Mü-opioid Receptor Level and Postoperative Pain in Patients With Gynecological Laparoscopy
Condition: Gynecological; Surgery (Previous), Affecting Fetus; Postoperative Pain
MeSH terms: Pain, Postoperative
Study type: Observational [Patient Registry]

Summary: 
      The hypothesis that gonadal hormones may affect the perception of pain is an interesting
      research area.

      This prospective observational study will undergo elective laparoscopic gynecological surgery
      to 18-65 years, is planned to participate in ASA 1-3, 60 volunteer patients.

      Patients who have known psychiatric disease and drug-users, an important cardiovascular or
      central nervous system disease, patients with pain syndromes or routinely using opioid, are
      non-irregular and predictable cycles of menstrual cycles and very urgent patients will not be
      included in the study.

      In our study, we aimed to determine the relationship between menstrual cyclus phases
      (follicular and luteal) of menstrual cyclus phases (follicular and luteal) in patients to
      undergo gynecological laparoscopic operation and the relationship between postoperative pain
      and opioid analgesic consumption.
    

Detailed description: 
      This prospective observational study is planned to include 60 volunteer patients aged 18-45,
      ASA 1-3, undergoing elective laparoscopic gynecological surgery. With the information to be
      obtained from the patients whose menstrual cycle regularly lasts 21-35 days, the cycle
      duration will be determined by counting from the first day of the last mens period. Days 6-12
      of the cycle will be grouped as follicular (F), and 20-24 as luteal (L). No surgery will be
      planned during the mens period (1-5 days). Patients will be excluded on days 13-19 of the
      cycle to better define the two stages.

      Remaining 3 ml of blood from routine venous blood samples taken from patients for
      preoperative evaluation will be stored to investigate μ-Opioid receptor levels. A continuous
      10 cm visual analog scale (VAS) will be used to determine the level of postoperative pain.

      Researchers who will make postoperative evaluations will be blind to menstrual cycles.

      The sensation of pain will be assessed every 10 minutes in the recovery room, intervening
      with a bolus of 10 mg iv tramadol for a pain score of 3 to 5 and a bolus of 20 mg for a pain
      score of more than 5. If the VAS does not drop below 3 after two additional tramadol boluses,
      rescue analgesia will be provided with 2 mg iv morphine.

      Patients will be followed in the ward and observations will be made at 6, 12 and 24 hours.

      Patients will be asked to evaluate their resting and coughing pains.
    

Intervention name(s): follicular cyclus; luteal cyclus
Intervention type(s): Other; Other
Intervention description(s): Days of cyclus 6-12; Days of cyclus 20-24
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Volunteer patients to undergo elective laparoscopic gynecological surgery by the Department
        of Obstetrics and Gynecology
      
Keywords: Mu-opioid receptor; Gynecological laparoscopic operation; menstrual cycle