Does Preoperative Vitamin D Level Effect Acute Postoperative Pain After Hip Arthroplasty Surgery

Year 2022, Volume: 8 Issue: 2, 258 - 268, 31.05.2022

Nilay Taş , Ali Altınbaş , Murat Cihan , Yunus Güzel , Tevfik Noyan

https://doi.org/10.19127/mbsjohs.1039087

Abstract

Objective: 25-OH Vitamin D is well known that has an important role in the perception of pain. Vitamin D insufficiency is important health problem all over the world. Most of the research related to vitamin D and pain is about chronic pain. In this study, it was investigated whether there is an association between Vitamin D levels and acute postoperative pain.
Methods: Preoperative Vitamin D levels were measured in patients who underwent elective hip replacement. Patients undergoing spinal anesthesia were administered patient-controlled analgesia (PCA). Patients whose pain assessment was performed with the postoperative visual analog scale (VAS), the time of initial analgesic administration, the number of analgesic needs, the number of bolus opioid use and additional NSAID use were evaluated.
Results: It has seen that a negative correlation between the vitamin D values and postoperative VAS scores. It was determined that patients with low vitamin D had earlier postoperative first analgesic administration time. It was also determined that as the vitamin D values decreased, the number of bolus opioids and total analgesic requirements used was higher.
Conclusion: In postoperative pain, low preoperative vitamin D level caused an increase in VAS scores and analgesic need and patients have low vitamin D also had earlier analgesic administration time. 

Keywords

25-OH Vitamin D, acute postoperative pain, hip arthroplasty, VAS

References

• 1. Banerjee A, Panettieri R Jr. Vitamin D modulates airway smooth muscle function in COPD. Curr Opin Pharmacol 2012; 12(3):266-74.
• 2. Quraishi SA, Camargo CA Jr. Vitamin D in acute stress and critical illness. Curr Opin Clin Nutr Metab Care 2012; 15(6):625-34.
• 3. Damera G, Fogle HW, Lim P, Goncharova EA, Zhao H, Banerjee A et al. Vitamin D inhibits growth of human airway smooth muscle cells through growth factor-induced phosphorylation of retinoblastoma protein and checkpoint kinase 1. Br J Pharmacol 2009; 158(6):1429-441.
• 4. Zosky GR, Berry LJ, Elliot JG, James AL, Gorman S, Hart PH. Vitamin D deficiency causes deficits in lung function and alters lung structure. Am J Respir Crit Care Med 2011; 183(10):1336-343.
• 5. Turan A, Hesler BD, You J, Saager L, Grady M, Komatsu R et al. The association of serum vitamin D concentration with serious complications after noncardiac surgery. Anesth Analg 2014; 119(3):603-12.
• 6. Janssen H, Samson MM, Verhaar JJ H. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr 2002; 75:611–15.
• 7. Doi J, Moro A, Fujiki M, Eghtesad B, Quintini C, Menon KVN et al. Nutrition Support in Liver Transplantation and Postoperative Recovery: The Effects of Vitamin D Level and Vitamin D Supplementation in Liver Transplantation. Nutrients 2020 Nov 28; 12(12):3677.
• 8. Ney J, Heyland DK, Amrein K, Marx G, Grottke O, Choudrakis M et al. The relevance of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration for postoperative infections and postoperative organ dysfunctions in cardiac surgery patients: The eVIDenCe study 2019 Dec; 38(6):2756-2762.
• 9. Quraishi SA, Bittner EA, Blum L, Hutter MM, Camargo JA Jr. Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery. JAMA Surg 2014; 149(2):112–118.
• 10. Meyer M, Leiss F, Greimel F, Renkawitz T, Grifka J, Maderbacher G et al. Impact of malnutrition and vitamin deficiency in geriatric patients undergoing orthopedic surgery. Acta Orthop 2021 Feb 4; 1-6.
• 11. Lee A, Chan Cheong SK, Samy W, Chiu CH, Gin T. Effect of Hypovitaminosis D on Postoperative Pain Outcomes and Short-Term Health-Related Quality of Life After Knee Arthroplasty: A Cohort Study. Medicine (Baltimore) 2015 Oct; 94(42):e1812.
• 12. Shipton EA, Shipton EE. Vitamin D and Pain: Vitamin D and Its Role in the Aetiology and Maintenance of Chronic Pain States and Associated Comorbidities. Pain Res Treat 2015; 2015:904967.
• 13. Zang L, Fu P, Huang YQ, Wu M, Li L, Zang J et al. Vitamin D deficiency and carotid artery intima-media thickness and coronary calcification in patients with diabetic nephropathy. Sichuan Da Xue Xue Bao Yi Xue Ban 2012 May; 43(3):420-4, 450.
• 14. Holick MF, Chen TC. Vitamin D deficiency; a worlwide problem with health consequences. Am J Clin Nutr 2008; 87(4):1080S-6S.
• 15. Wei Q, Chen Z, Tan X, Su H, Chen X, He W et al. Relation of Age, Sex and Bone Mineral Density to Serum 25-Hydroxyvitamin D Levels in Chinese Women and Men. Orthop Surg 2015; 7(4):343-9.
• 16. Hovsepian S, Amini M, Aminorroaya A, Amini P, Iraj B. Prevalence of Vitamin D Deficiency among Adult Population of Isfahan City, Iran. J Health Popul Nutr 2011 ;29(2):149-55.
• 17. Daly RM, Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Sikaris KA et al. Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national, population‐based study. Clin Endocrinol (Oxf) 2012; 77(1):26-35.
• 18. Mosekilde L. Vitamin D and the elderly. Clinical Endocrinology 2005; 62:265–28.
• 19. Lot A, Abdel-Nasser AM, Hamdy A, Omran AA, El-Rehany MA. Hypovitaminosis D in female patients with chronic low back pain. Clin Rheumatol 2007; 26(11):1895-901
• 20. Pyati S, Gan TJ. Perioperative pain management. CNS Drugs 2007; 21(3):185-211.
• 21. Fujino T, Odo M, Okada H, Takahashi S, Kikuchi T. Continuous pericapsular nerve group block for postoperative pain management in total hip arthroplasty: report of two cases. JA Clin Rep 2021; 7(1):22.
• 22. Gotz JS, Leiss F, Maderbacher G, Meyer M, Reinhard J, Zeman F et al. Implementing fast-track in total hip arthroplasty: rapid mobilization with low need for pain medication and low pain values: Retrospective analysis of 102 consecutive patients. Z Rheumatol 2021 Mar 11. doi: 10.1007/s00393-021-00978-5.
• 23. Pereira MP, Pogatzki-Zahn E. Gender aspects in postoperative pain. Curr Opin Anaesthesiol 2015 Oct;28(5):546-58.
• 24. Cepeda MS, Carr DB. Women experience more pain and require more morphine than men to achieve a similar degree of analgesia. Anesth Analg 2003; 97(5):1464-8.
• 25. Aasvang E, Kehlet H. Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth. 2005; 95(1):69-76.
• 26. Kim Y, Zhang F, Su K, LaRochelle M, Callahan M, Fisher D et al. Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study. J Gen Intern Med 2020; 35(9):2545-2552
• 27. Nawabi DH, Chin KF, Keen RW, Haddad FS. Vitamin D deficiency in patients with osteoarthritis undergoing total hip replacement: a cause for concern? J Bone Joint Surg Br 2010; 92(4):496-9.
• 28. Mak JC, Klein LA, Finnegan T, Mason RS, Cameron ID. An initial loading-dose vitamin D versus placebo after hip fracture surgery: baseline characteristics of a randomized controlled trial (REVITAHIP). BMC Geriatr 2014; 14:101–9.
• 29. Xu HW, Shen B, Hu T, Zhao WD, Wu DS, Wang SJ. Preoperative vitamin D status and its effects on short-term clinical outcomes in lumbar spine surgery. J Orthop Sci 2020; 25(5):787-792.
• 30. Helde-Frankling M, Björkhem-Bergman L. Vitamin D in Pain Management. Int J Mol Sci 2017; 18(10):2170.
• 31. Shinchuk LM, Holick MF. Vitamin d and rehabilitation: improving functional outcomes. Nutr Clin Pract 2007; 22(3):297-304.
• 32. Turner MK, Hooten WM, Schmidt JE, Kerkvliet JL, Townsend CO, Bruce BK. Prevalence and clinical correlates of vitamin D inadequacy among patients with chronic pain. Pain Med 2008; 9(8):979-84.
• 33. Wall C, de Steiger R. Pre-operative optimisation for hip and knee arthroplasty: Minimise risk and maximise recovery. Aust J Gen Pract 2020; 49(11):710-714.
• 34. Heidari B, Shirvani JS, Firouzjahi A, Heidari P, Hajian-Tilaki KO. Association between nonspecific skeletal pain and vitamin D deficiency. Int J Rheum Dis 2010; 13(4):340-6. 35. Bose S, Khanna A, You J, Arora L, Qavi S, Turan A. Low serum vitamin D levels are not associated with increased postoperative pain and opioid requirements: a historical cohort study. Can J Anaesth 2015; 62(7):770-6.
• 36. Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med 2008; 168(7):771-2.
• 37. Morrison RJM, Bunn D, Gray WK, Baker PN, White C, Rangan A et al. VASO (Vitamin D and Arthroplasty Surgery Outcomes) study - supplementation of vitamin D deficiency to improve outcomes after total hip or knee replacement: study protocol for a randomised controlled feasibility trial. Trials. 2017; 18(1):514.
• 38. Larrosa M, Gomez A, Casado E, Moreno M, Vázquez I, Orellana C et al. Hypovitaminosis D as a risk factor of hip fracture severity. Osteoporos Int 2012; 23(2):607-14.
• 39. Wu Z, Malihi Z, Stewart AW, Lawes CM, Scragg R. Effect of Vitamin D Supplementation on Pain: A Systematic Review and Meta-analysis. Pain Physician 2016; 19(7):415-27.