ASA: Pain Patients Often Deficient in Vitamin D

Clinical correlates include higher doses of morphine and longer duration of morphine use

THURSDAY, Oct. 18 (HealthDay News) -- Vitamin D deficiency is common in patients who are treated for chronic pain and may be associated with an increased need for opioids and a poorer prognosis, according to research presented this week at the annual meeting of the American Society of Anesthesiologists in San Francisco.

W. Michael Hooten, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues measured serum vitamin D levels in 267 patients who were admitted to a pain center in 2006. They defined an inadequate level as equal to or less than 20 ng/mL.

The researchers found that 69 (26 percent) of the patients had inadequate vitamin D levels. Among the 140 patients who used opioids, they found that 38 had inadequate levels. Compared to opioid users with adequate vitamin D levels, the investigators found that opioid users with inadequate levels used more morphine (a mean of 133.5 mg/day versus 70 mg/day), had a longer duration of morphine use (a mean of 71.1 months versus 43.8 months), and were more likely to report low levels of health and physical functioning.

"The prevalence and clinical correlates identified in this pilot study provide the basis for the ascertainment that vitamin D inadequacy may represent an under-recognized source of nociception and impaired neuromuscular functioning among patients with chronic pain," the authors conclude. "Moreover, prospective trials are warranted to assess the effects of vitamin D repletion on pain outcomes and physiological measures of neuromuscular functioning among patients with chronic pain and comorbid vitamin D inadequacy."


Physician's Briefing