA) or with postoperative pain (tC) proved to be significantly higher than levels determined just after surgery, but still under spinal anesthesia (tB), or those determined 1 day after the operation (tD); ß-endorphin IRM plasma levels at times tA and tC correlated positively with postoperative pain severity (tC). ß-Endorphin IRM CSF levels after surgery, but still under spinal anesthesia (tB), were significantly higher than levels determined at times tA, tC, or tD. No correlation was found between ß-endorphin IRM CSF levels and pain severity. In conclusion, postoperative pain severity appears to be related to ß-endorphin IRM levels in plasma before surgery as well as with postoperative pain; the analgesic significance of this material remains to be elucidated.

IMPLICATIONS: ß-Endorphin immunoreactive material has been determined in plasma and cerebrospinal fluid under perioperative conditions. Its release into the cardiovascular compartment is related to postoperative pain severity, although its analgesic significance remains to be elucidated.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.