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Expert Pearls

Surgery - Alpha-ketoglutarate

Alpha-ketoglutarate (AKG) 7.2 g and 5-hydroxymethylfurfural (5-HMF) 720 mg per day (SANOPAL), given in three single doses a day just before breakfast, lunch and dinner (lung cancer). [Eur J Cardiothorac Surg, 2007 Nov;32(5):776-82. Epub 2007 Sep 4. 46255 (07/2008)] Summary Interview

Surgery - anxiety, inflammation, melatonin, pain, sleep - 50788

Melatonin given perioperatively between 2-10 mg in a single or multiple doses throughout the day, up to possibly 300 mg/kg/bw, has analgesic, anxiolytic, anti-inflammatory and sleep normalizing effects, and an excellent safety profile, any of which may significantly improve quality of life in surgical patients. [Anaesthesia. 2014 Oct;69(10):1163-71. 50788 (5/2105)] Interview PubMed

Surgery - Glutamine

Glutamine 20-30 gm/d P.O. or I.V. for catabolic state. [J Nutr, 2001:2569S-2577S. 38827 (2003)] Summary Interview

Surgery - Glutamine - 2

Glutamine, a non-essential amino acid, under stress helps maintain gut barrier function, which prevents bacterial translocation and possible multi-organ system failure. [Nutrition, Sept/Oct 1994;10(5): 385-391. 21498 (1995)] Summary Interview

Surgery - magnesium - 50118

Magnesium sulphate (50 mg/kg in 100 ml saline over 10 min followed by a continuous infusion of 20 mg/kg/h) decreased blood loss; provided a better surgical condition; prolonged activated partial thromboplastin time; increased heart rate and lowered mean arterial pressure in microscopic disc surgery. [Anaesthesia, 2011 Dec;66(12):1140-5. 50118 (9/2012)] Interview PubMed

Surgery - N-acetylcysteine

N-acetylcysteine (NAC) I.V. at 50 mg/kg bolus 1 hour pre-operatively (CABG and/or valve surgery) and then at 50 mg/kg/d for the next 48 hours reduced atrial fibrillation. [Eur Heart J, 2008; 29(5): 625-31. 46319 (08/2008)] Summary Interview

Surgery - Omega-3 fatty acid therapy

Omega-3 fatty acid therapy is beneficial in reducing the incidence and severity of multiple organ failure; improving recovery from trauma; reducing the incidence of infectious complications; decreasing the cachectic effect of pancreatic malignancy; decreasing inflammatory conditions; decreasing the clinical severity scores of inflammatory bowel conditions such as ulcerative colitis; reducing the incidence of rejection in kidney transplant patients and prolongation of allograft survival. [Nutrition, 1998;14(7/8): 627-633. 30632 (1999)] Summary Interview

Surgery - Selenium

Selenium should be assessed and low serum levels should be replaced with 200-1000 mcg of selenium which can reduce complications and oxidative stress. [Biological Trace Element Research, 1995;50:149-155. 23738 (1995)] Summary Interview
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