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Perioperative magnesium infusion and postoperative pain.

BACKGROUND: NMDA receptor activation is considered one of the mechanisms involved in postoperative pain and hypersensitivity. Magnesium is the physiological blocker of the NMDA-receptor-complex-associated calcium ionophore. The aim of this study was to determine if a pre-, intra- and postoperative infusion of magnesium would reduce postoperative pain. METHODS: In a prospective, randomised, double-blinded and placebo-controlled study, 24 patients undergoing elective hysterectomy in standardised general anaesthesia received a 5 h infusion of either placebo or magnesium laevulinate (initial bolus 8 mmol: then 8 mmol/h) starting with induction of anaesthesia. Postoperative analgesia was by PCA morphine for the first 48 h and patients were followed for 5 d with regular assessment of pain and side-effect scores. RESULTS: Overall, pain scores were similar with magnesium and placebo infusion, although patients in the magnesium group experienced more episodes of severe or unbearable pain (placebo = 6%, magnesium = 16%, P = 0.02). Median pain scores were higher in the magnesium group only at 3 h postoperatively (P = 0.04): afterwards there were no significant differences. Except for the first postoperative hour (placebo = 12.8 +/- 4.7 mg, magnesium = 9.3 +/- 3.2 mg, P = 0.04), cumulative morphine consumption was similar. Gastrointestinal complication rates and patient satisfaction were similar in both groups. CONCLUSIONS: Perioperative magnesium infusion does not improve postoperative analgesia. At the doses used in this study, the use of magnesium is associated with short-term decreases in postoperative analgesia.

Adult↗

Electromyographic changes in automechanics with increased heavy metal levels.

Twenty automechanics possessing increased whole blood values of one or more of the following heavy metals; chromium, copper, lead, manganese and nickel, were studied for peripheral nerve affection by means of electromyography (both sensoric and motoric nerve potentials were recorded). The heavy metal contents were related to the findings of denervation, distal motor latency, distal sensory latency, motoric and sensoric conduction velocities. Apart from two workers, in whom only lead was assayed, the remaining group of 18 were assayed for all heavy metals under study. Six workers showed increased distal motor and/or sensory latency and seven decreased nerve conduction velocity (four motoric and three sensoric affections). Of the workers with nerve affection, three showed increased levels of lead (nickel and chromium also raised). Four workers showed increased lead, nickel and chromium and one of lead, chromium and manganese. All in all, 10 out of 20 workers (50 percent) with elevated lead levels showed definite signs of peripheral neuropathy and seven out of 14 with raised nickel values showed these signs but they could all be accounted for by the increased lead levels. All except seven workers with raised lead levels in the whole group showed values above the critical limit of 80.0 mug/100 ml in whole blood. The data argue for the highly toxic effect of lead and other heavy metals on the peripheral nervous system and stress the diverse toxic exposure which automechanics undergo during their work. The possibility of there being a synergistic action between heavy metals and components of mineral oil and petroleum is discussed.

Action Potentials↗

Bile pigment formation in plants.

The unicellular alga Cyanidium caldarium evolves carbon monoxide during the syntheis of the bile pigment, phycocyanobilin. Carbon monoxide and phycocyanobilin were produced in stoichiometric amounts at comparable rates. Therefore, the mechanism of bile pigment formation in this plant parallels that in mammals.

Bile Pigments↗

Linkage of genes controlling the rate of synthesis and structure of aminolevulinate dehydratase.

The rate of synthesis of delta-aminolevulinate dehydratase in mice is controlled by alleles at the levulinate (Lv) locus. Two structural mutations modifying the sensitivity of delta-aminolevulinate dehydratase to heat have been identified. Genetic analyses established that the structural locus for delta-aminolevulinate dehydratase was either physically close to or identical with the locus that controls its rate of synthesis.

Alleles↗

Biosynthesis of natural products.

The experimental verification of a proposed biosynthetic pathway for a given natural product is often difficult to obtain with the use of the whole organism (permeability factors) or, in the case of higher plants, a cell-free system. Until the purified enzyme for each step of biosynthesis is available, biosynthetic studies can, however, be carried out, albeit with modest incorporation values, by means of either hydroponic or injection methodology. Where viable seed sources are available it is suggested that improvements of several orders of magnitude in incorporation can be achieved by a short-term incubation (small pool size of precursors; trapping of reactive intermediates) or a long-term feeding (equilibration of precursor with the compartmentalized or induced synthetases). In bacterial, fungal, mammalian, and plant systems, where incorporation efficiencies provide the opportunity to study (13)C enrichment (at least equal to natural abundance of the isotope), we can expect a rapid expansion since the method removes the tedium of carbon-by-carbon degradation. For the next few years, however, the prognosis would seem to favor parallel studies of (13)C and (2)H, and of (14)C/(3)H ratio techniques since the last-mentioned method provides more information concerning the stereoselectivity of labeling processes on the microgram scale.

Alkaloids↗