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Comparative Evaluation of Pain, Stress, Neuropeptide Y, ACTH, and Cortisol Levels Between a Conventional Postoperative Care Protocol and a Fast-Track Recovery Program in Patients Undergoing Major Abdominal Surgery.
- Source :
-
Biological Research for Nursing . Mar2017, Vol. 19 Issue 2, p180-189. 10p. - Publication Year :
- 2017
-
Abstract
- Background: Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols. Objectives: To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols. Method: A clinical trial with repeated measurements was conducted (May 2012 to May 2014) with a sample of 63 hepatectomized or pancreatectomized patients randomized into two groups: FT (n = 29) or CON (n = 34). Demographic and clinical data were collected, and pain (Visual Analog Scale [VAS] and Behavioral Pain Scale [BPS]) and stress responses (3 self-report questions) assessed. NPY, ACTH, and cortisol plasma levels were measured at T1 = day of admission, T2 = day of surgery, and T3 = prior to discharge. Results: ACTHT1 and ACTHT2 levels were positively correlated with self-reported stress levels (ρ = .43 and ρ = .45, respectively, p < .05) in the FT group. NPY levels in the FT group were higher than those in the CON group at all time points (p ≤ .004); this difference remained significant after adjusting for T1 levels through analysis of covariance for age, gender, and body mass index (F = .003, F = .149, F = .015, respectively, p > .05). Conclusions: Neuropeptidic levels were higher in the FT group. Future research should evaluate this association further, as these biomarkers might serve as objective indicators of postoperative pain and stress. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ADRENOCORTICOTROPIC hormone
*ANALGESICS
*ANALYSIS of covariance
*ANTHROPOMETRY
*BIOMARKERS
*CANCER patients
*CANCER treatment
*CHI-squared test
*CONVALESCENCE
*STATISTICAL correlation
*MENTAL depression
*ELECTROCHEMICAL analysis
*ENTERAL feeding
*ENZYME-linked immunosorbent assay
*HEPATECTOMY
*LENGTH of stay in hospitals
*HOSPITAL wards
*HYDROCORTISONE
*INTRAVENOUS therapy
*LONGITUDINAL method
*EVALUATION of medical care
*MEDICAL protocols
*NEUROPEPTIDES
*OPERATING room nursing
*PANCREATECTOMY
*PATIENTS
*POSTOPERATIVE care
*POSTOPERATIVE pain
*PSYCHOLOGICAL tests
*RESEARCH funding
*STATISTICAL sampling
*SCALE analysis (Psychology)
*SELF-evaluation
*STATISTICS
*PHYSIOLOGICAL stress
*SURGERY
*SURGICAL complications
*T-test (Statistics)
*STATISTICAL power analysis
*DATA analysis
*SOCIOECONOMIC factors
*SPECIALTY hospitals
*EFFECT sizes (Statistics)
*PAIN measurement
*RANDOMIZED controlled trials
*VISUAL analog scale
*REPEATED measures design
*DATA analysis software
*EARLY ambulation (Rehabilitation)
*MANN Whitney U Test
*INTRACLASS correlation
RESEARCH evaluation
Subjects
Details
- Language :
- English
- ISSN :
- 10998004
- Volume :
- 19
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Biological Research for Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 121309933
- Full Text :
- https://doi.org/10.1177/1099800416682617