Dmytro Dmytriiev1, Dmytriieva Kateryna1, Nazarchuk Olexandr1, Dmytriiev Kostyantyn1
Resume. It’s known, that activation of TLR-4 monocytes/macrophages, except proinflammatory cytokines, leads to output of opioid peptides from last ones, which one of the important nociceptive system mechanisms.
Materials and methods. In 24 children operated on for tumors of the abdominal cavity, was managed 20 measurements of mechanical pain threshold using of set of 10 von Frey’s monofilaments (VFMs). Pain threshold was measured at the areas around the postoperative wound. Level of toll-like receptors TLR-4 in blood serum was determined by immunoassay method by the set “Human TLR4 ELISA Kit” (NeoBiolab, USA).
Results. Using of high doses of fentanyl (2800-6200 mcg/day), for analgesia in the early postoperative period in children, can lead to hyperalgesia. Hyperalgesia in the early postoperative period was represented by an increase of TLR-4 blood level (on the 3rd day level of TLR-4 was - 12,1±1,6, ng/ml, that was significantly higher than preoperative level - 5,2±1,4, ng/ml). Analysis of graphical dependence of distribution of residuals from predicted phenomena showed no correlation between them.
Conclusions. High fentanyl doses was associated with decreased pain threshold and development of hyperalgesia, which represented with an increase of TLR-4 levels in children blood.
Key words: Hyperalgesia, toll-like receptors, postoperative period, children.