Clinical Updates on Opioids Research and Pain Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 30 October 2024 | Viewed by 1987

Special Issue Editor


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Guest Editor
Department of Anesthesiology, Aretaieion University Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
Interests: anesthesiology; obstetric anesthesia; regional anesthesia; labor analgesia; perioperative care; postoperative pain; opioid-sparing techniques; opioid-free techniques quality of recovery
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Special Issue Information

Dear Colleagues,

The Journal of Clinical Medicine (JCM) is supporting the publication of a Special Issue on “Clinical Updates on Opioids Research and Pain Management”, for which I will be serving as the Guest Editor.

Opioids are widely utilized agents for pain control, both intraoperatively and postoperatively, to control the nociceptive pathway of pain; however, due to the abundance of adverse effects associated with their use, such as nausea, vomiting, respiratory depression, ileus, delayed gastric emptying, and pruritus, the use of opioid-sparing and opioid-free techniques have gained growing interest as part of a multimodal analgesic approach. In this context, and following the quest for non-opioid-based regimens in the era of an ever-increasing opioid epidemic, regional anesthesia and analgesia techniques are an interesting supplementary alternative aiming to minimize opioid use.

This Special Issue aims to provide up-to-date data by presenting research on opioids and pain management and to be a comprehensive aggregation of work performed by experts in the field, thus providing a valuable resource of knowledge for anesthesiologists worldwide. By providing the opportunity to publish a significant number of articles on this important issue in modern anesthesia practice, we hope that we will be able to enhance readers’ ability to appreciate recent advances in this field and augment their potential gain of knowledge. Therefore, this Special Issue encourages submissions on the current state of the art but also on ongoing controversies related to the practice of opioid research as well as opioid-sparing and opioid-free techniques.

I therefore kindly invite healthcare professionals and researchers involved in the care of patients to address relevant topics and submit original research articles, reviews, meta-analyses, observational studies, case reports, or case series to the JCM be published in this Special Issue after a thorough peer review by experts in the field.

I am very much looking forward to receiving your submissions.

Prof. Dr. Kassiani Theodoraki
Guest Editor

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Keywords

  • postoperative pain
  • acute pain
  • chronic pain
  • nociceptive
  • analgesia
  • analgesics
  • opioid-sparing
  • opioid-free

Published Papers (2 papers)

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Research

15 pages, 393 KiB  
Article
Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
by Ammara Khan, Akbar Waheed, Tayyaba Afsar, Ali Abusharha, Huma Shafique and Suhail Razak
J. Clin. Med. 2024, 13(1), 249; https://doi.org/10.3390/jcm13010249 - 31 Dec 2023
Cited by 1 | Viewed by 1143
Abstract
Effective postoperative pain management is essential for patient well-being and an efficient healthcare system. Variations in the Catechol O-Methyltransferase (COMT) gene, specifically rs4680, play a crucial role in pain perception and opioid response. This study seeks to elucidate the impact of rs4680 polymorphism [...] Read more.
Effective postoperative pain management is essential for patient well-being and an efficient healthcare system. Variations in the Catechol O-Methyltransferase (COMT) gene, specifically rs4680, play a crucial role in pain perception and opioid response. This study seeks to elucidate the impact of rs4680 polymorphism on tramadol efficacy and adverse reactions in post-surgical patients. We performed an uncontrolled cohort pharmacogenetics study in which participants underwent postoperative tramadol administration. The frequencies of rs4680 alleles were determined and the association between rs4680 genotypes and the efficacy of tramadol analgesic as pain relief, measured by the Numeric Rating Scale (NRS), was analyzed. Secondary outcomes included tramadol-induced sedation levels, opioid-induced nausea and vomiting, and other adverse effects of tramadol. Data analysis, using IBM SPSS Statistics 23, focused on pain and side effect differences across genotypes, with statistical significance set to p ≤ 0.05. The COMT (rs4680) genotype distribution exhibited a ‘G’ allele frequency of 41.5% and an ‘A’ allele frequency of 58.5%, with the AA genotype present in 44% of individuals, adhering to the Hardy–Weinberg equilibrium (p = 0.788). Patients with the AA genotype reported lower pain scores post-tramadol administration across all times examined (p < 0.001), but also experienced statistically significant (p < 0.001) higher incidences of tramadol-induced nausea, vomiting, and sedation. However, GG genotype individuals experienced poor pain relief from tramadol, requiring more supplemental analgesia. These significant findings underscore the critical role of COMT rs4680 polymorphism in response to tramadol and the necessity of a personalized approach to postoperative pain management. Full article
(This article belongs to the Special Issue Clinical Updates on Opioids Research and Pain Management)
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12 pages, 1932 KiB  
Article
Opioid Therapy and Implications for Oxidative Balance: A Clinical Study of Total Oxidative Capacity (TOC) and Total Antioxidative Capacity (TAC)
by Urszula Kosciuczuk, Piotr Jakubow, Katarzyna Tarnowska and Ewa Rynkiewicz-Szczepanska
J. Clin. Med. 2024, 13(1), 82; https://doi.org/10.3390/jcm13010082 - 22 Dec 2023
Cited by 1 | Viewed by 589
Abstract
Background: Opioids are used in pharmacotherapy for chronic pain. The phenomenon of their influence on the oxidative–antioxidant balance is poorly understood. Additionally, little is known about the oxidative status in patients receiving chronic opioid noncancer pain therapy. Methods: The primary goal was to [...] Read more.
Background: Opioids are used in pharmacotherapy for chronic pain. The phenomenon of their influence on the oxidative–antioxidant balance is poorly understood. Additionally, little is known about the oxidative status in patients receiving chronic opioid noncancer pain therapy. Methods: The primary goal was to explore oxidative status using the total oxidative capacity (TOC) and total antioxidative capacity (TAC) in patients with chronic lower back pain (LBP) treated with opioids. The secondary task was to present the risk factors connected with the duration of therapy or anthropometric parameters. Plasma TOC and TAC were analyzed in the study group (n = 28), i.e., patients with chronic LBP treated with opioids, and in the control group (n = 11), i.e., healthy volunteers. Results: The TAC was significantly lower in the study group compared to the control group (p < 0.05), while the TOC did not differ significantly. A statistically lower TOC for buprenorphine compared to oxycodone (p = 0.019) and tramadol (p = 0.036) was observed. The TOC did not differ between tramadol and oxycodone. The highest TAC was described for oxycodone, while the TAC for buprenorphine and tramadol was significantly lower in comparison with oxycodone (p = 0.007 and p = 0.016). The TOC/TAC ratio was higher in patients with nicotinism in both groups.Conclusions: Patients receiving chronic opioid therapy presented a lower antioxidative capacity. There were differences in opioid-induced oxidative imbalance, which is very important clinically. Nicotinism increases the oxidative–antioxidative imbalance. The least oxidative capacity was associated with buprenorphine, while oxycodone showed the greatest antioxidant activity. The most favorable TOC/TAC ratio was observed for buprenorphine. It is suggested that buprenorphine or oxycodone has the best profile, and there is no correlation with the duration of opioid therapy or the opioid dose. However, all opioid substances can potentially enhance the oxidative–antioxidative status. Full article
(This article belongs to the Special Issue Clinical Updates on Opioids Research and Pain Management)
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