Clinical Study A Clinical Experimental Model to Evaluate Analgesic Effect of Remote Ischemic Preconditioning in Acute Postoperative Pain Francisco Elano Carvalho Pereira, 1 Irene Lopes Mello, 2 Fernando Heladio de Oliveira Medeiros Pimenta, 2 Debora Maia Costa, 2 Deysi Viviana Tenazoa Wong, 3 Claudia Regina Fernandes, 1 Roberto César Lima Junior, 3 and Josenília M. Alves Gomes 1 1 Surgery Department, Federal University of Cear´ a, Fortaleza, CE, Brazil 2 Walter Cant´ ıdio University Hospital, Fortaleza, CE, Brazil 3 Physiology and Pharmacology Department, Federal University of Cear´ a, Fortaleza, CE, Brazil Correspondence should be addressed to Josen´ ılia M. Alves Gomes; gomes.josenilia@gmail.com Received 28 February 2016; Accepted 7 June 2016 Academic Editor: Donald A. Simone Copyright © 2016 Francisco Elano Carvalho Pereira et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tis study aims to evaluate the viability of a clinical model of remote ischemic preconditioning (RIPC) and its analgesic efects. It is a prospective study with twenty (20) patients randomly divided into two groups: control group and RIPC group. Te opioid analgesics consumption in the postoperative period, the presence of secondary mechanical hyperalgesia, the scores of postoperative pain by visual analog scale, and the plasma levels interleukins (IL-6) were evaluated. Te tourniquet applying afer spinal anesthetic block was safe, producing no pain for all patients in the tourniquet group. Te total dose of morphine consumption in 24 hours was signifcantly lower in RIPC group than in the control group ( = 0.0156). Te intensity analysis of rest pain, pain during coughing and pain in deep breathing, showed that visual analogue scale (VAS) scores were signifcantly lower in RIPC group compared to the control group:  = 0.0087, 0.0119, and 0.0015, respectively. Tere were no diferences between groups in the analysis of presence or absence of mechanical hyperalgesia ( = 0.0704) and in the serum levels of IL-6 dosage over time ( < 0.0001). Tis clinical model of remote ischemic preconditioning promoted satisfactory analgesia in patients undergoing conventional cholecystectomy, without changing serum levels of IL-6. 1. Introduction Ischemic preconditioning (IPC) is defned as brief periods of ischemia, interspersed with reperfusion, prior to a sustained period of ischemia. Tis procedure is performed in order to prepare and protect the cell to the damage caused by a long period of ischemia [1]. It is a powerful innate mechanism of multiple organs protection which can be induced by transient occlusion of the blood fow of an organ. Recently, other functions, besides the protection from reperfusion injury, have been attributed to preconditioning, including promoting analgesia [2–4]. Many surgical and nonsurgical cardioprotective strategies have been developed to reduce the levels of ischemic injury, some more successful than others. In addition to its protective efects in ischemia-reperfusion injury, there is a considerable amount of evidence indicating the efects of IPC in infam- matory conditions of nonischemic nature, probably through a systemic action [5]. Te efects of infammatory cytokines have been demon- strated in relation to TNF-alpha, which has been identifed as the major mediator involved in the development of tolerance to induced IPC [6]. A reduction was observed in IL-6 and IL- 1 levels afer limb ischemia in pigs [3] and increased IL-10 levels [7, 8]. Ischemic preconditioning has been proved to be benefcial in many clinical settings, most of them involving patients undergoing invasive or long duration procedures, which may result in a relative state of ischemia. Furthermore, Hindawi Publishing Corporation Pain Research and Treatment Volume 2016, Article ID 5093870, 6 pages http://dx.doi.org/10.1155/2016/5093870