CCL2/MCP-1 level in serum of acute pain syndrome patients with wounds sustained in combat

<b>Background:</b> The aim of our study was to examine the relationship between the inflammatory response and the pain response by determining the level of C-C motif chemokine ligand 2 (CCL2)/mono-cytechemoattractant protein-1 (MCP-1) in the serum of patients with combat injuries in the perioperative period with different methods of analgesia.<br /> <b>Materials and methods:</b> The study involved 24 servicemen with gunshot wounds to extremities of various localizations due to a mine or explosive mechanism. The patients were divided into 2 groups: group 1 (n = 12)–received standard general anesthesia (with intravenous infusion of 0.005% fentanyl, morphine 1%), group 2 (n = 12)–combination of general anesthesia and infiltration anesthesia of the wound with 0.5% bupivacaine.<br /> <b>Results:</b> The plasma CCL2/MCP-1 level in the patients prior surgery averaged 19.15 ± 6.80 pg/ml pg/ml; (p < 0.05). After 12 hours in patients from group 1 there was an increase in the level of CCL2/MCP-1 in the blood plasma (3.1 times), p < 0.05, and 9.5 times 24 hours after surgery. In group 2 there wasn’t an increase in inflammatory markers after 12 hours, but after 24 hours after surgery, plasma CCL2/MCP-1 level significantly increased 3.3 times (p < 0.05). In the preoperative period the pain intensity ranked by the visual analog scale 7.8 scores, in the postoperative period, the degree of pain intensity was quantitatively the lowest in group 2.<br /> <b>Conclusions:</b> MCP-1 biomarker levels may be an indicator of the intensity of the inflammatory process and pain in the perioperative period. The CCL2/MCP-1 level is significantly influenced by the type of anesthesia.