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Preoperative Norepinephrine Levels in Cerebrospinal Fluid and Plasma Correlate With Pain Intensity After Pediatric Spine Surgery

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Abstract

Purpose

Catecholamines were found to be involved in descending pain modulation and associated with perioperative pain. The purpose of the present study was to investigate the relationship between preoperative concentrations of catecholamines and postoperative pain intensity of pediatric patients.

Methods

Fifty adolescents with idiopathic scoliosis scheduled for elective spinal fusion surgery were enrolled in this prospective cohort study. Preoperative plasma and cerebrospinal fluid (CSF) samples were collected and analyzed by mass spectrometry. Pain intensity was assessed during the acute postoperative period and in the intermediate period.

Results

Preoperative plasma concentrations of norepinephrine (NE) and normetanephrine (NME), as well as the CSF concentration of NE, were significantly correlated with the presence of pain six weeks after surgery (r = 0.48, 0.50, and 0.50, respectively; p < .002). We also found that preoperative NE levels in CSF were significantly higher in patients reporting moderate to severe pain intensity than in patients with mild pain during the first day following surgery (0.268 ± 0.29 ng/mL vs. 0.121 ± 0.074 ng/mL, p = .01), as well as between patients reporting pain and painless patients at 6 weeks postsurgery (0.274 ± 0.282 ng/mL vs. 0.103 ± 0.046 ng/mL respectively, U = 69.5, p = .002).

Conclusions

These results support the potential role of catecholamine levels in predicting postoperative pain intensity.

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Authors and Affiliations

  1. Department of Anesthesia, McGill University, 845 Sherbrooke St W, Montreal, Quebec, H3A 0G4, Canada

    Catherine E. Ferland PhD & Pablo M. Ingelmo MD

  2. Research Institute of the McGill University Health Centre, 2155 Guy St, Montreal, Quebec, H3H 2L9, Canada

    Catherine E. Ferland PhD

  3. Alan Edwards Centre for Research on Pain, Suite 3100, Genome Building, 740 Dr. Penfield Avenue, Montreal, Quebec, H3A 0G1, Canada

    Catherine E. Ferland PhD, Pablo M. Ingelmo MD, Serge Marchand PhD & Jean A. Ouellet MD

  4. Shriners Hospital for Children-Canada, 1003 Decarie Blvd, Montreal, Quebec, H4A 0A9, Canada

    Catherine E. Ferland PhD, Neil Saran MD, MSc & Jean A. Ouellet MD

  5. Department of Pharmacology and Physiology, Université de Sherbrooke, Administration, 2500 Boulevard de l’Université, Sherbrooke, Quebec, J1K 2R1, Canada

    Alexandre J. Parent PhD & Philippe Sarret PhD

  6. Department of Surgery, McGill University, 845 Sherbrooke St W, Montreal, Quebec, H3A 0G4, Canada

    Neil Saran MD, MSc & Jean A. Ouellet MD

  7. Dép. des sciences de la santé, Université du Québec en Abitibi Témiscamingue, 445 Boulevard de l’Université, Rouyn-Noranda, Quebec, J9X 5E4, Canada

    Anaïs Lacasse PhD

  8. Department of Surgery, Université de Sherbrooke, Administration, 2500 Boulevard de l’Université, Sherbrooke, Quebec, J1K 2R1, Canada

    Serge Marchand PhD

  9. Centre de recherche du CHUS, aile 9, porte 6, 3001 12e Avenue N, Sherbrooke, Quebec, J1H 5N4, Canada

    Serge Marchand PhD & Philippe Sarret PhD

Authors
  1. Catherine E. Ferland PhD
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  2. Alexandre J. Parent PhD
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  3. Neil Saran MD, MSc
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  4. Pablo M. Ingelmo MD
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  5. Anaïs Lacasse PhD
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  6. Serge Marchand PhD
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  7. Philippe Sarret PhD
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  8. Jean A. Ouellet MD
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Corresponding author

Correspondence to Catherine E. Ferland PhD.

Additional information

The McGill Scoliosis & Spine Research Chair and the Louise and Alan Edwards Foundation financially supported this study.

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Ferland, C.E., Parent, A.J., Saran, N. et al. Preoperative Norepinephrine Levels in Cerebrospinal Fluid and Plasma Correlate With Pain Intensity After Pediatric Spine Surgery. Spine Deform 5, 325–333 (2017). https://doi.org/10.1016/j.jspd.2017.03.012

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  • DOI: https://doi.org/10.1016/j.jspd.2017.03.012

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