Pilot Study: Postoperative Pain Reduction by Pre Emptive N-Acetylcysteine

• Status: Completed
• Trial end date: 2018-10-29
• Target enrollment: 0
• Participant gender: All

Summary

Despite current available analgesic drugs, post-surgical pain management remains challenging. A potential new target for analgesic drugs are group-II metabotropic glutamate receptors subtypes (mGlu2 and mGlu3 receptors), since growing evidence from animal models show that activation of these receptors produce s analgesic effects in inflammatory and in neuropathic pain states. . N-Acetylcysteine (NAC) is a safe agent and with little to no side effects. NAC can induce analgesia by activating the glutamate:cystein antiporter, causing endogenous activation of the mGlu 2/3 receptors. However, this has only been investigated once in the peri-operative setting, were it showed preliminary promising result of reduction in opiate necessity. In healthy subjects there was a significant reduction in pain ratings to laser stimuli and amplitudes of laser evoked potentials after NAC. Based on these promising results, we hypothesize that pre emptive intravenous NAC can reduce postoperative pain and thereby cause less necessity for escape analgesics like opiates.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Radboud University
• Collaborator: Maxima Medical Center
• Treatments: Acetylcysteine; N-monoacetylcystine

Criteria

Inclusion Criteria:

• Subjects scheduled for laparoscopic unilateral inguinal hernia repair

• ASA 1 or2.

• Age >18 years.

Exclusion Criteria:

• Pregnancy or lactating

• Allergy to NAC

• History of chronic pain

• Use of opioids or neuropathic analgesics

• Use of NAC prior to trial (< 1 month of planned surgery)

• Alcoholism

• Diabetes Mellitus (insulin therapy)

• Asthma or Chronic Obstructive pulmonary Disease

• Known renal function disorders (MDRD <ô0)

• Known liver failure (bilirubin >1.Sx upper limit of normal)

• No written lC by patient