Influence of Surgical Incision Size and Interleukin 6 in the Occurrence of Postoperative Hyperalgesia in Lubumbashi/DR Congo  

作　　者：Christian Tshisuz-Nawej Nadine Kibwe Felly Kazadi Berenice Kamba Ruffin Nyembo Cédric Sangwa Patient Kayoyo Eric Kasamba Sebastien Mbuyi Claude Mwamba-Mulumba Berthe Barahyga Adelin Muganza Iteke Fefe Willy Arung Christian Tshisuz-Nawej;Nadine Kibwe;Felly Kazadi;Berenice Kamba;Ruffin Nyembo;Cédric Sangwa;Patient Kayoyo;Eric Kasamba;Sebastien Mbuyi;Claude Mwamba-Mulumba;Berthe Barahyga;Adelin Muganza;Iteke Fefe;Willy Arung(Anaesthesia-Resuscitation Department, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo;Medpark Clinic, Lubumbashi, DR Congo;Laboratory Service, Medpark Clinic, Lubumbashi, DR Congo;Surgery Department, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo;Department of Public Health (Biostatistics), University of Lubumbashi, Lubumbashi, DR Congo;Biomedical Departement, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo;Internal Medicine Department, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo;Anaesthesia-Resuscitation Department, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo)

机构地区：[1]Anaesthesia-Resuscitation Department, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo [2]Medpark Clinic, Lubumbashi, DR Congo [3]Laboratory Service, Medpark Clinic, Lubumbashi, DR Congo [4]Surgery Department, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo [5]Department of Public Health (Biostatistics), University of Lubumbashi, Lubumbashi, DR Congo [6]Biomedical Departement, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo [7]Internal Medicine Department, Faculty of Medicine, University of Lubumbashi, Lubumbashi, DR Congo [8]Anaesthesia-Resuscitation Department, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo

出　　处：《Open Journal of Anesthesiology》2024年第11期232-247,共16页麻醉学期刊（英文）

摘　　要：Background: It appeared that the conjunction inflammation and nerve damage (caused by surgery) generate the hyperalgesic component. But the probability of predicting hyperalgesia from the size of the surgical incision and/or the resulting inflammatory reaction is not well elucidated. This survey aims to study the influence of the size of the surgical incision and the resulting inflammatory reaction (interleukin 6 levels) in the occurrence of postoperative hyperalgesia in the population of Lubumbashi. Methods: The present study was descriptive cross-sectional. The data collection was prospective over 5 months, from February 1, 2024 to June 30, 2024. This study included any patient over the age of 18 who underwent surgery under general anesthesia. We used indirect signs to define hyperalgesia: higher (ENS > 6) and prolonged pain, postoperative overconsumption of morphine. Results: During our survey, we collected 48 operated patients who had severe postoperative pain, 16 of whom had hyperalgesia, i.e. a prevalence of hyperalgesia of 33.33%. The size of the incision most represented was between ≥20 and i.e. 62.50%. The type of surgery most affected by hyperalgesia was laparotomy. We observed an elevation of IL6 in 87.50% of patients. The largest elevation was 8.91 times the preoperative value and the smallest was 1.04 times. Pre- and postoperative IL6 levels were not associated with hyperalgesia (p = 0.265). Only the size of the surgical incision was associated with hyperalgesia (p = 0.04). Incision size values between [20 - 30] cm were those associated with hyperalgesia (p = 0.027). The model shows that making an incision greater than or equal to 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times and this is statistically significant (p = 0.004). Conclusion: According to this survey, the size of the surgical incision was associated with postoperative hyperalgesia and a size of more than 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times.Background: It appeared that the conjunction inflammation and nerve damage (caused by surgery) generate the hyperalgesic component. But the probability of predicting hyperalgesia from the size of the surgical incision and/or the resulting inflammatory reaction is not well elucidated. This survey aims to study the influence of the size of the surgical incision and the resulting inflammatory reaction (interleukin 6 levels) in the occurrence of postoperative hyperalgesia in the population of Lubumbashi. Methods: The present study was descriptive cross-sectional. The data collection was prospective over 5 months, from February 1, 2024 to June 30, 2024. This study included any patient over the age of 18 who underwent surgery under general anesthesia. We used indirect signs to define hyperalgesia: higher (ENS > 6) and prolonged pain, postoperative overconsumption of morphine. Results: During our survey, we collected 48 operated patients who had severe postoperative pain, 16 of whom had hyperalgesia, i.e. a prevalence of hyperalgesia of 33.33%. The size of the incision most represented was between ≥20 and i.e. 62.50%. The type of surgery most affected by hyperalgesia was laparotomy. We observed an elevation of IL6 in 87.50% of patients. The largest elevation was 8.91 times the preoperative value and the smallest was 1.04 times. Pre- and postoperative IL6 levels were not associated with hyperalgesia (p = 0.265). Only the size of the surgical incision was associated with hyperalgesia (p = 0.04). Incision size values between [20 - 30] cm were those associated with hyperalgesia (p = 0.027). The model shows that making an incision greater than or equal to 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times and this is statistically significant (p = 0.004). Conclusion: According to this survey, the size of the surgical incision was associated with postoperative hyperalgesia and a size of more than 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times.

关 键 词：Postoperative Hyperalgesia Prevalence Surgical Incision Size Interleukin 6 

分 类 号：R73[医药卫生—肿瘤]