Nitrous oxide (N(2)O) reduces postoperative opioid-induced hyperalgesia after remifentanil-propofol anaesthesia in humans.

BACKGROUND: The aim of this study was to test if intraoperative administration of N(2)O during propofol-remifentanil anaesthesia prevented the onset of postoperative opioid-induced hyperalgesia (OIH). METHODS: Fifty adult ASA I-II patients undergoing elective open septorhinoplasty under general anaesthesia were studied. Anaesthesia was with propofol, adjusted to bispectral index (40-50), and remifentanil (0.30 µg kg(-1) min(-1)). Patients were assigned to one of the two groups: with N(2)O (70%) and without N(2)O (100% oxygen). Mechanical pain thresholds were measured before surgery and 2 and 12-18 h after surgery. Pain measurements were performed on the arm using hand-held von Frey filaments. A non-parametric analysis of variance was used in the von Frey data analysis. P<0.05 was considered statistically significant. RESULTS: Baseline pain thresholds to mechanical stimuli were similar in both groups, with mean values of 69 [95% confidence interval (CI): 50.2, 95.1] g in the group without N(2)O and 71 (95% CI: 45.7, 112.1) g in the group with N(2)O. Postoperative pain scores and cumulative morphine consumption were similar between the groups. The analysis revealed a decrease in the threshold value in both groups. However, post hoc comparisons showed that at 12-18 h after surgery, the decrease in mechanical threshold was greater in the group without N(2)O than the group with N(2)O (post hoc analysis with Bonferroni's correction, P<0.05). CONCLUSIONS: Intraoperative 70% N(2)O administration significantly reduced postoperative OIH in patients receiving propofol-remifentanil anaesthesia.

[Lipoprotein in children and adolescents: relationship with family history of coronary artery disease]. / Lipoproteína en niños y adolescentes: relación con historia familiar de enfermedad coronaria.

BACKGROUND: Lipoprotein (a) is considered an independent cardiovascular risk factor. AIM: To study lipoprotein (a) levels in children of 18 years old or less with or without family history of coronary artery disease. SUBJECTS AND METHODS: Forty four children aged between 3 and 18 years old with a family history of coronary artery disease and 44 age and sex matched controls were studied. A fasting blood sample was obtained to measure total, HDL and LDL cholesterol, triglycerides, A1 and B apoproteins and lipoprotein (a). RESULTS: Compared to controls, children with a family history of coronary disease had higher total cholesterol (177 +/- 35 and 159 +/- 23 mg/dl respectively), LDL cholesterol (112 +/- 34 and 94 +/- 21 mg/dl respectively), triglycerides (89 +/- 38 and 71 +/- 25 mg/dl respectively), apoprotein B (85 +/- 17 and 65 +/- 13 mg/dl respectively) and lipoprotein (a) (40 +/- 50 and 22 +/- 31 mg/dl respectively). Thirty two percent of children with positive family history had lipoprotein (a) levels over 30 mg/dl, compared to 23% of controls. CONCLUSIONS: Children with family history of coronary artery disease have higher levels of cholesterol, triglycerides and lipoprotein (a) than matched controls.

Lipoproteína en niños y adolescentes: relación con historia familiar de enfermedad coronaria / Lipoprotein in children and adolescents: relation with familiar history of coronary disease

Lipoprotein(a) is considered an independent cardiovascular risk factor. Forty four children aged between 3 and 18 years old with family history of coronary artery disease and 44 age and sex matched controls were studied. A fasting blood sample was obtained to measure total, HDL and LDL, cholesterol, triglycerides. A1 and B apoproteins and lipoprotein (a). Comparaed to controls, children with family history of coronary disease had higher total cholesterol (177ñ35 and 159ñ23 mg/dl respectively). LDL cholesterol (112ñ34 and 94ñ21 mg/dl respectively), triglycerides (89ñ38 and 71ñ25 mg/dl respectively), apoprotein B (85ñ17 and 65ñ13 mg/dl respectively), and lipoprotein (a) (40ñ50 and 23ñ31 mg/dl respectively). Thirty two percent of children with positive family history had lipoprotein (a) levels over 30 mg/dl, compared to 23 percent of controls. Children with family history of coronary artery disease have higher levels of cholesterol, triglycerides and lipoprotein (a) than matched controls