Azasetron Boosts Acute Pain Relief and Cuts Nausea Post-Surgery, Without Affecting Chronic Pain Risk: Study

The study, published in BMC Anesthesiology, showed that azasetron had no impact on the occurrence of chronic pain following pulmonary surgery. The presence of preoperative pain, drinking, smoking, and open surgery were associated with chronic pain six months after surgery.

Chronic pain after pulmonary surgery remains a significant concern, impacting patients' quality of life and recovery. Traditional pain management strategies, including opioids and non-steroidal anti-inflammatory drugs (NSAIDs), often fall short of providing adequate long-term relief and come with potential side effects. To address this issue, the study focused on azasetron, a novel compound known for its potential analgesic properties.

Xihong Ye, Hubei University of Arts and Science, Jinzhou Street, Xiangcheng District, Xiangyang, China, and colleagues tested the efficacy of azasetron, a 5-HT3 receptor antagonist, on postoperative chronic pain following pulmonary surgery in a randomized triple-blind controlled study.

The study included 250 patients who were scheduled to receive pulmonary surgery. They were randomized to patient-controlled analgesia (PCA) using 200 µg sufentanil with normal saline or 200 µg sufentanil with 20 mg azasetron.

Pain levels were measured using the numerical rating scale (NRS) at baseline and on postoperative days 1, 2, and 3, as well as at 90 and 180 days. Negative binomial regression analysis was employed to identify factors influencing NRS scores six months post-surgery.

The following were the key findings:

• Azasetron did not affect the primary outcomes: the incidence of postoperative chronic pain on POD90 and 180.
• Azasetron decreased postoperative NRS at rest and activity on POD1, 2, and 3.
• Azasetron decreased postoperative nausea and vomiting on POD1 and 2.
• Univariate and multivariate negative binomial regression analysis identified preoperative pain, smoking, drinking, and open surgery are risk factors for chronic pain six months after surgery.

"Our findings indicate that adding azasetron to PCA does not affect the incidence of postoperative chronic pain after pulmonary surgery. However, azasetron does significantly alleviate postoperative acute pain and reduces nausea and vomiting, suggesting it is a safe and effective adjunct for multimodal postoperative analgesia," the researchers wrote.

"Additionally, preoperative pain, smoking, alcohol consumption, and open surgery were identified as risk factors for postoperative chronic pain," they concluded.

Reference:

Xu, Y., Jiang, F., Shi, S. et al. Efficacy of azasetron on postoperative chronic pain after pulmonary surgery: a randomized triple-blind controlled trial. BMC Anesthesiol 24, 261 (2024). https://doi.org/10.1186/s12871-024-02653-z