DOI: 10.4103/ija.ija_27_26 ISSN: 0019-5049

Modulation of mRNA expression of OXTR gene following the use of ultrasound-guided transversalis fascial plane block for prevention of chronic persistent postsurgical pain following caesarean delivery: A pilot study

Geetanjali T. Chilkoti, Diksha Gaur, Anju Gupta, Neha Tawar, Brijesh K. Mishra
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ABSTRACT

Background and Aims:

Chronic persistent postsurgical pain (CPSP) after caesarean delivery may occur in up to 18% of patients. Transversalis fascia plane block (TFPB) provides effective analgesia after caesarean delivery. Oxytocin (OXT) may influence pain perception through its receptor ( OXTR ). This study evaluated modulation of OXTR gene expression following TFPB and its association with CPSP.

Methods:

This pilot subanalysis of a prospective, randomised study included American Society of Anesthesiologists physical status I–III patients scheduled for lower-segment caesarean delivery under subarachnoid block. Group C received wound infiltration, whereas Group T received bilateral TFPB. Blood samples were collected preoperatively and 14 weeks postoperatively to assess OXTR gene expression.

Results:

Sixty patients (30 per group) were analysed for OXTR gene expression. Cycle threshold (Ct) values were obtained for OXTR and GAPDH , a normaliser gene. The mean delta Ct (ΔCt) was calculated as the difference between their mean Ct values. At 14 weeks, ΔCt was − 1.61 [standard deviation (SD): 0.84] [95% confidence interval (CI): −1.92, −1.30] in Group C and − 2.41 (SD: 0.72) (95% CI: −2.68, −2.14) in Group T, mean difference 0.80 (95% CI: 0.40, 1.20; P = 0.001; df = 58). In Group T, ΔCt correlated positively with Numeric Rating Scale-Pain at 14 weeks (r = 0.622; 95% CI: 0.337, 0.802; P < 0.001; df = 28). Fold change in OXTR expression was greater in Group T.

Conclusion:

TFPB was associated with upregulation of OXTR gene expression. Because ΔCt is inversely related to expression, its positive correlation with pain intensity indicates that lower OXTR expression is associated with greater pain intensity.

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