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Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: A Retrospective Chart Review.
Life (Basel). 2020 Jun 22; 10(6)L

Abstract

The purinergic P2Y12 receptor regulates microglial activation, resulting in persistence and aggravation of pain in neuropathic and nociceptive pain models. We conducted a retrospective chart review to explore the analgesic potency of the P2Y12 receptor-specific antagonist, clopidogrel, for clinical management of postoperative pain in patients who underwent abdominal surgery. Twenty-seven patients with cardiovascular comorbidities, who underwent laparoscopic abdominal surgery and had ceased aspirin (ASP, n = 17) or clopidogrel (CLP, n = 10) for 14 days pre-operatively, were enrolled retrospectively. In both groups, the number of opioids and non-steroidal anti-inflammatory drugs (NSAIDs) consumed for managing postoperative pain was compared using the chi-square test and Mann-Whitney test. Our results showed that from postoperative day (POD) 0 to POD 3, the average numerical rating reflecting the postoperative pain was comparable between the two groups (CLP: 4.0 ± 1.4 vs. ASP: 3.7 ± 0.8, P-value = 0.56). However, at POD 7, opioid consumption in the CLP-treated group (fentanyl-equivalent dose: 0.49 ± 0.56 mg) was significantly lower than that in the ASP-treated group (1.48 ± 1.35 mg, P-value = 0.037). After reaching a stable state by repeated systemic administration, clopidogrel sustained the analgesic efficacy for a certain period. In conclusion, microglial P2Y12 receptors may mediate signal transduction of postoperative nociceptive pain and enhance clinical opioid analgesia.

Authors+Show Affiliations

Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan. Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo 113-0033, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32580286

Citation

Tsuchida, Rikuhei, et al. "Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: a Retrospective Chart Review." Life (Basel, Switzerland), vol. 10, no. 6, 2020.
Tsuchida R, Sumitani M, Abe H, et al. Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: A Retrospective Chart Review. Life (Basel). 2020;10(6).
Tsuchida, R., Sumitani, M., Abe, H., Ando, M., Saita, K., Hattori, K., Mietani, K., Inoue, R., & Uchida, K. (2020). Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: A Retrospective Chart Review. Life (Basel, Switzerland), 10(6). https://doi.org/10.3390/life10060092
Tsuchida R, et al. Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: a Retrospective Chart Review. Life (Basel). 2020 Jun 22;10(6) PubMed PMID: 32580286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: A Retrospective Chart Review. AU - Tsuchida,Rikuhei, AU - Sumitani,Masahiko, AU - Abe,Hiroaki, AU - Ando,Masae, AU - Saita,Kosuke, AU - Hattori,Kohshi, AU - Mietani,Kazuhito, AU - Inoue,Reo, AU - Uchida,Kanji, Y1 - 2020/06/22/ PY - 2020/05/21/received PY - 2020/06/16/revised PY - 2020/06/20/accepted PY - 2020/6/26/entrez PY - 2020/6/26/pubmed PY - 2020/6/26/medline KW - ATP receptor KW - P2Y12 receptor KW - central sensitisation KW - clopidogrel KW - postoperative pain JF - Life (Basel, Switzerland) JO - Life (Basel) VL - 10 IS - 6 N2 - The purinergic P2Y12 receptor regulates microglial activation, resulting in persistence and aggravation of pain in neuropathic and nociceptive pain models. We conducted a retrospective chart review to explore the analgesic potency of the P2Y12 receptor-specific antagonist, clopidogrel, for clinical management of postoperative pain in patients who underwent abdominal surgery. Twenty-seven patients with cardiovascular comorbidities, who underwent laparoscopic abdominal surgery and had ceased aspirin (ASP, n = 17) or clopidogrel (CLP, n = 10) for 14 days pre-operatively, were enrolled retrospectively. In both groups, the number of opioids and non-steroidal anti-inflammatory drugs (NSAIDs) consumed for managing postoperative pain was compared using the chi-square test and Mann-Whitney test. Our results showed that from postoperative day (POD) 0 to POD 3, the average numerical rating reflecting the postoperative pain was comparable between the two groups (CLP: 4.0 ± 1.4 vs. ASP: 3.7 ± 0.8, P-value = 0.56). However, at POD 7, opioid consumption in the CLP-treated group (fentanyl-equivalent dose: 0.49 ± 0.56 mg) was significantly lower than that in the ASP-treated group (1.48 ± 1.35 mg, P-value = 0.037). After reaching a stable state by repeated systemic administration, clopidogrel sustained the analgesic efficacy for a certain period. In conclusion, microglial P2Y12 receptors may mediate signal transduction of postoperative nociceptive pain and enhance clinical opioid analgesia. SN - 2075-1729 UR - https://www.unboundmedicine.com/medline/citation/32580286/Clopidogrel,_an_ADP-P2Y12_Receptor_Antagonist,_Can_Prevent_Severe_Postoperative_Pain:_A_Retrospective_Chart_Review L2 - https://www.mdpi.com/resolver?pii=life10060092 DB - PRIME DP - Unbound Medicine ER -
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