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Sobański D, Staszkiewicz R, Filipowicz M, Holiński M, Jędrocha M, Migdał M, Grabarek BO. Evaluation of the Concentration of Selected Elements in the Serum of Patients with Degenerative Stenosis of the Lumbosacral Spine. Biol Trace Elem Res 2024:10.1007/s12011-024-04083-x. [PMID: 38321303 DOI: 10.1007/s12011-024-04083-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/27/2024] [Indexed: 02/08/2024]
Abstract
In humans, 23 elements have been shown to have biological activity. The purpose of this study was to evaluate the concentrations of iron (Fe), zinc (Zn), sodium (Na), potassium (K), magnesium (Mg), phosphorus (P), and calcium (Ca) in the serum of patients diagnosed with lumbar degenerative stenosis when compared to the concentrations of those elements in the serum of healthy volunteers. The study group consisted of 60 patients who were diagnosed with degenerative stenosis of the lumbosacral spine and who qualified for hemilaminectomy. The control group included 60 healthy volunteers without degenerative spinal stenosis. The clinical specimens studied had sera collected from both groups. The quantitative analysis of the selected elements revealed statistically significant (p < 0.05) lower concentrations of Zn (740 ± 110 µg/L vs. 880 ± 160 µg/L) and Mg (22,091 ± 4256 µg/L vs. 24,100 ± 4210 µg/L) in the serum of the patients from the study group when compared to the controls. By contrast, K (16,230 µg/L ± 1210 µg/L vs. 13,210 µg/L ± 1060 µg/L) and Fe (141.87 µg/L ± 11.22 µg/L vs. 109.1 µg/L ± 26.43 µg/L) levels were significantly higher in the study group compared to the controls (p < 0.05). No statistically significant changes were detected in the concentrations of the assessed micronutrients and macronutrients in both sexes in either the study group, the control group, or those based on body mass index (p > 0.05). In the serum samples from the study group, the strongest correlations were noted between the concentrations. In the study group, we showed a significant relationship between the levels of Fe/Zn (r = 0.41), Fe/Na (r = 0.41), Fe/P (r = 0.55), Zn/P (r = 0.68), Zn/K (r = 0.48), Zn/Ca (r = 0.94), Mg/Ca (r = 0.79), and Na/K (r = 0.67). We showed that only Mg concentration varied statistically significantly with the severity of pain (p < 0.05). These findings suggest that the assessment of Fe, Zn, Mg, and K concentrations can be helpful in predicting the onset of degenerative changes in the spine.
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Affiliation(s)
- Dawid Sobański
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland.
- Collegium Medicum, WSB University, 41-300, Dabrowa Gornicza, Poland.
| | - Rafał Staszkiewicz
- Collegium Medicum, WSB University, 41-300, Dabrowa Gornicza, Poland
- Department of Neurosurgery, 5th Military Clinical Hospital with the SP ZOZ Polyclinic in Krakow, 30-901, Krakow, Poland
- Department of Neurosurgery, Faculty of Medicine in Zabrze, Academy of Silesia, 40-555, Katowice, Poland
| | - Michał Filipowicz
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Mateusz Holiński
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Maciej Jędrocha
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Marek Migdał
- Department of Neurosurgery, Szpital sw. Rafala in Krakow, 30-693, Krakow, Poland
| | - Beniamin Oskar Grabarek
- Collegium Medicum, WSB University, 41-300, Dabrowa Gornicza, Poland
- Gyncentrum, Laboratory of Molecular Biology and Virology, 40-851, Katowice, Poland
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Yazdi AP, Esmaeeli M, Gilani MT. Effect of intravenous magnesium on postoperative pain control for major abdominal surgery: a randomized double-blinded study. Anesth Pain Med (Seoul) 2022; 17:280-285. [PMID: 35918860 PMCID: PMC9346203 DOI: 10.17085/apm.22156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to evaluate the postoperative analgesic effect of magnesium sulfate during abdominal surgery. Methods This randomized double-blinded study involved 84 patients candidates for abdominal surgery into two same groups. In the magnesium group, at first 25 mg/kg/1 h magnesium sulfate; and then, 100 mg/kg/24 h was infused in the intensive care unit. The pain intensity (the primary outcome), was assessed using the numeric rating scale (NRS) every 3 h. If the NRS was > 3, morphine (as a secondary outcome) was used and evaluated. The results were analyzed using SPSS ver. 19 software, and statistical significance was set at P < 0.05 Results Demographic parameters were similar between the groups. The pain intensity were similar at first and then at the third hour in both groups (P = 0.393 and P = 0.172, respectively), but thereafter between 6 and 24 h, the pain severity was significantly lower in the magnesium group (4.4 ± 1.3 in the control and 3.34 ± 1 in the magnesium group at 6th hour and P = 0.001). In addition, morphine intake in the first 24 h in the two groups had a significant difference, with 13.2 ± 5.7 mg in control group and 8 ± 3.5 mg in magnesium group (P = 0.001). Conclusions In this study, intravenous magnesium sulfate after abdominal surgeries for 24 h resolved the pain intensity after six hours and reduced morphine dosage.
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Affiliation(s)
- Arash Peivandi Yazdi
- Department of Anesthesiology, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrdad Esmaeeli
- Department of Anesthesiology, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehryar Taghavi Gilani
- Department of Anesthesiology, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Corresponding author: Mehryar Taghavi Gilani, M.D. Department of Anesthesiology, Lung Diseases Research Center, Mashhad University of Medical Sciences, Emam Reza Hospital, Sina Ave., Mashhad 9137913316, Iran Tel: 98-5138583878, Fax: 98-5138436199 E-mail:
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Nikooseresht M, Hajian P, Moradi A, Sanatkar M. Evaluation of the Effects of Oral Magnesium Sachet on the Prevention of Spinal Anesthesia-Induced Headache After Cesarean Section: A Randomized Clinical Trial. Anesth Pain Med 2022; 12:e121834. [PMID: 35433384 PMCID: PMC8995875 DOI: 10.5812/aapm.121834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Post-dural puncture headache (PDPH) is a common complication of spinal anesthesia. It often goes away after a few days but may be more severe in some patients and persists for weeks. Objectives: This study aimed to evaluate the effect of oral magnesium on the prevention of PDPH after cesarean section for the first time. Methods: In this double-blind, randomized clinical trial, 100 candidates for elective cesarean section under spinal anesthesia were randomly divided into 2 groups: (i) the intervention group that received 300 mg of oral magnesium powder and (ii) the control group that received starch powder. The frequency and severity of headache and amount of analgesic consumption in both groups were measured 1, 2, and 3 days after cesarean section. Data were analyzed using SPSS version 22 at 95% CI. Results: The frequency of PDPH 1, 2, and 3 days after surgery was 8% vs 24% (P = 0.029), 10% vs 26% (P = 0.039), and 12% vs 18% (P = 0.401) in the intervention and control groups, respectively. The mean and SD of pain severity was 0.52 ± 1.83 vs 1.5 ± 2.84 (P = 0.03) on the first day, 0.70 ± 2.19 vs 1.58 ± 2.86 (P = 0.05) on the second day, and 0.82 ± 2.32 vs 1.18 ± 2.62 on the third day (P = 0.43) in the intervention and control groups, respectively. Although more patients in the control group received rescue analgesia, no significant difference was seen between the 2 study groups. Conclusions: In women candidates for cesarean section, oral administration of 300 mg magnesium 2 hours before surgery significantly reduces the frequency and severity of PDPH, but its impact on reducing analgesic consumption is not significant.
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Affiliation(s)
- Mahshid Nikooseresht
- Department of Anesthesiology, Clinical Research Development Unit of Fatemiyeh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Pouran Hajian
- Department of Anesthesiology, Clinical Research Development Unit of Fatemiyeh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
- Corresponding Author: Department of Anesthesiology, Clinical Research Development Unit of Fatemiyeh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. , Tel: 0098 9188114116
| | - Abas Moradi
- Department of Social Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Sanatkar
- School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Vitenson J, Starch-Jensen T, Bruun NH, Larsen MK. The use of advanced platelet-rich fibrin after surgical removal of mandibular third molars: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 51:962-974. [PMID: 35033409 DOI: 10.1016/j.ijom.2021.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/30/2021] [Accepted: 11/25/2021] [Indexed: 12/29/2022]
Abstract
The objective of this systematic review was to test the hypothesis of no difference in recovery following surgical removal of mandibular third molars with the application of advanced platelet-rich fibrin (A-PRF) in the extraction socket compared with alternative biomaterials or natural wound healing. A search of MEDLINE (PubMed), Embase, Cochrane Library, and Scopus was conducted. Human randomized controlled trials published in English up until December 31, 2020 were included. Outcome measures were pain, facial swelling, trismus, soft tissue healing, alveolar osteitis, and quality of life; these were evaluated by descriptive statistics and meta-analysis including 95% confidence intervals (CI). Four studies with a low or moderate risk of bias fulfilled the inclusion criteria. A-PRF resulted in significantly lower pain scores when compared with leucocyte platelet-rich fibrin or natural wound healing after 2 days (-16.8, 95% CI -18.9 to -14.7), 3 days (-12.1, 95% CI -13.4 to -10.7), and 7 days (-1.9, 95% CI -2.9 to -0.9). A-PRF seems to have a negligible effect on facial swelling and trismus and some beneficial effect on soft tissue healing. Alveolar osteitis and quality of life were not assessed. The included studies were characterized by considerable heterogeneity and confounding variables. Thus, the level of evidence appears to be inadequate for clinical recommendations according to the focused question.
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Affiliation(s)
- J Vitenson
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
| | - T Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - N H Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - M K Larsen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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Abstract
In terms of antinociceptive action, the main mode of action of magnesium involves its antagonist action at the N-methyl-d-aspartate (NMDA) receptor, which prevents central sensitization and attenuates preexisting pain hypersensitivity. Given the pivotal function of NMDA receptors in pain transduction, magnesium has been investigated in a variety of pain conditions. The oral and parenteral administration of magnesium via the intravenous, intrathecal, or epidural route may alleviate pain and perioperative anesthetic and analgesic requirements. These beneficial effects of magnesium therapy have also been reported in patients with neuropathic pain, such as malignancy-related neurologic symptoms, diabetic neuropathy, postherpetic neuralgia, and chemotherapy-induced peripheral neuropathy. In addition, magnesium treatment is reportedly able to alleviate fibromyalgia, dysmenorrhea, headaches, and acute migraine attacks. Although magnesium plays an evolving role in pain management, better understanding of the mechanism underlying its antinociceptive action and additional clinical studies is required to clarify its role as an adjuvant analgesic.
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