Gabapentin-induced changes of plasma cortisol level and immune status in hysterectomized women

• Published in: International immunopharmacology 2014-12, Vol.23 (2), p.530-536
• Main Authors: Karbić, Vlasta Orlić, Škoda, Marko, Antončić, Dragana, Krištofić, Ines, Komar, Daniela, Trobonjača, Zlatko
• Format: Article
• Language: English
• Subjects: Amines - administration & dosage; Amines - therapeutic use; Antigens, CD - immunology; B-Lymphocytes - drug effects; B-Lymphocytes - immunology; Catecholamines - blood; Cyclohexanecarboxylic Acids - administration & dosage; Cyclohexanecarboxylic Acids - therapeutic use; Female; Flow Cytometry; Gabapentin; gamma-Aminobutyric Acid - administration & dosage; gamma-Aminobutyric Acid - therapeutic use; Humans; Hydrocortisone - blood; Hysterectomy; Hysterectomy - psychology; Immune status; Immunomodulation; Immunomodulation - drug effects; Killer Cells, Natural - drug effects; Killer Cells, Natural - immunology; Lymphocyte Count; Pain Measurement; Pain, Postoperative - blood; Pain, Postoperative - immunology; Pain, Postoperative - prevention & control; Predictive Value of Tests; Regression Analysis; Stress, Psychological - blood; Stress, Psychological - immunology; Stress, Psychological - prevention & control
• ISSN: 1567-5769; 1878-1705
• DOI: 10.1016/j.intimp.2014.09.029

We have examined the effects of gabapentin (GBP) on stress-related changes of cortisol and catecholamines in patients who underwent hysterectomy because of uterine fibrinoids. Additionally, we have observed the effect of GBP on the immune status in the acute stress response to surgery. Sixty patients scheduled for an abdominal hysterectomy were randomly assigned to the GBP administration 1h before surgery (n=30 pts), or to the placebo group (n=30 pts). Blood samples were collected before and 24h after the surgery. The intensity of pain was assessed by a visual analogue scale (VAS) every 8h at rest. Immunomodulatory effects of GBP were determined by flow cytometry. We followed the total proportion of CD3+ lymphocytes, CD3+CD4+, CD3+CD8+, CD19+ B lymphocytes, CD16+CD56+CD3−NK cells and CD16+CD56+CD3+ NKT cells before and 24h after hysterectomy. The plasma cortisol and catecholamines concentration was used to estimate the level of the stress response. VAS pain score at rest was significantly lower in the GBP group than in the placebo group (P=0.003). Application of GBP significantly decreased the plasma cortisol level 24h after the operation in comparison to the placebo group (P