Plasma Concentrations of Immunoreactive Beta-Endorphin and Substance P in Patients Undergoing Surgery under General vs Spinal Anaesthesia

Janicki, Piotr K.; Erskine, R.; Watt, Michael

doi:10.1055/s-2007-1002061

Cited by 12 publications

(3 citation statements)

References 6 publications

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“…The concentration range at which morphine and DAMGO have been effective in our study is high relative to the range of serum levels of opioids in heavy users [34], as well as to the levels of endogenous opioids in patients undergoing surgery [35]. These high concentrations of morphine and DAMGO needed to inhibit osteocalcin production in our experiments make the involvement of endogenous opioids in the osteocalcin decrease found in stressful situations unlikely.…”

Section: Discussionmentioning

confidence: 84%

Expression of Opioid Receptors in Osteoblast-Like MG-63 Cells, and Effects of Different Opioid Agonists on Alkaline Phosphatase and Osteocalcin Secretion by These Cells

Pérez‐Castrillón¹,

Olmos²,

Gómez

et al. 2000

Neuroendocrinology

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We have previously shown that several stressful situations associated with tissue injury determine a decrease in serum osteocalcin concentration. Since reduced osteocalcin production is a marker of decreased osteoblastic activity, this finding could be related to the pathogenesis of osteoporosis secondary to some diseases. Endogenous opioids are involved in stress response. Proenkephalin-derived peptides have been shown to inhibit alkaline phosphatase activity, another marker of bone formation, in the murine cell line ROS-17/2.8. On the other hand, serum osteocalcin has been reported as being low in heroin abusers. We have therefore thought it of interest to study the presence of opioid receptors in the human osteoblast-like cell line MG-63, and to evaluate the effects of different opioid agonists on the secretion of alkaline phosphatase and osteocalcin by these cells. The presence of opioid receptors was studied by means of RT-PCR and immunohistochemistry. RT-PCR studies suggested the presence of specific mRNA for the three types of receptors, and immunohistochemistry clearly showed their occurrence. Osteocalcin synthesis was significantly inhibited by high concentrations of the mu agonists morphine and (D-Ala²,N-MePhe⁴,Gly⁵-ol)-enkephalin although no changes were seen with the delta agonist (D-Ala²,D-leu⁵)-enkephalin. Morphine-induced osteocalcin inhibition was abolished when osteoblastic cells were incubated simultaneously with naloxone, whereas it was potentiated when cells were preincubated with naloxone. None of the opioid agonists modified the secretion of alkaline phosphatase. In conclusion, human osteoblast-like cells MG-63 express the three types of opioid receptors. Endogenous opioids may be involved in the reduction of osteocalcin observed in stressful situations associated with tissue injury.

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Section: Discussionmentioning

confidence: 84%

Expression of Opioid Receptors in Osteoblast-Like MG-63 Cells, and Effects of Different Opioid Agonists on Alkaline Phosphatase and Osteocalcin Secretion by These Cells

Pérez‐Castrillón¹,

Olmos²,

Gómez

et al. 2000

Neuroendocrinology

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“…Für die Durchführung von Operationen am Hüftgelenk sind grundsätzlich regionale Verfahren ebenso wie Allgemeinnarkosen geeignet. Gleichwohl haben die unterschiedlichen Verfahren spezifische Vor-und Nachteile (12,13,21,23,33,46,(50)(51)(52)67,97,99,109,110,112,113), die in Tab. 3 zusarnrnengefaßt werden.…”

Section: Das Idealec' Anästhesieverfahrenunclassified

Hüfttotalendoprothesen - Besonderheiten aus anästhesiologischer Sicht

Ullrich¹,

Holz²,

Krier³

1994

Anästhesiol Intensivmed Notfallmed Schmerzther

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Total hip replacement is a frequently practised operation. Depending on age, circumstances and individual assessment, cemented, non-cemented and hybrid forms are used. Apart from general risks, such as vascular and/or neural injuries, thrombosis and infections, there are specific risks, depending on the surgical technique. If cemented systems are used, the anesthesiologist must be on the alert in respect of a possible multi-causal cardiopulmonary depression during the implantation of the prosthesis. Incidents may be reduced or moderated by measures such as reduction of pressure from the femoral cavity or anesthetic measures such as avoidance of N2O during or after cementation, use of anti-histamines, etc., but there is no absolute protection from severe reactions by the cardiopulmonary system. In these cases it is imperative to recognise and treat hypoxic conditions immediately, whatever the cause, such as cardiac or pulmonary depression. If a non-cemented hip replacement is used or a revision is necessary the main problem is usually a higher blood loss. Especially in such cases it is necessary to apply a well-organised sequence of blood-saving methods to protect patients from the general risks of homologous blood transfusion. Even though the main concern of the public is the possibility of contamination of donor blood with the AIDS virus, transmission of hepatitis C virus is a much more common problem. Depending on the diagnostic methods the occurrence of thrombosis after total hip replacement has been reported to be as much as 55%. To minimise this high incidence, sufficient prophylaxis, adequate fluid therapy, suitable anesthetic techniques and cutting down on the duration of the operation should be taken into account. The use of low molecular weight heparins has certain advantages. If deep vein thrombosis has occurred, therapy consists of anticoagulation with intravenous heparin and immobilisation. A rare but severe complication is a deep hip prosthetic infection. More than 50% of infections are caused by coagulase-negative staphylococci and anaerobic bacteria. To avoid sepsis it is imperative to employ adequate high-dosage antibiotics, revisional surgery and, if necessary, even excision arthroplasty. There is no "ideal" anesthesiological method for total hip replacement. Regional techniques as well as general anesthesia have their specific pros and cons which are controversially discussed in respect of their priority. To achieve early diagnosis of embolism, especially in the case of high risk patients, the exigency of extensive haemodynamic monitoring as well as Doppler-ultrasound is discussed.(ABSTRACT TRUNCATED AT 400 WORDS)

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“…The site of surgery was the only factor investigated here which was responsible for this increment. An effective blockade of the afferent input has been proposed in several reports [21,26,32] for different types of surgery and can therefore be legitimately proposed as the appropriate strategy also in this instance. However, other factors not covered here may have determined the increment of b-endorphin, for example in the pre-operative period.…”

mentioning

confidence: 99%

Increase of Plasmatic β-Endorphin Immunoreactive Material in Children in the Perioperative Period: The Influence of the Site of Surgery

Bachiocco¹,

Mastrolia²,

Gentili³

et al. 2008

Eur J Pediatr Surg

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Plasma Concentrations of Immunoreactive Beta-Endorphin and Substance P in Patients Undergoing Surgery under General vs Spinal Anaesthesia

Cited by 12 publications

References 6 publications

Expression of Opioid Receptors in Osteoblast-Like MG-63 Cells, and Effects of Different Opioid Agonists on Alkaline Phosphatase and Osteocalcin Secretion by These Cells

Expression of Opioid Receptors in Osteoblast-Like MG-63 Cells, and Effects of Different Opioid Agonists on Alkaline Phosphatase and Osteocalcin Secretion by These Cells

Hüfttotalendoprothesen - Besonderheiten aus anästhesiologischer Sicht

Increase of Plasmatic β-Endorphin Immunoreactive Material in Children in the Perioperative Period: The Influence of the Site of Surgery

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