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https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#1
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28806217/the-effect-of-ondansetron-on-acute-opioid-tolerance-in-patients-receiving-intrathecal-opioids-prior-to-cesarean-delivery
#2
Kevin C Greer, Abdullah S Terkawi, Siny Tsang, Priyanka Singla, Marcel E Durieux, Mohamed Tiouririne
BACKGROUND: Multiple animal studies suggest that ondansetron ameliorates opioid-induced hyperalgesia and tolerance. In this study, we aimed to determine if the administration of ondansetron prior to spinal anesthesia would have an effect on intrathecal opioid-induced acute opioid tolerance, postoperative pain, and analgesic requirements in patients undergoing cesarean delivery with spinal anesthesia. METHODS: Eighty-six patients undergoing elective cesarean delivery were recruited and randomly allocated to receive either 8 mg intravenous ondansetron (n = 44) or placebo (n = 42) in a prospective, double-blind design...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28806211/the-opiorphin-analog-str-324-decreases-sensory-hypersensitivity-in-a-rat-model-of-neuropathic-pain
#3
Alain Van Elstraete, Philippe Sitbon, Leila Hamdi, Victor Juarez-Perez, Jean-Xavier Mazoit, Dan Benhamou, Catherine Rougeot
BACKGROUND: Neuropathic pain represents a therapeutic challenge, and treatments with increased efficacy and tolerability still need to be developed. Opiorphin protects endogenous enkephalins from degradation, potentiating enkephalin-dependent analgesia via the activation of opioid pathways. Enkephalins are natural ligands of opioid receptors, with strong affinity for δ-opioid receptors. Expression of functional δ-opioid receptors increases in sensory neurons after peripheral nerve injury in neuropathic pain models...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28779916/effects-of-korean-hand-acupressure-on-opioid-related-nausea-and-vomiting-and-pain-after-caesarean-delivery-using-spinal-anaesthesia
#4
Na Young Ahn, Hye-Ja Park
OBJECTIVE: This study examined the effects of Korean hand acupressure on opioid-related nausea and vomiting, and pain after caesarean delivery. METHODS: Fifty participants were randomly assigned to an acupressure group or a control group. Korean hand acupressure discs were applied for 24 h onto 12 acupressure points (K-9, F-4 for nausea and vomiting; M-3, M-4, L-4, H-2, H-3, H-7 for abdominal pain; and I-38, J-2 for back pain). Nausea and vomiting incidences, the opioid-related symptom distress scale scores, and pain scores were analysed using chi-square test, Fisher's exact test, Mann-Whitney U test, or the repeated-measures analysis of variance...
August 2017: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/28767505/age-dependent-plasticity-in-endocannabinoid-modulation-of-pain-processing-through-postnatal-development
#5
Charlie H-T Kwok, Ian M Devonshire, Amer Imraish, Charles M Greenspon, Stevie Lockwood, Catherine Fielden, Andrew Cooper, Stephen Woodhams, Sarir Sarmad, Catherine A Ortori, David A Barrett, David Kendall, Andrew J Bennett, Victoria Chapman, Gareth J Hathway
Significant age and experience-dependent remodelling of spinal and supraspinal neural networks occur resulting in altered pain responses in early life. In adults endogenous opioid peptide and endocannabinoid (ECs) pain control systems exist which modify pain responses but the role they play in acute responses to pain and postnatal neurodevelopment is unknown. Here we have studied the changing role of the ECs in brainstem nuclei essential for the control of nociception from birth to adulthood in both rat and human...
August 1, 2017: Pain
https://www.readbyqxmd.com/read/28763410/risk-factors-for-prolonged-opioid-use-following-spine-surgery-and-the-association-with-surgical-intensity-among-opioid-naive-patients
#6
Andrew J Schoenfeld, Kenneth Nwosu, Wei Jiang, Allan L Yau, Muhammad Ali Chaudhary, Rebecca E Scully, Tracey Koehlmoos, James D Kang, Adil H Haider
BACKGROUND: There is a growing concern that the use of prescription opioids following surgical interventions, including spine surgery, may predispose patients to chronic opioid use and abuse. We sought to estimate the proportion of patients using opioids up to 1 year after discharge following common spinal surgical procedures and to identify factors associated with sustained opioid use. METHODS: This study utilized 2006 to 2014 data from TRICARE insurance claims obtained from the Military Health System Data Repository...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28763302/intramuscularly-injected-neurotropin-reduced-muscular-mechanical-hyperalgesia-induced-by-repeated-cold-stress-in-rats
#7
Teruaki Nasu, Shiori Murase, Yoshiko Takeda-Uchimura, Kazue Mizumura
An extract of rabbit skin inflamed by inoculation with the vaccinia virus, neurotropin [by intravenous, oral, and intramuscular (i.m.) administration], has been used in China and Japan for the treatment of chronic pain. In this study, we investigated the analgesic mechanism of i.m. neurotropin. Rats were exposed to repeated cold stress, and muscular mechanical hyperalgesia was evaluated by measuring the withdrawal threshold of the gastrocnemius muscle using Randall-Selitto apparatus. I.m. but not subcutaneous, neurotropin dose dependently reduced the repeated cold stress-induced muscular mechanical hyperalgesia for 3 h, but it had no effect in normal rats...
July 31, 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/28755985/peripheral-and-central-sites-of-action-for-anti-allodynic-activity-induced-by-the-bifunctional-opioid-npff-receptors-agonist-bn-9-in-inflammatory-pain-model
#8
Run Zhang, Biao Xu, Meng-Na Zhang, Ting Zhang, Zi-Long Wang, Geng Zhao, Guang-Hai Zhao, Ning Li, Quan Fang, Rui Wang
The activation of opioid and neuropeptide FF (NPFF) receptors plays important roles to modulate nociceptive signal in inflammatory pain states. Recently, BN-9 (Tyr-D.Ala-Gly-Phe-Gln-Pro-Gln-Arg-Phe-NH2) was pharmacologically characterized as a novel bifunctional agonist at both opioid and NPFF receptors. In the present study, the anti-allodynic activity and site(s) of action of BN-9 were assessed in a mouse model of carrageenan-induced inflammatory pain. In mice, BN-9 induced a dose-dependent anti-allodinic effect through opioid receptor at supraspinal or spinal level, and this effect was augmented by pretreatment with the NPFF receptor antagonist at the same level...
July 26, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28745932/genetic-deletion-of-microglial-panx1-attenuates-morphine-withdrawal-but-not-analgesic-tolerance-or-hyperalgesia-in-mice
#9
Nicole E Burma, Heather Leduc-Pessah, Tuan Trang
Opioids are among the most powerful analgesics for managing pain, yet their repeated use can lead to the development of severe adverse effects. In a recent study, we identified the microglial pannexin-1 channel (Panx1) as a critical substrate for opioid withdrawal. Here, we investigated whether microglial Panx1 contributes to opioid-induced hyperalgesia (OIH) and opioid analgesic tolerance using mice with a tamoxifen-inducible deletion of microglial Panx1. We determined that escalating doses of morphine resulted in thermal pain hypersensitivity in both Panx1-expressing and microglial Panx1-deficient mice...
July 26, 2017: Channels
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#10
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28722336/evidence-for-the-modulation-of-nociception-in-mice-by-central-mast-cells
#11
C L Kissel, K J Kovács, A A Larson
BACKGROUND: Hyperalgesia that develops following nerve ligation corresponds temporally and in magnitude with the number of thalamic mast cells located contralateral to the ligature. We tested the possibility that mast cells modulate nociception centrally, similar to their role in the periphery. METHODS: We examined the central effect of two hyperalgesic compounds that induce mast cell degranulation and of stabilized mast cells using cromolyn. RESULTS: Thermal hyperalgesia (tail flick) induced by nerve growth factor (NGF, a neurotrophic compound) and mechanical hyperalgesia (von Frey) induced by dynorphin A (1-17) (opioid compound) each correlated with the per cent of thalamic mast cells that were degranulated...
July 19, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28719458/acupuncture-for-chronic-pain-an-update-and-critical-overview
#12
Changshik Yin, Thomas E Buchheit, Jongbae J Park
PURPOSE OF REVIEW: Acupuncture is now recommended for several chronic pain conditions. Despite supportive evidence of its effectiveness, this ancient approach is often misunderstood, and may still be underused in mainstream practice. A critical review on its effectiveness and practice integration, and mechanisms of action is essential to the medical community that is continuing to seek nonopioid therapies for chronic pain. RECENT FINDINGS: Mounting evidence supports the effectiveness of acupuncture to treat chronic low back, neck, shoulder, and knee pain, as well as headaches...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28705210/transcutaneous-electrical-stimulation-of-somatic-afferent-nerves-in-the-foot-relieved-symptoms-related-to-postoperative-bladder-spasms
#13
Chanjuan Zhang, Zhiying Xiao, Xiulin Zhang, Liqiang Guo, Wendong Sun, Changfeng Tai, Zhaoqun Jiang, Yuqiang Liu
BACKGROUND: Bladder spasm is a common side effect of urological surgery. Main treatment modalities include opioids or anticholinergic medication; however, bladder spasms still occur even after these interventions. Recent studies indicate that transcutaneous stimulation of the foot can result in 50% increase in bladder capacity in healthy adults, and inhibit bladder detrusor overactivity in spinal cord injured patients. In this study, we examined the effects of transcutaneous electrical stimulation of the foot on bladder spasms related symptoms...
July 13, 2017: BMC Urology
https://www.readbyqxmd.com/read/28699350/analgesic-properties-of-opioid-nk1-multitarget-ligands-with-distinct-in-vitro-profiles-in-naive-and-chronic-constriction-injury-mice
#14
Joanna Starnowska, Roberto Costante, Karel Guillemyn, Katarzyna Popiolek-Barczyk, Nga N Chung, Carole Lemieux, Attila Keresztes, Joost Van Duppen, Adriano Mollica, John Streicher, Jozef Vanden Broeck, Peter W Schiller, Dirk Tourwé, Joanna Mika, Steven Ballet, Barbara Przewlocka
The lower efficacy of opioids in neuropathic pain may be due to the increased activity of pronociceptive systems such as substance P. We present evidence to support this hypothesis in this work from the spinal cord in a neuropathic pain model in mice. Biochemical analysis confirmed the elevated mRNA and protein level of pronociceptive substance P, the major endogenous ligand of the neurokinin-1 (NK1) receptor, in the lumbar spinal cord of chronic constriction injury (CCI)-mice. To improve opioid efficacy in neuropathic pain, novel compounds containing opioid agonist and neurokinin 1 (NK1) receptor antagonist pharmacophores were designed...
July 26, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28681962/systematic-review-of-management-of-chronic-pain-after-surgery
#15
REVIEW
V Wylde, J Dennis, A D Beswick, J Bruce, C Eccleston, N Howells, T J Peters, R Gooberman-Hill
BACKGROUND: Pain present for at least 3 months after a surgical procedure is considered chronic postsurgical pain (CPSP) and affects 10-50 per cent of patients. Interventions for CPSP may focus on the underlying condition that indicated surgery, the aetiology of new-onset pain or be multifactorial in recognition of the diverse causes of this pain. The aim of this systematic review was to identify RCTs of interventions for the management of CPSP, and synthesize data across treatment type to estimate their effectiveness and safety...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28680103/chemogenetic-silencing-of-gabaergic-dorsal-horn-interneurons-induces-morphine-resistant-spontaneous-nocifensive-behaviours
#16
Keisuke Koga, Kensho Kanehisa, Yuta Kohro, Miho Shiratori-Hayashi, Hidetoshi Tozaki-Saitoh, Kazuhide Inoue, Hidemasa Furue, Makoto Tsuda
Inhibitory interneurons in the spinal dorsal horn (SDH) are crucial for processing somatosensory information originating in the periphery. However, the effects of the acute and selective inactivation of GABAergic SDH interneurons on pain processing are not fully understood. In this study, we used designer receptors exclusively activated by designer drugs (DREADD) technology and vesicular GABA transporter-Cre (Vgat-Cre) mice to selectively express a modified human muscarinic Gi protein-coupled receptor (hM4Di) in Vgat-Cre (+) GABAergic SDH interneurons in the fourth lumbar segment...
July 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28676317/anterograde-amnesia-and-disorientation-are-associated-with-in-patients-without-traumatic-brain-injury-taking-opioids-retrograde-amnesia-ra-is-absent-ra-assessment-should-be-integral-to-post-traumatic-amnesia-testing
#17
Jessica McLellan BPsych, Laurence A G Marshman, Maria Hennessy
The Glasgow Coma Scale (GCS) only assesses orientation after traumatic brain injury (TBI). 'Post-traumatic amnesia' (PTA) comprises orientation, anterograde amnesia (AA) and retrograde amnesia (RA). However, RA is often disregarded in formalized PTA assessment. Drugs can potentially confound PTA assessment: e.g. midazolam can cause AA. However, potential drug confounders are also often disregarded in formalized PTA testing. One study of medium-stay elective-surgery orthopaedic patients (without TBI) demonstrated AA in 80% taking opiates after general anesthesia...
July 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28673713/alterations-in-opioid-inhibition-cause-widespread-nociception-but-do-not-affect-anxiety-like-behavior-in-oral-cancer-mice
#18
Yi Ye, Daniel G Bernabé, Elizabeth Salvo, Chi T Viet, Kentaro Ono, John C Dolan, Malvin Janal, Brad E Aouizerat, Christine Miaskowski, Brian L Schmidt
Widespread pain and anxiety are commonly reported in cancer patients. We hypothesize that cancer is accompanied by attenuation of endogenous opioid-mediated inhibition, which subsequently causes widespread pain and anxiety. To test this hypothesis we used a mouse model of oral squamous cell carcinoma (SCC) in the tongue. We found that mice with tongue SCC exhibited widespread nociceptive behaviors in addition to behaviors associated with local nociception that we reported previously. Tongue SCC mice exhibited a pattern of reduced opioid receptor expression in the spinal cord; intrathecal administration of respective mu (MOR), delta (DOR), and kappa (KOR) opioid receptor agonists reduced widespread nociception in mice, except for the fail flick assay following administration of the MOR agonist...
June 30, 2017: Neuroscience
https://www.readbyqxmd.com/read/28673596/intra-spinal-microstimulation-may-alleviate-chronic-pain-after-spinal-cord-injury
#19
Bin Shu, Fei Yang, Yun Guan
Chronic pain after spinal cord injury (SCI) is a form of central neuropathic pain that is debilitating and often refractory to current pharmacological treatments. Neurostimulation pain therapies, such as epidural spinal cord stimulation, have only moderate success in reducing SCI pain. The pathogenesis of SCI pain may involve a state of central neuronal hyperexcitability, especially in the spinal cord dorsal horn, that develops after injury. We hypothesize that the neuronal structures near the spinal cord injury site may be an important pain generator, and intraspinal microstimulation (ISMS) may normalize dorsal horn neuronal hyperexcitability and hence alleviate SCI pain...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28663618/postoperative-analgesia-after-panhysterectomy-addition-of-clonidine-to-bupivacaine-boon-for-the-patients
#20
Keshav Govind Rao, Aparna Shukla, Shilpi Misra
INTRODUCTION: Postoperative period after panhysterectomy is very painful as there is too much tissue handling. In the practice of regional anesthesia neuraxial, opioids have been used extensively as an adjuvant to bupivacaine to enhance the potency and duration of sensory and motor block produced by bupivacaine with satisfactory results. However, delayed respiratory depression by opioids has prompted further research to develop nonopioid analgesics. This study was undertaken to assess the degree of sensory and motor block and postoperative analgesia provided by low dose 50 μg intrathecal clonidine admixed with 0...
April 2017: Anesthesia, Essays and Researches
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