Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative changes in various acute phase proteins (transferrin, albumin, prealbumin, orosomucoid, haptoglobin, IgA, IgG, and IgM), plasma glucose, and cortisol were studied in twelve otherwise healthy premenopausal women undergoing elective hysterectomy during either general anaesthesia or epidural analgesia (T4-S5). The results showed a 10-20% decrease of all proteins during the first postoperative day (p less than 0.05), followed by a gradual, significant increase of orosomucoid to 80% and of haptoglobin to 140% above preoperative levels on day seven after surgery in both groups. The other proteins remained significantly decreased during the second postoperative day, but returned to preoperative levels by day seven after surgery in both groups. Epidural analgesia blocked the normal postoperative increase in plasma glucose and cortisol. Plasma levels of transferrin, albumin, prealbumin, IgA, IgG, and IgM were significantly lower during the first postoperative day in the epidural group. It is concluded that postoperative changes in acute phase proteins are mediated by factors other than neurogenic stimuli and adrenal hormones.
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PMID:Release mechanisms of postoperative changes in various acute phase proteins and immunoglobulins. 694 1

Frequently fluid may be aspirated from epidural catheters during epidural anesthesia/analgesia. This fluid may be either cerebrospinal fluid or local anesthetic. Several methods for differentiation of the two fluids have been recommended. In this study, the reliability of the "glucose test" was analyzed. Epidural catheters were inserted into 43 healthy, nondiabetic parturients and then gently aspirated. Aspirate was tested for glucose using glucose oxidase paper. Positive aspirates were assessed for the presence of prealbumin, which is a protein marker for cerebrospinal fluid. Of the patients undergoing cesarean section, 17 of 27 patients yielded a glucose-positive aspirate, and of the patients undergoing labor analgesia, 6 of 16 patients were found to be positive for glucose. None of these patients developed total spinal anesthesia or postdural puncture headache. Visually, none of the aspirates were significantly blood-tinged, blood being a possible source of glucose. When the glucose-positive aspirates were subjected to immunoelectrophoresis, 6 of 7 aspirates revealed a prealbumin band. In conclusion, the glucose test for cerebrospinal fluid may be misleading. The source of this glucose may be normal cerebrospinal fluid drainage into the epidural space.
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PMID:Glucose in epidural catheter aspirate. 845 64

The objective demonstration of improved postoperative recovery suggests that the surgical injury response induced by the laparoscopic approach is less intensive than that after open surgery. Twenty-five patients diagnosed as having noncomplicated gallstones were studied prospectively. They were operated by laparoscopy (group I, n = 12) or open surgery (group II, n = 13). Analgesia requirements (p < 0.026) and postoperative stay (p < 0.001) were significantly less in group 1. Cholecystectomy performed by either technical options induced a significant increase over basal values of glucose, lactate, white blood cell count, prolactin, ACTH, cortisol, interleukin 6, C-reactive protein, and PCO2. Both surgical procedures induced a significant reduction of total proteins, albumin, prealbumin, free fatty acids hemoglobin, hematocrit, and pH. There were no differences between the levels of growth hormone, insulin, glucagon, or PO2 during any of the periods studied. Comparison of the results of the two cholecystectomy techniques showed that laparoscopic cholecystectomy induced a significantly less intensive acute-phase response (area under the curve) of interleukin 6 (17 +/- 17 versus 47 +/- 26 pg/ml x hr x 10(2); p < 0.003), C-reactive protein (16 +/- 12 versus 35 +/-16 mg/dl x hr x 10; p < 0.004), and prealbumin (16 +/- 2.7 versus 13.8 +/- 2.3 mg/dl x hr x 10(2); p < 0.05). The surgical injury response after laparoscopic cholecystectomy is similar to that after open cholecystectomy, but the aeute-phase response component is less intense. This finding may be a consequence of the reduced size of the operative wound with laparoscopic cholecystectomy.
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PMID:Acute phase is the only significantly reduced component of the injury response after laparoscopic cholecystectomy. 866 26