{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T03:15:55Z","timestamp":1775099755089,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009757","name":"H.K.H. Kronprinsessan Lovisas F\u00f6rening f\u00f6r Barnasjukv\u00e5rd","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009757","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008352","name":"Stiftelsen Samariten","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Alpha\u20101\u2010acid glycoprotein is an acute\u2010phase protein with a high affinity for amide local anesthetics. Compared to adults, neonates have lower concentrations of this glycoprotein in plasma, and are therefore at higher risk of developing local anesthetic toxicity. Alpha\u20101\u2010acid glycoprotein concentrations rise in adults after surgery as a response to stress as well as in inflammatory conditions. Previous studies have shown that concentrations of alpha\u20101\u2010acid\u2010glycoprotein in neonates vary postpartum, influenced by gestational age and mode of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aims to determine the concentrations of alpha\u20101\u2010acid glycoprotein pre\u2010 and postoperatively in neonates undergoing major surgery. This information is important for determining safe and effective dosage of local anesthetic in this vulnerable group of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective observational study, 25 neonates (median 3\u2009days of age) undergoing major surgery were included. Blood sampling was performed preoperatively and at four occasions postoperatively. Alpha\u20101\u2010acid\u2010glycoprotein plasma concentrations were analyzed using an immunoturbidimetric assay. Mann\u2013Whitney <jats:italic>U<\/jats:italic> test, Kruskal\u2013Wallis and Spearman ranking correlation test were used for the statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher plasma concentrations of alpha\u20101\u2010acid\u2010glycoprotein were found 48\u2009h postoperatively compared to preoperatively [median (inter\u2010quartile range) 0.815\u2009g\u2009L<jats:sup>\u22121<\/jats:sup> (0.663\u20130.983\u2009g\u2009L<jats:sup>\u22121<\/jats:sup>) vs. 0.300\u2009g\u2009L<jats:sup>\u22121<\/jats:sup> (0.205\u20130.480\u2009g\u2009L<jats:sup>\u22121<\/jats:sup> <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001)], respectively. It was not possible to detect any influence of sex, postnatal age, gestational age, or delivery mode on alpha\u20101\u2010acid\u2010glycoprotein concentrations in our data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Alpha\u20101\u2010acid\u2010glycoprotein concentrations increase in neonates as a response to surgery regardless of gestational age, sex, or mode of delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14672","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T11:29:46Z","timestamp":1681730986000},"page":"571-576","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Alpha\u20101\u2010acid glycoprotein and its potential impact on local anesthetic dose in neonates"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2679-3358","authenticated-orcid":false,"given":"Camilla","family":"Linnarsson","sequence":"first","affiliation":[{"name":"Department of Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Bartocci","sequence":"additional","affiliation":[{"name":"Department of Neonatology Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn A.","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Staffan","family":"Eksborg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"von Horn","sequence":"additional","affiliation":[{"name":"Division of Clinical Chemistry, Department of Laboratory Medicine Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Anell","family":"Olofsson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198711193172105"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)10316-0"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2011.10.008"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2004.11.002"},{"key":"e_1_2_12_6_1","first-page":"211","article-title":"The European Society of Regional Anaesthesia and Pain Therapy\/American Society of Regional Anesthesia and Pain Medicine recommendations on local anesthetics and adjuvants dosage in pediatric regional anesthesia","volume":"43","author":"Suresh S","year":"2018","journal-title":"Reg Anesth Pain 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