The Impact of Microbiota and Associated Blood Tryptophan Metabolites on Pain Perception in Patients Undergoing Lumbar Disc Herniation Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 37
- 试验地点
- 1
- 主要终点
- Tryptophan metabolites (Picolinic Acid)
研究概览
简要总结
It is well-established that the gut microbiota plays a crucial role in various pain mechanisms, including visceral pain, inflammatory pain, headache, neuropathic pain, and opioid tolerance. Changes in the gut microbiome can alter pain perception. In our study, The investigator investigated the effects of microbiota alterations and the associated tryptophan metabolites on acute pain using the Visual Analog Scale (VAS).
详细描述
The study included patients aged 18 and above undergoing lumbar disc herniation surgery. Blood samples were collected preoperatively, at 8 hours, and at 24 hours postoperatively to analyze tryptophan metabolites (picolinic acid, 3- Hydroxykynurenine, anthranilic acid, kynurenine, quinolinic acid, kynurenic acid, xanthurenic acid). Concurrent VAS pain assessments were conducted, and correlations between tryptophan metabolites and VAS were evaluated.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients undergoing lumbar disc herniation surgery at Dokuz Eylül University Hospital.
- •Patients who have read and consented to the informed consent form for the study.
- •Age 18 years or older.
- •Surgery duration exceeding 2 hours.
排除标准
- •Patients are unwilling to participate in the study.
- •Surgery duration less than 2 hours.
- •Patients under the age of
- •Patients with a history of abdominal surgery.
- •Patients who received antibiotic therapy for intestinal pathology within the last 3 weeks.
- •Patients with known abdominal pathologies suspected to alter the microbial flora (e.g., Crohn's disease, ulcerative colitis, celiac disease).
结局指标
主要结局
Tryptophan metabolites (Picolinic Acid)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between picolinic acid and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative, 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. After the necessary centrifugation processes, the relevant laboratory team analyzed the picolinic acid levels (ng/mL).
Tryptophan metabolites (Quinolinic Acid)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between quinolinic acid and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative, 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. After the necessary centrifugation processes, the relevant laboratory team analyzed the quinolinic acid levels (ng/mL).
Visual Analog Scale
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
In VAS assessment, patients are typically asked to choose a value between "0, no pain" and "10, the worst imaginable pain." VAS is an 11-point scale (ranging from 0 to 10) that allows patients to numerically express the intensity of their pain. Blood samples were planned and collected from patients during the preoperative evaluation, at the 8th postoperative hour, and at the 24th postoperative hour, adhering to clinical routines for these procedures. Concurrently with each blood draw, the patient's VAS score, the nature of the pain, and vital signs were recorded.
Tryptophan metabolites (Kynurenine)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between kynurenine and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative, 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. After the necessary centrifugation processes, the relevant laboratory team analyzed the kynurenine levels (ng/mL).
Tryptophan metabolites (3-Hydroxykynurenine)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between 3-Hydroxykynurenine and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. After the necessary centrifugation processes, the relevant laboratory team analyzed the 3-Hydroxykynurenine levels(ng/mL).
Tryptophan metabolites (Anthranilic Acid)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between anthranilic acid and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative, 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. The relevant laboratory team measured the anthranilic acid levels (ng/mL) following the required centrifugation procedures.
Tryptophan metabolites (Kynurenic Acid)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between kynurenic acid and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative, 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. After the necessary centrifugation processes, the relevant laboratory team analyzed the kynurenic acid levels (ng/mL).
Tryptophan metabolites (Xanthurenic Acid)
时间窗: Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery
2 mL of blood was used from the blood samples taken during routine surgery preparation for the patients and from the routine blood samples taken in the postoperative period, and no additional invasive intervention was performed. The investigator elucidated the relationship between xanthurenic acid and its variations due to microbiota alterations with VAS in acute pain. Preoperative, postoperative, 8th-hour, and 24th-hour blood samples were routinely collected from patients, with 2 mL of sample material used each time. After the necessary centrifugation processes, the relevant laboratory team analyzed the xanthurenic acid levels (ng/mL).
次要结局
- Pulse Rate (beats per minute)(Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery)
- Respiratory Rate (breaths per minute)(Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery)
- Comorbidity Assessment in Relation to Pain and Tryptophan Metabolites(Preoperative anamnesis process: Prior to surgery, during patient assessment, Follow-up: Through study completion, an average of 1 year)
- Anesthesia duration and surgery times(During surgery)
- Height of Investigator(Preoperative: During the preoperative anamnesis process)
- Gender of Investigator(Preoperative: During the preoperative anamnesis process)
- Systolic Blood Pressure (mmHg)(Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery)
- Diastolic Blood Pressure (mmHg)(Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery)
- Anesthesia induction drugs(During anesthesia procedure)
- Oxygen Saturation (%)(Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery)
- Nature of Postoperative Pain Assessed by the McGill Pain Questionnaire (MPQ)(Preoperative: Before surgery; Postoperative 8th-hour: 8 hours after surgery;Postoperative 24th-hour: 24 hours after surgery)
- Age of Investigator(Preoperative: During the preoperative anamnesis process)
- Body Mass Index (BMI) of Investigator(Preoperative: During the preoperative anamnesis process)
- Weight of Investigator(Preoperative: During the preoperative anamnesis process)
研究者
Yunus Çelik, MD
Principal Investigator
Dokuz Eylul University