Volume 26, Issue 124, June 2022

Plasma antioxidant status in patients undergoing long-term opioid treatment

Ogurčáková Daniela^1,2, Kočan Ladislav³, Šimonová Jana⁴, Martuliak Igor⁵, Sabol František⁶, Vašková Janka^2♦

¹Pain management clinic Algmed, Rastislavova 45, 04001 Košice, Slovak Republic
²Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovak Republic
³Clinic of Anaesthesiology and Intensive Care Medicine, East Slovak Institute of Cardiovascular Disease, Ondavská 8, 040 11 Košice, Slovak Republic
⁴1st Clinic of Anaesthesiology and Intensive Care Medicine, Louis Pasteur University Hospital, SNP 1, 040 11 Košice, Slovak Republic
⁵Department of Algeziology, F.D. Roosevelt Teaching Hospital with Policlinic Banská Bystrica and Slovak Medical University in Banská Bystrica, nám. Ludvika Svobodu 8, 97401 Banská Bystrica, Slovak Republic
⁶Department of Cardiac Surgery, East Slovak Institute of Cardiovascular Disease, Ondavská 8, 040 11 Košice, Slovak Republic

^♦Corresponding author
Janka Vašková, assoc. prof. Dr. PhD. Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Tr. SNP 1, 04066 Košice, Slovak Republic

ABSTRACT

Background: Opioid treatment is now an integral part of pharmacotherapy for severe chronic malignant and non-malignant pain. Currently, there is a sufficient selection of opioids to allow individualized pain treatment. Several experimental studies have confirmed the effect of opioids on oxidative stress. The aim of this work is to determine the presence of redox changes occurring as a result of long-term opioid use in patients with chronic pain. Results: Six months of opioid use for severe pain was evaluated in 37 patients. Patients formed three groups depending opioid treatment (oxycodone, fentanyl and tapentadol) and were compared with 42 healthy probands. Compared to control, activities of superoxide dismutase were decreased, while those of glutathione peroxidase and glutathione reductase were significantly increased in all groups. Together with lowered levels of reduced glutathione, this indicated conditions of oxidative stress. There were no differences between treatment groups. Conclusion: It is necessary to know the risks of side effects and provide patients with possible solutions. At this stage and with this number of subjects, we can conclude that neither the form of administration nor the type of opioid has any effect on reducing oxidative stress from opioid metabolism in the treatment of severe pain.

Keywords: antioxidant enzymes, pain, glutathione, opioids, oxidative stress

Medical Science, 2022, 26, ms217e2319

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DOI: https://doi.org/10.54905/disssi/v26i124/ms217e2319

Published: 11 June 2022