Two-for-One Deal with Antibiotic

Rocephin used for bacterial infections can also relieve pain after surgical procedures

(RxWiki News) It's a "twofer": who knew that a medicine used for fighting infections could also be a pain reliever for surgery? 

A new study has shown that a single dose of the antibiotic ceftriaxone (brand name Rocephin) also relieved pain in patients going under the knife for carpal tunnel syndrome.

Ceftriaxone increased all patients' pain thresholds 10-fold after surgery, these researchers found. The higher the pain threshold, the longer it takes for a person to feel pain.

"Ask your MD about pain management."

Angela Macaluso, PhD, from the Department of Medical and Surgical Sciences and Translational Medicine at University Sapienza in Rome, Italy, led a study investigating how ceftriaxone affected patients having surgery on nerves in the hand and wrist.

The study included 45 adult patients who were assigned to receive one of three intravenous solutions, including saline, ceftriaxone or the antibiotic cefazolin (brand names Ancef and Kefzol), an hour before surgery.

Ceftriaxone is often given before surgery to prevent infections during an operation. Cefazolin is an antibiotic similar to ceftriaxone but has not been shown to relieve pain.

Patients, who were between 28 and 80 years of age, had pain from at least a month and a half to as long as six months. A little more than two-thirds of the patients were women.

Patients who had other kinds of chronic pain, psychiatric or neurological disorders, or were allergic to penicillin and cephalosporins were excluded from the study.

Each patient's pain level was measured 10 minutes before the medicine injections and four to six hours after surgery. Conventional analgesics, or pain relieving medicines, of any kind were allowed in the first six hours after surgery.

Those patients who were given the saline solution received another pain reliever five to 10 minutes after the second evaluation of pain.

Patients given saline or cefazolin did not have any significant changes in pain levels prior to surgery compared to six hours after.

The potential benefit of ceftriaxone in relieving neuropathic and other kinds of chronic pain should outweigh the adverse effects with repeated usage of the medicines, according to the researchers.

"The study reports for the first time that a single preoperative dose of ceftriaxone causes [pain relief] in humans," the researchers wrote in their report. 

The medicine can also be used when severe pain is expected to develop after surgery, according to the researchers.

The authors noted a few limitations to their study. Patients' initial pain levels might have been higher because of inflammation from surgery. The patients' pain may have decreased with natural recovery time after surgery.

Further, the authors only looked at mechanical pain thresholds and did not ask patients about their own individual pain level.

The study, funded in part by the Italian Ministry of Health, was published in the June issue of The Journal of Pain. No conflicts of interest were declared.

Review Date: 
June 27, 2013