Use of tyrosyl-D-arginil-phenylalanyl-glycine amide acetate in the early postoperative period in gynecological and urological cancer patients

BACKGROUND: Postoperative pain syndrome has a negative impact on all vital systems of the body, slowing down the wound healing period and creating a risk of adverse hemodynamic events, thromboembolic complications and the development of chronic pain syndrome. Tyrosyl-D-arginyl-phenylalanyl-glycine amide (TAPGA) is an innovative tetrapeptide drug for subcutaneous administration.

AIM: The aim of the study was to evaluate the efficacy and safety of TAPGA in the early postoperative period in oncological patients of gynecological and urological profile.

MATERIALS AND METHODS: The study was conducted at the Ostroverkhov Kursk Oncology Scientific and Clinical Center. A retro- and prospective analysis of 50 patients from the departments of gynecological oncology (women after hysterectomy) and urological oncology (men after prostatectomy) was performed. Two groups were formed. Patients in the first group were prescribed a combination of “TAFGAA+ketorolac” in the early postoperative period, patients in the second group received pain therapy consisting of a combination of “rimeperidine+ketorolac”. Statistical analysis of the data was performed in Excel, differences between quantitative characteristics in the study groups were assessed using the paired Student’s t-test. Statistically significant results were considered to be values of p < 0.05.

RESULTS: The pain intensity in women of the 1st group was less than in women of the group 2, there was a significantly lower visual analogue scale (VAS) score in women of the group 1 compared to the group 2. In men, there were no significant differences in the intensity of pain syndrome between the prescriptions of these drug combinations — the VAS was no more than 4 points for the entire observation period. Postoperative nausea and vomiting of varying degrees were noted in 100% of women in the group 2 and only in 33% of women in the group 1. In men, this adverse event was noted in 70% of patients in the group 2 and in 50% of the group 1. Patients were activated faster in the group 1. Hemodynamic parameters did not differ significantly in the compared groups of gynecological and urological profiles, however, 13% of female patients had arterial hypertension, which could be caused by both insufficient pain relief and the presence of concomitant hypertension. Recorded the following adverse events were reported in group 1: asthenia — 2 cases, 2 cases of headache in women and 1 case in men.

CONCLUSONS: TAFGAA in the early postoperative period provided reliable and effective analgesia with a favorable safety profile within the framework of multimodal pain relief.