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https://www.readbyqxmd.com/read/29346227/refractory-pain-management-in-amyloid-associated-peripheral-neuropathy
#1
Nafisseh S Warner, James C Watson, Markus A Bendel, Susan M Moeschler
OBJECTIVE: Systemic amyloidosis is a disease that often involves multiple organ systems, including the peripheral nervous system. Patients may present with severe, refractory neuropathic pain; however, the optimal treatment approach for pain for these patients remains unclear. CASE REPORT: A man with severe, refractory neuropathic pain in his bilateral upper and lower extremities and the trunk secondary to amyloid neuropathy is presented. Multiple medication trials, including neuropathic and opioid agents, produced considerable adverse effects and minimal relief...
January 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29332567/nociceptin-orphanin-fq-peptide-nop-receptor-modulators-an-update-in-structure-activity-relationships
#2
Carlo Mustazza, Stefano Pieretti, Francesca Marzoli
Nociceptin /Orphanin FQ Peptide" receptor (NOPr) is a G-protein-coupled receptor with the nociceptin/orphanin FQ peptide (N/OFQ) as endogenous agonist. It is expressed in the nervous system as well as in some non-neural tissues. Its activation has pronociceptive effect at the supraspinal level, whereas at the spinal level it produces nociceptive effects at low doses and antinociceptive effects at higher doses. NOPr is also involved in mood and blood pressure regulation, immunoregulation, airway constriction, feeding, urination, bowel motility, learning and memory...
January 10, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29318865/-advances-in-acupuncture-mechanism-research-on-the-changes-of-synaptic-plasticity-pain-memory-for-chronic-pain
#3
Yi-Ling Yang, Jian-Peng Huang, Li Jiang, Jian-Hua Liu
Previous studies have shown that there are many common structures between the neural network of pain and memory, and the main structure in the pain network is also part of the memory network. Chronic pain is characterized by recurrent attacks and is associated with persistent ectopic impulse, which causes changes in synaptic structure and function based on nerve activity. These changes may induce long-term potentiation of synaptic transmission, and ultimately lead to changes in the central nervous system to produce "pain memory"...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29315129/relative-contributions-of-adductor-canal-block-and-intrathecal-morphine-to-analgesia-and-functional-recovery-after-total-knee-arthroplasty-a-randomized-controlled-trial
#4
Abhijit Biswas, Anahi Perlas, Meela Ghosh, KiJinn Chin, Ahtsham Niazi, Barjind Pandher, Vincent Chan
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia may enhance early rehabilitation after orthopedic surgery. This randomized double-blind trial investigates the relative contributions of adductor canal block and low-dose intrathecal morphine (ITM) to postoperative analgesia and functional recovery after total knee arthroplasty. METHODS: Two-hundred one patients undergoing elective unilateral total knee arthroplasty under spinal anesthesia were randomized to 3 groups...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#5
RANDOMIZED CONTROLLED TRIAL
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29298517/histamine-h1-receptor-antagonists-facilitate-electroacupuncture-analgesia
#6
Jaung-Geng Lin, Yu-Chen Lee, Cheng-Hao Tu, Iona MacDonald, Hsin-Yi Chung, Sih-Ting Luo, Shih-Ya Hung, Yi-Hung Chen
This study investigated the influence of the histamine H1 receptor antagonists, chlorpheniramine (CHL) and pyrilamine, on the analgesic effects of acupuncture in mice. Nociceptive response was evaluated by the acetic acid-induced abdominal writhe test. Electroacupuncture (EA) at bilateral ST36 reduced the manifestations of acetic acid-induced abdominal writhing, whereas needle insertion without electrostimulation had no such effect. Notably, EA treatment was not associated with any analgesic effects in mice pretreated with naloxone...
January 3, 2018: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/29288142/patient-reported-outcome-measures-utility-for-predicting-spinal-surgery-in-an-integrated-spine-practice
#7
James R Babington, Alicia Edwards, Anna Wright, Taitea Dykstra, Andrew S Friedman, Rajiv K Sethi
BACKGROUND: For the majority of patients, spinal surgery is an elective treatment. The decision as to when and if to pursue surgery is complicated and influenced by a myriad of factors including pain intensity and duration, impact on functional activities, referring physician recommendation and surgeon preference. By understanding the factors that lead a patient to choose surgery we may better understand the decision making process, improve outcomes, and provide more effective care. OBJECTIVE: To investigate the relationship between patient-reported outcome measures (PROMs) at initial physiatry clinic consultation and subsequent decision to pursue surgical treatment...
December 26, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29284862/comparison-of-enhancement-of-analgesic-effect-of-intrathecal-neostigmine-by-intrathecal-clonidine-and-transdermal-nitroglycerin-patch-on-bupivacaine-spinal-anesthesia
#8
Mathew V Mammen, Manoj Tripathi, Harish C Chandola, Amit Tyagi, Prateek Singh Bais, Om Prakash Sanjeev
Background: Relief of pain is very important goal intraoperatively and postoperatively. Neostigmine has been used successfully intrathecally with other agents such as clonidine and opioids for pain relief. Aims: This study aims to compare and evaluate the efficacy and safety of combining intrathecal (IT) neostigmine with IT clonidine and transdermal nitroglycerin (tNTG) patch for the relief of pain in patients after surgery. Settings and Design: This was a randomized, prospective, and comparative study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284849/comparison-of-the-efficacy-and-safety-of-morphine-and-fentanyl-as-adjuvants-to-bupivacaine-in-providing-operative-anesthesia-and-postoperative-analgesia-in-subumblical-surgeries-using-combined-spinal-epidural-technique
#9
Owais Mushtaq Shah, Kharat Mohammad Bhat
Introduction: The combined spinal epidural (CSE) technique involves intentional subarachnoid blockade and epidural catheter placement during the same procedure to combine their individual best features, to reduce the total drug dosage and avoid their respective disadvantages. The addition of opioids to local anesthetics (bupivacaine) for CSE anesthesia (CSEA) is increasingly common to enhance the block. Neuraxial fentanyl is more potent and has shorter duration of action than morphine which provides prolonged anesthesia and analgesia, however at the cost of increased incidence of adverse effects like delayed respiratory depression...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284839/-comparison-of-nalbuphine-hydrochloride-and-fentanyl-as-an-adjuvant-to-bupivacaine-for-spinal-anesthesia-in-lower-abdominal-surgeries-a-randomized-double-blind-study
#10
Umesh N Prabhakaraiah, Archana B Narayanappa, Shivakumar Gurulingaswamy, Krishna Kempegowda, Kiran A Vijaynagar, Nagarajaiah B Hanumantharayappa, Diwakar S Ramegowda
Background and Aims: Opioids have been favored as adjuvants to local anesthetics during spinal anesthesia. Nalbuphine, a μ-receptor antagonist and ĸ-receptor agonist, seems to be a suitable adjuvant to local anesthetics. The aim of this study was to compare postoperative analgesia and adverse effects of nalbuphine and fentanyl when used as an adjuvant to hyperbaric bupivacaine during spinal anesthesia. Materials and Methods: Sixty patients belonging to the American Society of Anesthesiologists Physical Status I and II were randomly allocated into two groups of thirty each...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29278605/erector-spinae-plane-block-for-surgery-of-the-posterior-thoracic-wall-in-a-pediatric-patient
#11
Maria Alejandra Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn Chin
OBJECTIVE: Historically, regional anesthesia for surgery on the posterior thoracic wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior thoracic wall. We report the use of the ESP block for this clinical application in a pediatric patient. CASE REPORT: A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4-T7 dermatomes...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29276474/experimental-gene-therapy-with-serine-histogranin-and-endomorphin-1-for-the-treatment-of-chronic-neuropathic-pain
#12
Stanislava Jergova, Catherine E Gordon, Shyam Gajavelli, Jacqueline Sagen
The insufficient pain relief provided by current pharmacotherapy for chronic neuropathic pain is a serious medical problem. The enhanced glutamate signaling via NMDA receptors appears to be one of the key events in the development of chronic pain. Although effective, clinical use of systemic NMDA antagonists is limited by adverse effects such as hallucinations and motor dysfunction. Opioids are also potent analgesics but their chronic use is accompanied by tolerance and risk of addiction. However, combination of NMDA antagonists and opioids seems to provide a stable pain relieve at subthreshold doses of both substances, eliminating development of side effects...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/29261544/mu-opioid-receptors-in-ganglia-but-not-in-muscle-mediate-peripheral-analgesia-in-rat-muscle-pain
#13
Ana Bagues, María Isabel Martín, Alejandro Higuera-Matas, Jesús Esteban-Hernández, Emilio Ambrosio, Eva María Sánchez-Robles
BACKGROUND: Previous studies have demonstrated the participation of peripheral μ-opioid receptors (MOR) in the antinociceptive effect of systemically administered morphine and loperamide in an orofacial muscle pain model, induced by hypertonic saline, but not in a spinally innervated one, in rats. In this study, we determine whether this peripheral antinociceptive effect is due to the activation of MOR localized in the muscle, ganglia, or both. METHODS: To determine the local antinociceptive effect of morphine and loperamide, 2 models of acute muscle pain (trigeminal and spinal) were used...
December 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29249383/neuropathic-pain-and-sci-identification-and-treatment-strategies-in-the-21st-century
#14
REVIEW
Maya N Hatch, Timothy R Cushing, Gregory D Carlson, Eric Y Chang
Pain is a common complication in patients following spinal cord injury (SCI), with studies citing up to 80% of patients reporting some form of pain. Neuropathic pain (NP) makes up a substantial percentage of all pain symptoms in patients with SCI and is often complex. Given the high prevalence of NP in patients with SCI, proper identification and treatment is imperative. Indeed, identification of pain subtypes is a vital step toward determining appropriate treatment. A variety of pharmacological and non-pharmacological treatments can be undertaken including antiepileptics, tricyclic antidepressants, opioids, transcranial direct current stimulation, and invasive surgical procedures...
January 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29248528/feasibility-safety-and-efficacy-of-subcutaneous-peripheral-nerve-field-stimulation-for-the-treatment-of-refractory-low-back-pain-a-two-year-single-center-study
#15
Basem Ishak, Benito Campos, Heike Brunn, Andreas W Unterberg, Rezvan Ahmadi
Chronic low back pain is challenging to treat. Minimal invasive neurostimulation therapies, such as subcutaneous peripheral nerve field stimulation (SPNS), improve pain relief and quality of life,. The goal of the present study was to assess the usefulness, safety, and efficacy of SPNS in patients with chronic low back pain (CLBP). Twenty-six consecutive patients with CLBP were prospectively included in the study. For trial neurostimulation, two electrodes were implanted vertically at a depth of 1 cm into the subcutaneous tissue, ≤ 10 cm from the region of maximum pain...
December 14, 2017: Neuroscience
https://www.readbyqxmd.com/read/29245271/metastatic-esophageal-cancer-presenting-as-shock-by-injury-of-vagus-nerve-mimicking-baroreceptor-reflex-a-case-report
#16
Kenji Tsuchihashi, Tomoyasu Yoshihiro, Tomomi Aikawa, Kenta Nio, Kotoe Takayoshi, Taku Yokoyama, Mitsuhiro Fukata, Shuji Arita, Hiroshi Ariyama, Yukiko Shimizu, Yuichiro Yoshida, Takehiro Torisu, Motohiro Esaki, Keita Odashiro, Hitoshi Kusaba, Koichi Akashi, Eishi Baba
RATIONALE: Neurogenic shock is generally typified by spinal injury due to bone metastases in cancer patients, but continuous disturbance of the vagus nerve controlling the aortic arch baroreceptor can cause shock by a reflex response through the medulla oblongata. PATIENT CONCERNS: A 43-year-old woman with dysphagia presented to our hospital. Computed tomography showed a primary tumor adjacent to and surrounding half the circumference of the descending aorta, and multiple cervical lymph node metastases, including a 55 × 35-mm lymph node overlapping the root of the left vagus nerve...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29245259/efficacy-of-pudendal-nerve-block-for-alleviation-of-catheter-related-bladder-discomfort-in-male-patients-undergoing-lower-urinary-tract-surgeries-a-randomized-controlled-double-blind-trial
#17
Li Xiaoqiang, Zhang Xuerong, Liu Juan, Bechu Shelley Mathew, Yin Xiaorong, Wan Qin, Luo Lili, Zhu Yingying, Luo Jun
BACKGROUND: Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29244102/association-of-opioid-usage-with-spinal-cord-stimulation-outcomes
#18
Ashwini D Sharan, Jonathan Riley, Steven Falowski, Jason E Pope, Allison T Connolly, Edward Karst, Nirav Dalal, David A Provenzano
Study Design: Observational study using insurance claims. Objective: To quantify opioid usage leading up to spinal cord stimulation (SCS) and the potential impact on outcomes of SCS. Setting: SCS is an interventional therapy that often follows opioid usage in the care continuum for chronic pain. Methods: This study identified SCS patients using the Truven Health MarketScan databases from January 2010 to December 2014...
December 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29233569/continuous-adductor-canal-blocks-provide-superior-ambulation-and-pain-control-compared-to-epidural-analgesia-for-primary-knee-arthroplasty-a-randomized-controlled-trial
#19
Erdan Kayupov, Kamil Okroj, Adam C Young, Mario Moric, Timothy J Luchetti, Gilat Zisman, Asokumar Buvanendran, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Adductor canal blocks (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty. METHODS: Following institutional review board approval, 145 patients were randomized to 1 of 3 groups: combined spinal-epidural (CSE), spinal + continuous ACB (CACB), or general + CACB...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29225780/the-decision-to-delivery-interval-in-emergency-caesarean-sections-impact-of-anaesthetic-technique-and-work-shift
#20
Anette Hein, David Thalen, Ylva Eriksson, Jan G Jakobsson
Background: One important task of the emergency anaesthesia service is to provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS). A Decision to Delivery Interval (DDI) <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA), spinal anaesthesia (SPA) with opioid supplementation, or "top-up" of labour epidural analgesia (tEDA) with local anaesthesia and fentanyl mixture) and work shift for ECS at Danderyds Hospital, Sweden...
2017: F1000Research
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