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intrathecal morphine

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https://www.readbyqxmd.com/read/29773484/the-effect-of-a-single-intraoperative-dose-of-intravenous-dexamethasone-8-mg-on-post-cesarean-delivery-analgesia-a-randomized-controlled-trial
#1
U Ituk, K Thenuwara
BACKGROUND: A single perioperative dose of dexamethasone has been shown to improve postoperative analgesia and reduce opioid consumption. However, this analgesic and opioid sparing effect has not been well assessed as part of a multimodal analgesic regimen in women post-cesarean delivery. METHODS: Healthy women having cesarean delivery under spinal anesthesia were randomly assigned to receive intravenous dexamethasone 8 mg or placebo after delivery and clamping of the umbilical cord...
March 26, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29596830/liposome-encapsulated-clodronate-specifically-depletes-spinal-microglia-and-reduces-initial-neuropathic-pain
#2
Yi-Rui Wang, Xiao-Fang Mao, Hai-Yun Wu, Yong-Xiang Wang
Liposome-encapsulated clodronate (LEC) is a specific depletor of macrophages. Our study characterized the LEC depletory effects, given intrathecally, on spinal microglia and assessed its effects on initiation and maintenance of neuropathic pain. Measured by using the MTT assay, LEC treatment specifically inhibited cell viability of cultured primary microglia, but not astrocytes or neurons, from neonatal rats, with an IC50 of 43 μg/mL. In spinal nerve ligation-induced neuropathic rats, pretreatment (1 day but not 5 days earlier) with intrathecal LEC specifically depleted microglia (but not astrocytes or neurons) in both contralateral and ipsilateral dorsal horns by the same degree (63% vs...
March 28, 2018: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29593735/involvement-of-macrophage-inflammatory-protein-1-family-members-in-the-development-of-diabetic-neuropathy-and-their-contribution-to-effectiveness-of-morphine
#3
Ewelina Rojewska, Magdalena Zychowska, Anna Piotrowska, Grzegorz Kreiner, Irena Nalepa, Joanna Mika
Current investigations underline the important roles of C-C motif ligands in the development of neuropathic pain; however, their participation in diabetic neuropathy is still undefined. Therefore, the goal of our study was to evaluate the participation of macrophage inflammatory protein-1 (MIP-1) family members (CCL3, CCL4, CCL9) in a streptozotocin (STZ)-induced mouse model of diabetic neuropathic pain. Single intrathecal administration of each MIP-1 member (10, 100, or 500 ng/5 μl) in naïve mice evoked hypersensitivity to mechanical (von Frey test) and thermal (cold plate test) stimuli...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29570548/intrathecal-baclofen-therapy-prior-to-spinal-fusion-for-patients-with-gross-motor-function-classification-system-iv-v-cerebral-palsy
#4
Kristin Buxton, Rachel Difazio, Ann Morgan, Margaret McCabe, Peter W Forbes
BACKGROUND: Patients with Gross Motor Function Classification System (GMFCS) IV-V cerebral palsy (CP) have significant spasticity and frequently develop scoliosis. Intrathecal baclofen (ITB) pumps are effective in managing spasticity. The effect of ITB therapy on the postoperative course following spinal fusion in patients with GMFCS IV-V CP has not been described. This study sought to compare postoperative recovery, including complications, in patients using ITB therapy with those with no ITB therapy...
March 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29544720/pruritus-after-intrathecal-morphine-for-cesarean-delivery-incidence-severity-and-its-relation-to-serum-serotonin-level
#5
M Aly, A Ibrahim, W Farrag, K Abdelsalam, H Mohamed, A Tawfik
BACKGROUND: Pruritus is the most common side effect of intrathecal morphine, especially in parturients. The exact mechanism is not clear and many possible mechanisms have been suggested. Among these is the activation of the 5-hydroxytryptamine sub-type-3 receptors by intrathecal morphine. METHODS: Forty parturients who underwent elective cesarean delivery under spinal anesthesia were divided into two groups of 20 each in this prospective, randomized study. Both groups received an intrathecal injection of 0...
February 16, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29543644/intrathecal-drug-delivery-systems-for-refractory-pancreatic-cancer-pain-observational-follow-up-study-over-an-11-year-period-in-a-comprehensive-cancer-center
#6
Gabriel Carvajal, Denis Dupoiron, Valerie Seegers, Nathalie Lebrec, François Boré, Pierre-Yves Dubois, Damien Leblanc, Thierry Delorme, Sabrina Jubier-Hamon
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death in Europe and the United States. Studies have demonstrated that patients with pancreatic cancer have a high prevalence of pain, with rates varying from 47% to 82%. Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. METHODS: The IDDS for pancreatic cancer pain was a follow-up observational study designed to evaluate 11-year results of IDDS for refractory pancreatic cancer pain at the Institut de Cancérologie de L'Ouest, Paul Papin in France...
March 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29542370/role-of-primary-care-physicians-in-intrathecal-pain-management-a-narrative-review-of-the-literature
#7
Gladstone C McDowell, Joseph Winchell
OBJECTIVES: The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misuse and overdose. It is important for PCPs to be aware of pain management strategies other than systemic opioid dose escalation when patients with chronic pain fail to respond to conservative therapies and to initiate a multimodal treatment plan...
March 28, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29500928/exchange-factor-directly-activated-by-camp-pkc%C3%AE%C2%B5-signalling-mediates-chronic-morphine-induced-expression-of-purine-p2x3-receptor-in-rat-dorsal-root-ganglia
#8
Wenying Wang, Xiaqing Ma, Limin Luo, Min Huang, Jing Dong, Xiaoli Zhang, Wei Jiang, Tao Xu
BACKGROUND AND PURPOSE: The P2X3 receptor is a major receptor in the processing of nociceptive information in dorsal root ganglia. We investigated the role of the P2X3 receptor and the detailed mechanisms underlying chronic morphine-induced analgesic tolerance in rats. EXPERIMENTAL APPROACH: Repeated i.t. morphine treatment was used to induce anti-nociceptive tolerance. The expression of spinal P2X3 receptor, phosphorylated PKCε and exchange factor directly activated by cAMP (Epac) were evaluated...
May 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29486720/intrathecal-morphine-administration-reduces-postoperative-pain-and-peripheral-endocannabinoid-levels-in-total-knee-arthroplasty-patients-a-randomized-clinical-trial
#9
Martin Kaczocha, Syed Azim, James Nicholson, Mario J Rebecchi, Yong Lu, Tian Feng, Jamie L Romeiser, Ruth Reinsel, Sabeen Rizwan, Shivam Shodhan, Nora D Volkow, Helene Benveniste
BACKGROUND: The primary goal of this study was to determine whether administration of intrathecal morphine reduces postoperative pain. The secondary goal was to determine the effect of intrathecal morphine upon circulating levels of the weakly analgesic endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and the related lipids palmitoylethanolamide (PEA) and oleoylethanolamide (OEA). METHODS: Forty two total knee arthroplasty (TKA) patients were enrolled in a prospective, double-blinded, randomized study...
February 27, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29480977/unique-intradural-inflammatory-mass-containing-precipitated-morphine-confirmatory-analysis-by-lesa-ms-and-maldi-ms
#10
Alexander J Kim, Sankha Basu, Carolyn Glass, Edgar L Ross, Nathalie Agar, Qing He, David Calligaris
Opioids are often used for analgesia via continuous intrathecal delivery by implantable devices. A higher concentration and daily dose of opioid have been postulated as risk factors for intrathecal granuloma formation. We present a 42-year-old female patient with chronic abdominal pain from refractory pancreatitis, with an intrathecal drug delivery device implanted 21 years prior, delivering continuous intrathecal morphine. After many years without concerning physical signs or complaints, with gradual increases in daily morphine dose, she presented with rapidly progressive neurologic deficits, including lower extremity, bladder, and bowel symptoms...
February 26, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29478715/validated-chromatographic-method-for-the-simultaneous-determination-of-eight-drugs-morphine-ropivacaine-bupivacaine-baclofen-clonidine-sufentanil-fentanyl-and-ziconotide-for-intrathecal-analgesia
#11
J Sorrieul, J Robert, V Gibory, M Collet, M Boutet, H Kieffer, C Folliard, D Dupoiron, C Devys
Intrathecal analgesia has increased over the past two decades in various indications: chronic refractory pain from cancerous or non-cancerous origins, spasticity. These different indications involve the use of different molecules alone or in combination such as morphine, ropivacaine, bupivacaine, fentanyl, sufentanil, clonidine, baclofen and ziconotide. Pump refills are prepared at the pharmacy under a laminar flow hood. An analytical control should be carried out before release of the preparation. A new method of analytical control by chromatography has been developed and validated according to the International Conference on Harmonization guideline in order to secure the production process...
May 2018: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29474216/anesthesia-and-analgesia-for-gynecological-surgery
#12
Allana Munro, Ana Sjaus, Ronald B George
PURPOSE OF REVIEW: High-quality analgesia has been linked to improved patient satisfaction as well as improved short-term and long-term postoperative outcomes. Acute surgical pain is a modifiable risk factor for development of chronic postoperative pain, which is reported by up to 26% of gynecologic surgical patients. In other surgical populations, multimodal analgesia has shown improved pain control and decreased reliance on opioids. This review examines recent evidence for various analgesic modalities applied specifically to the gynecologic surgical population...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29465625/spinal-bromodomain-containing-protein-4-contributes-to-neuropathic-pain-induced-by-hiv-glycoprotein-120-with-morphine-in-rats
#13
Keiya Takahashi, Hyun Yi, Ching-Hang Liu, Shue Liu, Yuta Kashiwagi, Dennis J Patin, Shuanglin Hao
The symptoms of HIV-sensory neuropathy are dominated by neuropathic pain. Recent data show that repeated use of opiates enhances the chronic pain states in HIV patients. Limited attention has so far been devoted to exploring the exact pathogenesis of HIV painful disorder and opiate abuse in vivo, for which there is no effective treatment. Bromodomain-containing protein 4 (Brd4) is a member of the bromodomain and extraterminal domain protein (BET) family and functions as a chromatin 'reader' that binds acetylated lysines in histones in brain neurons to mediate the transcriptional regulation underlying learning and memory...
April 11, 2018: Neuroreport
https://www.readbyqxmd.com/read/29458911/pharmacogenetic-study-of-pruritus-induced-by-epidural-morphine-for-post-cesarean-section-analgesia
#14
Chia-Chi Kung, Shiou-Sheng Chen, Hong-Jyh Yang, Chih-Jun Lai, Li-Kuei Chen
OBJECTIVE: The mechanism through which neuroaxial morphine causes pruritus has not been elucidated clearly and thoroughly. MATERIALS AND METHODS: a study in 129 female parturients was conducted to investigate the effect of 14 single nucleotide polymorphisms (SNPs) on phenotype (pruritus) induced by neuroaxial (including intrathecal or epidural) morphine for cesarean section. Clinical phenotype, subjective complaints and objective observations were recorded. DNA from blood samples was used to record the SNPs...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29433962/does-intrathecal-morphine-in-spinal-anesthesia-have-a-role-in-modern-multimodal-analgesia-for-primary-total-joint-arthroplasty
#15
Jonathan W Cheah, David C Sing, Erik N Hansen, Pedram Aleshi, Thomas P Vail
BACKGROUND: Intrathecal morphine (ITM) combined with bupivacaine spinal anesthesia can improve postoperative pain, but has potential side effects of postoperative nausea/vomiting (PONV) and pruritus. With the use of multimodal analgesia and regional anesthetic techniques, postoperative pain control has improved significantly to a point where ITM may be avoided in total joint arthroplasty (TJA). METHODS: We performed a retrospective study of primary TJA patients who underwent a standardized multimodal recovery pathway and received bupivacaine neuraxial anesthesia with ITM vs bupivacaine neuraxial anesthesia alone (control)...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29416861/prevalence-and-management-of-intrathecal-morphine-induced-pruritus-in-new-zealand-m%C3%A4-ori-healthcare-recipients
#16
Jennifer M Woods, Anecita Gigi Lim
Aims and objectives: The aim of this article was to determine whether the incidence of intrathecal morphine-induced pruritus (ITMI) was influenced by ethnicity, age or gender in relation to orthopaedic versus caesarean surgeries. Background: The use of intrathecal morphine for patients undergoing total hip and knee joint replacements and for lower segment caesarean sections (LSCS) has gained popularity worldwide since its introduction over 30 years ago. Several international studies show that morphine delivered via the intrathecal route is an effective and safe method of pain relief...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29416859/applying-realistic-medicine-to-intrathecal-opioid-utilisation-in-scotland-do-we-have-a-standardised-approach
#17
Robert Hart, Gordon Burns, Susan Smith
Intrathecal opioids (ITOs) are commonly administered as part of a multimodal anaesthetic strategy for a variety of surgical procedures. The evolution of laparoscopic surgical techniques has seen the popularity of ITOs increase as they are effective, well tolerated and lack the cardiovascular side effects associated with epidural infusions. The risk of delayed respiratory depression remains a concern; therefore, high-quality post-operative monitoring is vital. The evidence regarding the practicalities of ITO administration such as opioid dose, type, side effect prevalence and ideal post-operative care arrangements are sparse...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29415719/microrna-365-alleviates-morphine-analgesic-tolerance-via-the-inactivation-of-the-erk-creb-signaling-pathway-by-negatively-targeting-%C3%AE-arrestin2
#18
Xian-Ping Wu, Rui-Xuan She, Yan-Ping Yang, Zu-Min Xing, Han-Wen Chen, Yi-Wen Zhang
BACKGROUND: Morphine is widely used in clinical practice for a class of analgesic drugs, long-term use of morphine will cause the action of tolerance. MicroRNAs have been reported to be involved in morphine analgesic tolerance.. METHODS: Forty male SD rats were selected and randomly divided into 5 groups: the control group, morphine tolerance group, miR-365 mimic + morphine (miR-365 mimic) group, miR-365 inhibitor + morphine (miR-365 inhibitor) group and miR-365 negative control (NC) + morphine (miR-365 NC) group...
February 7, 2018: Journal of Biomedical Science
https://www.readbyqxmd.com/read/29406831/contribution-of-spinal-5-ht5a-receptors-to-the-antinociceptive-effects-of-systemically-administered-cannabinoid-agonist-win-55-212-2-and-morphine
#19
Ahmet Goktan Aksu, Ozgur Gunduz, Ahmet Ulugol
The antinociceptive effects of cannabinoids and opioids have been known for centuries. Serotonin and its receptors are also known to play important roles in nociception. However, the contribution of spinal 5-HT5A receptors in antinociceptive effects of cannabinoids and opioids has not been studied. We conducted this study to clarify spinal mechanisms of the actions of the antinociceptive effects of cannabinoids and opioids. Hot-plate and tail-flick tests were used to assess the antinociceptive activity in Balb/c mice...
February 6, 2018: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/29404792/intrathecal-drug-delivery-and-spinal-cord-stimulation-for-the-treatment-of-cancer-pain
#20
REVIEW
Fangfang Xing, R Jason Yong, Alan David Kaye, Richard D Urman
PURPOSE OF REVIEW: The purpose of the present investigation is to summarize the body and quality of evidence including the most recent studies in support of intrathecal drug delivery systems and spinal cord stimulation for the treatment of cancer-related pain. RECENT FINDINGS: In the past 3 years, a number of prospective studies have been published supporting intrathecal drug delivery systems for cancer pain. Additional investigation with adjuvants to morphine-based analgesia including dexmedetomidine and ziconotide support drug-induced benefits of patient-controlled intrathecal analgesia...
February 5, 2018: Current Pain and Headache Reports
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