P-012 - A Systematic Review of the Effectiveness of Turmeric in Post-Procedural Pain Reduction

Abstract Title: A Systematic Review of the Effectiveness of Turmeric in Post-Procedural Pain Reduction

Background: Turmeric has been used as a medicinal herb for centuries and has recently grown in popularity. The biochemically active compound of turmeric is curcumin, a β diketone that gives turmeric its anti-inflammatory properties. Curcumin may interact in an additional endogenous opioid pathway shown in rat studies. Previous systematic reviews and meta-analyses suggest turmeric supplementation can be as effective as NSAIDs in decreasing arthritic pain and inflammation through COX-2 inhibition and reduction of oxidative stress. However, no systematic reviews or meta-analyses have been completed regarding the use of curcumin specifically in post-procedural pain management.

Purpose/Objectives: The purpose of this systematic review was to assess randomized controlled trials that compared the effectiveness of turmeric in reducing pain levels vs placebo or in addition to other medications used for post-procedural pain control, such as NSAIDs, acetaminophen, or opioids. Turmeric has been shown to be effective in reducing arthritic pain due to its anti inflammatory properties, but its effectiveness in reducing acute post-procedural pain has not been established.

Methods: Databases searched were Cochrane, EMBASE, Cinhal, PubMed, ScienceDirect, and Web of Science up to and including August 2023 using keywords "turmeric", "surgery" and pain. Inclusion criteria included randomized control studies, studies in or translated into English, and studies could include other herbal supplements used in conjunction with turmeric, but the dosage of turmeric needed to be reported. Exclusion criteria included animal studies, studies not available in English, unavailable full research articles, and unknown or unreported dosage of turmeric. A total of 4,366 abstracts were returned. After applying exclusion criteria, we screened 35 research articles. After screening, six research articles were eligible.

Results: Each research article was reviewed for funding, study design, dosage, and timing of turmeric, type of surgery, pain levels, and complications. Evidence from these six articles suggests that there is no significant reduction in post-operative pain with the administration of turmeric in the post-operative pain management plan compared to standard post-operative pain management medications administered alone. The studies included in the study, unfortunately, did not utilize a consistent time frame in the collection of pain data, so we were unable to compare all six studies at the same points post-surgery. Due to the small number of studies, a reliable meta-analysis was unable to be performed.

Conclusions/Implications for future research and/or clinical care: Although turmeric has well-established anti-inflammatory properties, this systematic review suggests that there is no significant reduction of post-operative pain with the use of turmeric as compared to standard post-operative pain management alone. Larger and more rigorous studies would be useful, with the same post-operative pain scale used in conjunction with consistent time points status post-surgery. In the future when enough studies are available, a meta-analysis would also be beneficial to qualitatively assess the effects of turmeric on acute post-operative pain.

References: 1. Sharifi-Rad J, Rayess YE, Rizk AA, Sadaka C, Zgheib R, Zam W, Sestito S, Rapposelli S, Neffe-Skocinska K, Zielinska D, Salehi B, Setzer WN, Dosoky NS, Taheri Y, El Beyrouthy M, Martorell M, Ostrander EA, Suleria HAR, Cho WC, Maroyi A, Martins N. Turmeric and Its Major Compound Curcumin on Health: Bioactive Effects and Safety Profiles for Food, Pharmaceutical, Biotechnological and Medicinal Applications. Front Pharmacol. 2020 Sept 15;11:01021. doi: 10.3389/fphar.2020.01021. PMID: 33041781; PMCID:PMC7522354.

2. Zhao G, Shi Y, Gong C, Liu T, Nan W, Ma L, Wu Z, Da C, Zhou K, Zhang H. Curcumin Exerts Antinociceptive Effects in Cancer-Induced Bone Pain via an Endogenous Opioid Mechanism. Front Neurosci. 2021 Sept 3;15:696861. doi: 10.3389/fnins.2021.696861. PMID: 34539332; PMCID: PMC8446608