Paracetamol Metabolism After Liver Surgery
关键词
抽象
描述
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.
日期
最后验证: | 09/30/2014 |
首次提交: | 01/14/2013 |
提交的预估入学人数: | 01/14/2013 |
首次发布: | 01/16/2013 |
上次提交的更新: | 10/14/2014 |
最近更新发布: | 10/15/2014 |
实际学习开始日期: | 01/31/2013 |
预计主要完成日期: | 04/30/2014 |
预计完成日期: | 05/31/2014 |
状况或疾病
干预/治疗
Other: Liver resection group
相
手臂组
臂 | 干预/治疗 |
---|---|
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 |
资格标准
有资格学习的年龄 | 18 Years 至 18 Years |
有资格学习的性别 | All |
取样方式 | Probability Sample |
接受健康志愿者 | 是 |
标准 | 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. |
结果
主要结果指标
1. Urinary cysteine [Post operative days 1-4]
次要成果指标
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]
其他成果措施
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]