Skip to main content
Top
Published in: Surgical Endoscopy 12/2011

01-12-2011

Efficacy of turmeric (curcumin) in pain and postoperative fatigue after laparoscopic cholecystectomy: a double-blind, randomized placebo-controlled study

Authors: Krishna Adit Agarwal, C. D. Tripathi, Brij B. Agarwal, Satish Saluja

Published in: Surgical Endoscopy | Issue 12/2011

Login to get access

Abstract

Objective

Better patient-reported outcomes (PROs) of laparoscopic cholecystectomy (LC) are premised upon PROs such as postoperative pain and fatigue. These PROs are indices of convalescence and return to normal activity. Curcumin (turmeric) is used in India for traumatic pain and fatigue for its anti-inflammatory/antioxidant and tissue modulation/healing properties. We studied the effect of curcumin on pain and postoperative fatigue in patients of LC.

Methods and procedures

From July to September 2009, 50 consecutive day-care LC candidates were enrolled for a prospective, double-blind randomized placebo-controlled study. A uniform general anesthesia and analgesia protocol was followed. Curcumin/placebo and rescue analgesic were prescribed at discharge. Patients were told to maintain pain/fatigue/adverse event diaries based upon 100-point visual analog pain scale (VAS) and 10-point interval rating fatigue scale (IRS). Patients were followed up at third day (D3), first week (W1), second week (W2), and third week (W3). The blind labels were opened at the end of study.

Results

Demographic characteristics, comorbidity, and gallbladder pathology profiles were comparable in the study (n = 25) and control groups (n = 25). There was no adverse surgical outcome, adverse PRO or withdrawal. Pain and fatigue scores at D3 were similar in the two groups. At W1 and W2, the study group showed significantly lower (p value 0.000) mean pain scores, i.e., 15 ± 5.204 versus 30 ± 13 in controls. Fatigue scores at W1, W2, and W3 were significantly lower (p value 0.000) in the study group, i.e., 2.16 ± 1.748, 1, and 0, respectively, versus 5.16 ± 1.375, 4.20 ± 1.633, and 1 in controls. All patients were pain free at W3. Analgesic tablet usage was significantly lower (p value 0.000) in the study group, i.e., 6.96 ± 1.837 versus 39.32 ± 16.509 in controls.

Conclusions

Turmeric (curcumin) improves postoperative pain- and fatigue-related PROs following LC.
Literature
1.
go back to reference Topal B, Peeters G, Verbert A, Penninckx F (2007) Outpatient laparoscopic cholecystectomy: clinical pathway implementation is efficient and cost effective and increases hospital bed capacity. Surg Endosc 21:1142–1146PubMedCrossRef Topal B, Peeters G, Verbert A, Penninckx F (2007) Outpatient laparoscopic cholecystectomy: clinical pathway implementation is efficient and cost effective and increases hospital bed capacity. Surg Endosc 21:1142–1146PubMedCrossRef
2.
go back to reference Tang B, Hanna GB, Joice P, Cuschieri A (2004) Identification and categorization of technical errors by Observational Clinical Human Reliability Assessment (OCHRA) during laparoscopic cholecystectomy. Arch Surg 139:1215–1220PubMedCrossRef Tang B, Hanna GB, Joice P, Cuschieri A (2004) Identification and categorization of technical errors by Observational Clinical Human Reliability Assessment (OCHRA) during laparoscopic cholecystectomy. Arch Surg 139:1215–1220PubMedCrossRef
3.
go back to reference Bisgaard T, Klarskov B, Rosenberg J, Kehlet H (2001) Factors determining convalescence after uncomplicated laparoscopic cholecystectomy. Arch Surg 136:917–921PubMedCrossRef Bisgaard T, Klarskov B, Rosenberg J, Kehlet H (2001) Factors determining convalescence after uncomplicated laparoscopic cholecystectomy. Arch Surg 136:917–921PubMedCrossRef
4.
go back to reference Bisgaard T, Kehlet H, Rosenberg J (2001) Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg 167:84–96PubMedCrossRef Bisgaard T, Kehlet H, Rosenberg J (2001) Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg 167:84–96PubMedCrossRef
5.
go back to reference Bisgaard T (2006) Analgesic treatment after laparoscopic cholecystectomy: a critical assessment of the evidence. Anesthesiology 104:835–846PubMedCrossRef Bisgaard T (2006) Analgesic treatment after laparoscopic cholecystectomy: a critical assessment of the evidence. Anesthesiology 104:835–846PubMedCrossRef
6.
go back to reference Goel A, Kunnumakkara AB, Aggarwal BB (2008) Curcumin as “Curecumin”: from kitchen to clinic. Biochem Pharmacol 75:787–809PubMedCrossRef Goel A, Kunnumakkara AB, Aggarwal BB (2008) Curcumin as “Curecumin”: from kitchen to clinic. Biochem Pharmacol 75:787–809PubMedCrossRef
7.
go back to reference Anand P, Thomas SG, Kunnumakkara AB, Sundaram C, Harikumar KB, Sung B, Tharakan ST, Misra K, Priyadarsini IK, Rajasekharan KN, Aggarwal BB (2008) Biological activities of curcumin and its analogues (Congeners) made by man and Mother Nature. Biochem Pharmacol 76:1590–1611PubMedCrossRef Anand P, Thomas SG, Kunnumakkara AB, Sundaram C, Harikumar KB, Sung B, Tharakan ST, Misra K, Priyadarsini IK, Rajasekharan KN, Aggarwal BB (2008) Biological activities of curcumin and its analogues (Congeners) made by man and Mother Nature. Biochem Pharmacol 76:1590–1611PubMedCrossRef
8.
go back to reference Agarwal BB (2011) Do dietary spices impair the patient-reported outcomes for stapled hemorrhoidopexy? A randomized controlled study. Surg Endosc 25(5):1535–1540PubMedCrossRef Agarwal BB (2011) Do dietary spices impair the patient-reported outcomes for stapled hemorrhoidopexy? A randomized controlled study. Surg Endosc 25(5):1535–1540PubMedCrossRef
9.
go back to reference Bisht S, Feldmann G, Soni S, Ravi R, Karikar C, Maitra A, Maitra A (2007) Polymeric nanoparticle-encapsulated curcumin (“nanocurcumin”): a novel strategy for human cancer therapy. J Nanobiotechnol 5:3CrossRef Bisht S, Feldmann G, Soni S, Ravi R, Karikar C, Maitra A, Maitra A (2007) Polymeric nanoparticle-encapsulated curcumin (“nanocurcumin”): a novel strategy for human cancer therapy. J Nanobiotechnol 5:3CrossRef
10.
go back to reference Reeta KH, Mehla J, Gupta YK (2009) Curcumin is protective against phenytoin-induced cognitive impairment and oxidative stress in rats. Brain Res 1301:52–60PubMedCrossRef Reeta KH, Mehla J, Gupta YK (2009) Curcumin is protective against phenytoin-induced cognitive impairment and oxidative stress in rats. Brain Res 1301:52–60PubMedCrossRef
11.
go back to reference Christensen T, Hougård F, Kehlet H (1985) Influence of pre- and intra- operative factors on the occurrence of postoperative fatigue. Br J Surg 72:63–65PubMedCrossRef Christensen T, Hougård F, Kehlet H (1985) Influence of pre- and intra- operative factors on the occurrence of postoperative fatigue. Br J Surg 72:63–65PubMedCrossRef
12.
go back to reference MacFadyen BV (1995) Outcomes in medical care—what are they? Surg Endosc 9:1213–1214PubMed MacFadyen BV (1995) Outcomes in medical care—what are they? Surg Endosc 9:1213–1214PubMed
13.
go back to reference Agarwal BB, Mahajan KC (2010) Laparoscopic biliary tract injury prevention: zero tolerance, error free performance. Surg Endosc 24:728–729PubMedCrossRef Agarwal BB, Mahajan KC (2010) Laparoscopic biliary tract injury prevention: zero tolerance, error free performance. Surg Endosc 24:728–729PubMedCrossRef
14.
go back to reference Pappas-Gogos G, Tsimogiannis KE, Zikos N, Nikas K, Manataki A, Tsimoyiannis EC (2008) Preincisional and intraperitoneal ropivacaine plus normal saline infusion for postoperative pain relief after laparoscopic cholecystectomy: a randomized double-blind controlled trial. Surg Endosc 22:2036–2045PubMedCrossRef Pappas-Gogos G, Tsimogiannis KE, Zikos N, Nikas K, Manataki A, Tsimoyiannis EC (2008) Preincisional and intraperitoneal ropivacaine plus normal saline infusion for postoperative pain relief after laparoscopic cholecystectomy: a randomized double-blind controlled trial. Surg Endosc 22:2036–2045PubMedCrossRef
15.
go back to reference Wasowicz-Kemps DK, Slootmaker SM, Kemps HM, Borel-Rinkes IH, Biesma DH, van Ramshorst B (2009) Resumption of daily physical activity after day-case laparoscopic cholecystectomy. Surg Endosc 23:2034–2040PubMedCrossRef Wasowicz-Kemps DK, Slootmaker SM, Kemps HM, Borel-Rinkes IH, Biesma DH, van Ramshorst B (2009) Resumption of daily physical activity after day-case laparoscopic cholecystectomy. Surg Endosc 23:2034–2040PubMedCrossRef
16.
go back to reference Torres K, Torres A, Staśkiewicz GJ, Chrościcki A, Loś T, Maciejewski R (2009) A comparative study of angiogenic and cytokine responses after laparoscopic cholecystectomy performed with standard- and low-pressure pneumoperitoneum. Surg Endosc 23:2117–2123PubMedCrossRef Torres K, Torres A, Staśkiewicz GJ, Chrościcki A, Loś T, Maciejewski R (2009) A comparative study of angiogenic and cytokine responses after laparoscopic cholecystectomy performed with standard- and low-pressure pneumoperitoneum. Surg Endosc 23:2117–2123PubMedCrossRef
17.
go back to reference Agarwal BB, Agarwal KA, Mahajan KC (2009) Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early results. Surg Endosc 23:242–247PubMedCrossRef Agarwal BB, Agarwal KA, Mahajan KC (2009) Prospective double-blind randomized controlled study comparing heavy- and lightweight polypropylene mesh in totally extraperitoneal repair of inguinal hernia: early results. Surg Endosc 23:242–247PubMedCrossRef
18.
19.
go back to reference Gögenur I, Bisgaard T, Burgdorf S, van Someren E, Rosenberg J (2009) Disturbances in the circadian pattern of activity and sleep after laparoscopic versus open abdominal surgery. Surg Endosc 23:1026–1031PubMedCrossRef Gögenur I, Bisgaard T, Burgdorf S, van Someren E, Rosenberg J (2009) Disturbances in the circadian pattern of activity and sleep after laparoscopic versus open abdominal surgery. Surg Endosc 23:1026–1031PubMedCrossRef
20.
go back to reference Aggarwal BB, Sung B (2009) Pharmacological basis for the role of curcumin in chronic diseases: an age-old spice with modern targets. Trends Pharmacol Sci 30:85–94PubMedCrossRef Aggarwal BB, Sung B (2009) Pharmacological basis for the role of curcumin in chronic diseases: an age-old spice with modern targets. Trends Pharmacol Sci 30:85–94PubMedCrossRef
21.
go back to reference Deeb D, Jiang H, Gao X, Al-Holou S, Danyluk AL, Dulchavsky SA, Gautam SC (2007) Curcumin [1,7-bis(4-hydroxy-3-methoxyphenyl)-1–6-heptadine-3, 5-dione; C21H20O6] sensitizes human prostate cancer cells to tumor necrosis factor-related apoptosis-inducing ligand/Apo2L-induced apoptosis by suppressing nuclear factor-kappaB via inhibition of the prosurvival Akt signaling pathway. J Pharmacol Exp Ther 321:616–625PubMedCrossRef Deeb D, Jiang H, Gao X, Al-Holou S, Danyluk AL, Dulchavsky SA, Gautam SC (2007) Curcumin [1,7-bis(4-hydroxy-3-methoxyphenyl)-1–6-heptadine-3, 5-dione; C21H20O6] sensitizes human prostate cancer cells to tumor necrosis factor-related apoptosis-inducing ligand/Apo2L-induced apoptosis by suppressing nuclear factor-kappaB via inhibition of the prosurvival Akt signaling pathway. J Pharmacol Exp Ther 321:616–625PubMedCrossRef
22.
go back to reference Gao X, Kuo J, Jiang H, Deeb D, Liu Y, Divine G, Chapman RA, Dulchavsky SA, Gautam SC (2004) Immunomodulatory activity of curcumin: suppression of lymphocyte proliferation, development of cell-mediated cytotoxicity, and cytokine production in vitro. Biochem Pharmacol 68:51–61PubMedCrossRef Gao X, Kuo J, Jiang H, Deeb D, Liu Y, Divine G, Chapman RA, Dulchavsky SA, Gautam SC (2004) Immunomodulatory activity of curcumin: suppression of lymphocyte proliferation, development of cell-mediated cytotoxicity, and cytokine production in vitro. Biochem Pharmacol 68:51–61PubMedCrossRef
23.
go back to reference Gaedeke J, Noble NA, Border WA (2005) Curcumin blocks fibrosis in anti-Thy 1 glomerulonephritis through up-regulation of heme oxygenase 1. Kidney Int 68:2042–2049PubMedCrossRef Gaedeke J, Noble NA, Border WA (2005) Curcumin blocks fibrosis in anti-Thy 1 glomerulonephritis through up-regulation of heme oxygenase 1. Kidney Int 68:2042–2049PubMedCrossRef
24.
go back to reference Rose S (2009) Darwin 200: Should scientists study race and IQ? NO: Science and society do not benefit. Nature 457:786–788PubMedCrossRef Rose S (2009) Darwin 200: Should scientists study race and IQ? NO: Science and society do not benefit. Nature 457:786–788PubMedCrossRef
25.
go back to reference Sharma S, Kulkarni SK, Agrewala JN, Chopra K (2006) Curcumin attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain. Eur J Pharmacol 536(3):256–261PubMedCrossRef Sharma S, Kulkarni SK, Agrewala JN, Chopra K (2006) Curcumin attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain. Eur J Pharmacol 536(3):256–261PubMedCrossRef
26.
go back to reference Sharma S, Chopra K, Kulkarni SK (2007) Effect of insulin and its combination with resveratrol or curcumin in attenuation of diabetic neuropathic pain: participation of nitric oxide and TNF-alpha. Phytother Res 21(3):278–283PubMedCrossRef Sharma S, Chopra K, Kulkarni SK (2007) Effect of insulin and its combination with resveratrol or curcumin in attenuation of diabetic neuropathic pain: participation of nitric oxide and TNF-alpha. Phytother Res 21(3):278–283PubMedCrossRef
27.
go back to reference Maes M, Mihaylova I, Bosmans E (2007) Not in the mind of neurasthenic lazybones but in the cell nucleus: patients with chronic fatigue syndrome have increased production of nuclear factor kappa beta. Neuro Endocrinol Lett 28(4):456–462PubMed Maes M, Mihaylova I, Bosmans E (2007) Not in the mind of neurasthenic lazybones but in the cell nucleus: patients with chronic fatigue syndrome have increased production of nuclear factor kappa beta. Neuro Endocrinol Lett 28(4):456–462PubMed
28.
go back to reference Tajik H, Tamaddonfard E, Hamzeh-Gooshchi N (2007) Interaction between curcumin and opioid system in the formalin test of rats. Pak J Biol Sci 15:2583–2586CrossRef Tajik H, Tamaddonfard E, Hamzeh-Gooshchi N (2007) Interaction between curcumin and opioid system in the formalin test of rats. Pak J Biol Sci 15:2583–2586CrossRef
29.
go back to reference Tajik H, Tamaddonfard E, Hamzeh-Gooshchi N (2008) The effect of curcumin (active substance of turmeric) on the acetic acid-induced visceral nociception in rats. Pak J Biol Sci 11(2):312–314PubMedCrossRef Tajik H, Tamaddonfard E, Hamzeh-Gooshchi N (2008) The effect of curcumin (active substance of turmeric) on the acetic acid-induced visceral nociception in rats. Pak J Biol Sci 11(2):312–314PubMedCrossRef
30.
go back to reference Mittal N, Joshi R, Hota D, Chakrabarti A (2009) Evaluation of antihyperalgesic effect of curcumin on formalin-induced orofacial pain in rat. Phytother Res 23(4):507–512PubMedCrossRef Mittal N, Joshi R, Hota D, Chakrabarti A (2009) Evaluation of antihyperalgesic effect of curcumin on formalin-induced orofacial pain in rat. Phytother Res 23(4):507–512PubMedCrossRef
31.
go back to reference Yeon KY, Kim SA, Kim YH, Lee MK, Ahn DK, Kim HJ, Kim JS, Jung SJ, Oh SB (2010) Curcumin produces an antihyperalgesic effect via antagonism of TRPV1. J Dent Res 89(2):170–174PubMedCrossRef Yeon KY, Kim SA, Kim YH, Lee MK, Ahn DK, Kim HJ, Kim JS, Jung SJ, Oh SB (2010) Curcumin produces an antihyperalgesic effect via antagonism of TRPV1. J Dent Res 89(2):170–174PubMedCrossRef
32.
go back to reference Agarwal BB (2008) Journey of the carbon-literate and climate-conscious endosurgeon having a head, heart, hands, and holistic sense of responsibility. Surg Endosc 22:2539–2540PubMedCrossRef Agarwal BB (2008) Journey of the carbon-literate and climate-conscious endosurgeon having a head, heart, hands, and holistic sense of responsibility. Surg Endosc 22:2539–2540PubMedCrossRef
Metadata
Title
Efficacy of turmeric (curcumin) in pain and postoperative fatigue after laparoscopic cholecystectomy: a double-blind, randomized placebo-controlled study
Authors
Krishna Adit Agarwal
C. D. Tripathi
Brij B. Agarwal
Satish Saluja
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 12/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-1793-z

Other articles of this Issue 12/2011

Surgical Endoscopy 12/2011 Go to the issue