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ANTIHYPERALGESIC EFFECTS OF HISTAMINE-H1 RECEPTOR ANTAGONISTS IN TOTAL HIP ARTHROPLASTY
ESRA Academy. Ifrim D. Sep 8, 2016; 138297; 0123 Topic: Acute Postoperative Pain - Postoperative & Perioperative Analgesia
Dr. Dragos Ifrim
Dr. Dragos Ifrim

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Abstract
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Background and Aims:

Histamine-H1 receptor antagonists have been involved in the inhibition of the NMDA receptor. Therefore we measured the postoperative hyperalgesia after administration of hydroxyzine.

Methods:

During this prospective double-blinded randomized pilot study, approved by the Ethical Committee, 36 patients scheduled for total hip arthroplasty received orally, either hydroxyzine 150 mg (GH) or placebo (GP) before surgery. Anaesthesia was conducted under sevoflurane (MAC= 2%) and boluses of sufentanil. Consumption of sufentanil was recorded. Pain scores (0-10), morphine consumption (mg) and area of hyperalgesia (cm2), evaluated with Von Frey filaments, were recorded postoperatively during 24 hours. Student t-test and continuous mixed models were performed.

Results:

Groups were similar in terms of demographic data, duration of anaesthesia and surgery (P> 0.05). Peroperative requirement of sufentanil was similar in GP and GH (20 µg [15–22.25] vs 22.5 µg [20-25] ; P= 0.0577). Morphine consumption increased similarly in both groups (5.56 ± 3.71 mg up to 14.11 ± 5.71 mg in GP vs 4.89 ± 3.85 mg up to 13.11 ± 5.94 mg in GH ; P= 0.512). Pain decreased from 5.17 ± 1.91 to 0.83 ± 1.04 in GP and from 5.28 ± 1.81 to 1.39 ± 1.29 in GH: there was no difference between groups (P= 0.508). The area of hyperalgesia was similar between groups: 90.87 cm2 [46.27 – 108.37] in GP vs 54.61 cm2 [44.34 – 107.74] in GH; P= 0.719.

Conclusions:

Under the condition of the study, hydroxyzine is devoid of antihyperalgesic effects in total hip arthroplasty during the early postoperative period.

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