Paracetamol Metabolism After Liver Surgery
Ключевые слова
абстрактный
Описание
Paracetamol is normally metabolised by the glucuronidation and sulfation of paracetamol to non toxic end products. If paracetamol is administered in supra-therapeutic doses this pathway becomes saturated and an alternative pathway is utilised. This results in a toxic metabolite called N-acetyl-p-benzoquinone imine (NAPQI). If NAPQI is not metabolised by glutathione to cysteine and mercapturic acid, then NAPQI bind to hepatic cells resulting in necrosis and hepatotoxicity.
Therefore the investigators plan to measure the levels of the paracetamol metabolites in patient undergoing liver resection.
Patients will undergo liver resection according to their onco-surgical requirements. As part of the normal post operative care they will receive 1g paracetamol every six hours unless stated otherwise by the operating surgeon. Urinary samples will be taken for the first 4 post operative days and used for analysis of the urinary paracetamol metabolite levels.
Даты
| Последняя проверка: | 09/30/2014 |
| Первый отправленный: | 01/14/2013 |
| Предполагаемая регистрация отправлена: | 01/14/2013 |
| Первое сообщение: | 01/16/2013 |
| Последнее обновление отправлено: | 10/14/2014 |
| Последнее обновление опубликовано: | 10/15/2014 |
| Фактическая дата начала исследования: | 01/31/2013 |
| Предполагаемая дата завершения начальной школы: | 04/30/2014 |
| Предполагаемая дата завершения исследования: | 05/31/2014 |
Состояние или болезнь
Вмешательство / лечение
Other: Liver resection group
Фаза
Группы рук
| Рука | Вмешательство / лечение |
|---|---|
| Liver resection group Patients undergoing liver resection and receiving paracetamol (observation of routine administration) | Other: Liver resection group Normal administration of paracetamol as prescribed by operating surgeon |
Критерии приемлемости
| Возраст, имеющий право на обучение | 18 Years Чтобы 18 Years |
| Полы, имеющие право на обучение | All |
| Метод отбора проб | Probability Sample |
| Принимает здоровых добровольцев | да |
| Критерии | Inclusion Criteria: - Patients undergoing liver surgery Exclusion Criteria: - Contra-indication to paracetamol - Inability to give written, informed consent. - Jaundice (Bilirubin > 100 μmol/L). - Liver resection combined with secondary surgical procedure. - Age < 18 years. - Pregnant women. |
Результат
Основные показатели результатов
1. Urinary cysteine [Post operative days 1-4]
Меры вторичного результата
1. mercapturic acid [post operative days 1-4]
2. Glutathione [day of surgery and post operative days 1 and 3]
3. Paracetamol level [day of surgery and post operative days 1 and 3]
Другие показатели результатов
1. Glucuronamide [Post-operative days 1-4]
2. Sulphate [Post-operative days 1-4]
3. 5-oxoproline [Post-operative days 1-4]
4. Complications [Day of surgery and post-operative days 1-30]
5. Post-operative blood tests (FBC, U&E, LFTs, Coag) [Post-operative dyas 1-7]
