SHANGHAI / LONDON (IT BOLTWISE) – A new study shows that abstinent smokers have increased pain sensitivity during nicotine withdrawal. This sensitivity is associated with altered activity in certain brain regions. The research results could help refine preoperative guidelines and reduce the use of opioids in smokers before surgery.
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A recent study has revealed that abstinent smokers experience increased pain sensitivity during nicotine withdrawal. This sensitivity is associated with altered activity in specific brain regions. Compared to non-smokers, abstinent smokers require more postoperative pain medications, especially opioids. Pain sensitivity increases the longer you stay nicotine-free, but returns to normal after about three months.
The researchers, including Zhijie Lu from Fudan University Minhang Hospital and Kai Wei from Shanghai Eastern Hepatobiliary Surgery Hospital, examined brain activity that explains the link between nicotine withdrawal and pain sensitivity. The study included 60 male patients, 30 of whom were abstinent smokers and 30 of whom were nonsmokers, who underwent partial hepatectomy. The results showed that abstinent smokers had a lower pain threshold and higher postoperative analgesic requirements.
Neuroimaging studies revealed that there is altered brain function in abstinent smokers, including reduced amplitude of low-frequency fluctuations in the ventromedial prefrontal cortex and increased regional homogeneity in the left middle occipital gyrus. These changes could explain the increased pain sensitivity during nicotine withdrawal. The researchers emphasize that these findings are not intended to discourage people from quitting smoking before surgery, but rather to help better understand the mechanisms and develop strategies to address the clinical challenges.
The study provides new insights into the neurobiological mechanisms underlying nicotine withdrawal-induced hyperalgesia. These findings may reveal potential therapeutic targets for postoperative pain in abstinent smokers. Researchers are already working on exploring postoperative painkillers that may be more effective than opioids in abstinent smokers, as well as the effectiveness of preoperative nicotine replacement therapies.
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