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document
Intranasal nicotine for postoperative pain treatment . BACKGROUND Despite pharmacological treatment , 70-80 % of patients report moderate to severe pain after surgery . Because nicotine has been reported to have analgesic properties in animal and human volunteer studies , the authors assessed the analgesic efficacy of a single 3 mg dose of nicotine nasal spray administered before emergence from general anesthesia . METHODS The authors conducted a randomized , double blind , placebo controlled trial of 20 healthy women ( mean age 45 ( SD 8 ) yr ) who were to undergo uterine surgery through a low transverse incision . After the conclusion of surgery but before emergence from general anesthesia , the anesthesiologist administered either nicotine nasal spray or a placebo . Numerical analog pain score and morphine utilization and hemodynamic values were measured for 24 h. RESULTS The patients treated with nicotine reported lower pain scores during the first hour after surgery ( peak numerical analog score , 7.6 ( SD 1.4 ) versus 5.3 ( SD 1.6 ) ; P < 0.001 ) and used half the amount of morphine as the control group ( 12 ( SD 6 ) versus 6 ( SD 5 ) mg ; P < 0.05 ) . Patients who received nicotine still reported less pain than those in the control group 24 h after surgery ( 1.5 ( SD 0.5 ) versus 4.9 ( SD 1.4 ) ; P < 0.01 ) . Systolic blood pressure was lower in the group that received nicotine ( 105 ( SD 3 ) versus 122 ( SD 3 ) ; P < 0.001 ) , but there was no difference in diastolic blood pressure or heart rate . CONCLUSIONS Treatment with a single dose of nicotine immediately before emergence from anesthesia was associated with significantly lower reported pain scores during the first day after surgery . The decreased pain was associated with a reduction in morphine utilization and the analgesic effect of nicotine was not associated with hypertension or tachycardia .
19743
Intervention_Pharmacological
nicotine
19744
Intervention_Pharmacological
nicotine
19745
Intervention_Control
placebo
19746
Intervention_Surgical
uterine surgery
19747
Intervention_Surgical
low transverse incision
19748
Intervention_Pharmacological
nicotine nasal spray
19749
Intervention_Control
placebo
19750
Outcome_Pain
lower pain scores
19751
Outcome_Other
amount of morphine
19752
Outcome_Pain
reported less pain
19753
Outcome_Physical
Systolic blood pressure was lower
19754
Outcome_Physical
no difference in diastolic blood pressure or heart rate .
19755
Outcome_Pain
pain scores
19756
Outcome_Pain
pain
19757
Participant_Condition
postoperative pain treatment .
19758
Participant_Condition
healthy
19759
Participant_Age
mean age 45 ( SD 8 ) yr
19760
Participant_Condition
undergo uterine surgery through a low transverse incision