Efficacy of turmeric (curcumin) in pain and postoperative fatigue after laparoscopic cholecystectomy: a double-blind, randomized placebo-controlled study
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Better patient-reported outcomes (PROs) of laparoscopic cholecystectomy (LC) are premised upon PROs such as postoperative pain and fatigue. These PROs are indices of convalescence and return to normal activity. Curcumin (turmeric) is used in India for traumatic pain and fatigue for its anti-inflammatory/antioxidant and tissue modulation/healing properties. We studied the effect of curcumin on pain and postoperative fatigue in patients of LC.
Methods and procedures
From July to September 2009, 50 consecutive day-care LC candidates were enrolled for a prospective, double-blind randomized placebo-controlled study. A uniform general anesthesia and analgesia protocol was followed. Curcumin/placebo and rescue analgesic were prescribed at discharge. Patients were told to maintain pain/fatigue/adverse event diaries based upon 100-point visual analog pain scale (VAS) and 10-point interval rating fatigue scale (IRS). Patients were followed up at third day (D3), first week (W1), second week (W2), and third week (W3). The blind labels were opened at the end of study.
Demographic characteristics, comorbidity, and gallbladder pathology profiles were comparable in the study (n = 25) and control groups (n = 25). There was no adverse surgical outcome, adverse PRO or withdrawal. Pain and fatigue scores at D3 were similar in the two groups. At W1 and W2, the study group showed significantly lower (p value 0.000) mean pain scores, i.e., 15 ± 5.204 versus 30 ± 13 in controls. Fatigue scores at W1, W2, and W3 were significantly lower (p value 0.000) in the study group, i.e., 2.16 ± 1.748, 1, and 0, respectively, versus 5.16 ± 1.375, 4.20 ± 1.633, and 1 in controls. All patients were pain free at W3. Analgesic tablet usage was significantly lower (p value 0.000) in the study group, i.e., 6.96 ± 1.837 versus 39.32 ± 16.509 in controls.
Turmeric (curcumin) improves postoperative pain- and fatigue-related PROs following LC.
KeywordsLaparoscopic cholecystectomy Postoperative pain Postoperative fatigue Turmeric Curcumin Patient-reported outcomes
We are grateful to Dr. Konark Malhotra for his help in documentation and data compilation. We express our thanks to Indsaff, Inc., India for the gift of the curcumin/placebo and blind labeling of the same.
Krishna A. Agarwal, C. D. Tripathi, Brij B. Agarwal, and Satish Saluja have no conflicts of interest or financial ties to disclose.
- 14.Pappas-Gogos G, Tsimogiannis KE, Zikos N, Nikas K, Manataki A, Tsimoyiannis EC (2008) Preincisional and intraperitoneal ropivacaine plus normal saline infusion for postoperative pain relief after laparoscopic cholecystectomy: a randomized double-blind controlled trial. Surg Endosc 22:2036–2045PubMedCrossRefGoogle Scholar
- 21.Deeb D, Jiang H, Gao X, Al-Holou S, Danyluk AL, Dulchavsky SA, Gautam SC (2007) Curcumin [1,7-bis(4-hydroxy-3-methoxyphenyl)-1–6-heptadine-3, 5-dione; C21H20O6] sensitizes human prostate cancer cells to tumor necrosis factor-related apoptosis-inducing ligand/Apo2L-induced apoptosis by suppressing nuclear factor-kappaB via inhibition of the prosurvival Akt signaling pathway. J Pharmacol Exp Ther 321:616–625PubMedCrossRefGoogle Scholar
- 22.Gao X, Kuo J, Jiang H, Deeb D, Liu Y, Divine G, Chapman RA, Dulchavsky SA, Gautam SC (2004) Immunomodulatory activity of curcumin: suppression of lymphocyte proliferation, development of cell-mediated cytotoxicity, and cytokine production in vitro. Biochem Pharmacol 68:51–61PubMedCrossRefGoogle Scholar