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https://www.readbyqxmd.com/read/29238167/comparison-of-dexmedetomidine-and-fentanyl-as-local-anesthetic-adjuvants-in-spinal-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
REVIEW
ShuJun Sun, JiaMei Wang, NaRen Bao, Ying Chen, Jun Wang
Purpose: To compare the effects of dexmedetomidine (Dex) and fentanyl as adjuvants to local anesthetics in spinal anesthesia. Methods: Two researchers independently searched the PUBMED, EMBASE, Cochrane library, and CBM for randomized controlled trials comparing the effects of Dex and fentanyl as adjuvants to local anesthetics for intrathecal injection. Results: A total of 639 patients from nine studies were included in this meta-analysis...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29236228/population-pharmacokinetic-pharmacodynamic-modeling-of-ropivacaine-in-spinal-anesthesia
#2
Zoubir Djerada, Catherine Feliu, Yoann Cazaubon, Faouzi Smati, Philippe Gomis, Dominique Guerrot, Beny Charbit, Olivier Fernandes, Jean-Marc Malinovsky
BACKGROUND: Ropivacaine is frequently used in spinal anesthesia but the relationship between plasma concentrations and sensory block level remains unknown. OBJECTIVE: The aim of this study was to assess the relationship between plasma ropivacaine concentrations and effects during spinal anesthesia. METHODS: Sixty patients aged between 18 and 82 years were included in this study after providing written informed consent. Patients were randomly assigned to receive intrathecal administration of ropivacaine 15, 20 or 25 mg...
December 13, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29233885/a-perspective-on-na-and-k-channel-inactivation
#3
REVIEW
Clay M Armstrong, Stephen Hollingworth
We are wired with conducting cables called axons that rapidly transmit electrical signals (e.g., "Ouch!") from, for example, the toe to the spinal cord. Because of the high internal resistance of axons (salt water rather than copper), a signal must be reinforced after traveling a short distance. Reinforcement is accomplished by ion channels, Na channels for detecting the signal and reinforcing it by driving it further positive (to near 50 mV) and K channels for then restoring it to the resting level (near -70 mV)...
December 12, 2017: Journal of General Physiology
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
#4
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/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#5
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29229558/enhanced-activities-of-%C3%AE-subunit-containing-gabaa-receptors-blocked-spinal-long-term-potentiation-and-attenuated-formalin-induced-spontaneous-pain
#6
Jiang-Ping Liu, Yong-Tao He, Xing-Lian Duan, Zhan-Wei Suo, Xian Yang, Xiao-Dong Hu
The δ subunit-containing γ-Aminobutyric acid type A receptors (δ-GABAARs) are located at extrasynaptic sites and persistently active in the control of neuronal excitability. Here we recorded primary afferent C fiber-evoked field potentials in the superficial dorsal horn of rat spinal cords in vivo, and investigated the possible influence of δ-GABAARs activities on nociceptive synaptic transmission. We found that δ-GABAARs-preferring agonist THIP, when topically applied onto spinal cord dorsum, inhibited the basal synaptic responses in a dose-dependent manner...
December 8, 2017: Neuroscience
https://www.readbyqxmd.com/read/29217858/effect-of-co-administration-of-different-doses-of-phenylephrine-with-oxytocin-on-the-prevention-of-oxytocin-induced-hypotension-in-caesarean-section-under-spinal-anaesthesia-a-randomised-comparative-study
#7
Ranjitha Gangadharaiah, Devika Rani Duggappa, Sudheesh Kannan, S B Lokesh, Karuna Harsoor, K M Sunanda, S S Nethra
Introduction: Co-administration of phenylephrine prevents oxytocin-induced hypotension during caesarean section under spinal anaesthesia (SA), but higher doses cause reflex bradycardia. This study compares the effects of co-administration of two different doses of phenylephrine on oxytocin-induced hypotension during caesarean section under SA. Methods: In this prospective, double-blind study, 90 parturients belonging to the American Society of Anesthesiologists' physical status 1 or 2, undergoing caesarean section under SA were randomised into Group A: oxytocin 3U and phenylephrine 50 μg, Group B: oxytocin 3U and phenylephrine 75 μg, Group C: oxytocin 3U and normal saline, administered intravenously over 5 min after baby extraction...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29209779/central-regulation-of-brown-adipose-tissue-thermogenesis-and-energy-homeostasis-dependent-on-food-availability
#8
REVIEW
Yoshiko Nakamura, Kazuhiro Nakamura
Energy homeostasis of mammals is maintained by balancing energy expenditure within the body and energy intake through feeding. Several lines of evidence indicate that brown adipose tissue (BAT), a sympathetically activated thermogenic organ, turns excess energy into heat to maintain the energy balance in rodents and humans, in addition to its thermoregulatory role for the defense of body core temperature in cold environments. Elucidating the central circuit mechanism controlling BAT thermogenesis dependent on nutritional conditions and food availability in relation to energy homeostasis is essential to understand the etiology of symptoms caused by energy imbalance, such as obesity...
December 5, 2017: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/29207811/comparative-evaluation-of-ropivacaine-and-fentanyl-versus-ropivacaine-and-fentanyl-with-clonidine-for-postoperative-epidural-analgesia-in-total-knee-replacement-surgery
#9
Shivali Panwar, Preeti S Govind, Parag Jyoti Duarah, Hari Kishan Mahajan, Smita Anil Korde
Introduction: Clonidine an alpha 2 adrenoceptor agonist possesses analgesic properties and has been used as an adjuvant in epidural analgesia. The addition of clonidine to other analgesics may result in enhanced analgesia through additive mechanisms or synergistic mechanisms. The enhanced analgesia may lead to a decrease in the dosage of analgesic drugs along with reduction of side effects. Aim: The purpose of this study was to evaluate the effect of adding clonidine to epidural ropivacaine and fentanyl mixture in terms of quality of analgesia and side effects in patients of total knee replacement surgery...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29206803/clinical-indicators-of-the-need-for-telemetry-postoperative-monitoring-in-patients-with-suspected-obstructive-sleep-apnea-undergoing-total-knee-arthroplasty
#10
Kethy M Jules-Elysée, Natasha A Desai, Yan Ma, Wei Zhang, Thuyvan H Luu, Stavros G Memtsoudis, Gregory A Liguori
BACKGROUND AND OBJECTIVES: Obstructive sleep apnea is associated with increased complication rates postoperatively. Current literature does not provide adequate guidance on management of these patients. This study used the STOP-Bang questionnaire to diagnose patients with possible obstructive sleep apnea (score ≥3). We hypothesized that a STOP-Bang score of 3 or greater would significantly correlate with the number of oxygen desaturation episodes during the first 48 hours after total knee arthroscopy...
December 4, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29206213/duloxetine-protects-against-oxaliplatin-induced-neuropathic-pain-and-spinal-neuron-hyperexcitability-in-rodents
#11
Woojin Kim, Yeongu Chung, Seunghwan Choi, Byung-Il Min, Sun Kwang Kim
Oxaliplatin is a widely used chemotherapy agent, but induces serious peripheral neuropathy. Duloxetine is a dual reuptake inhibitor of serotonin and norepinephrine, and is shown to be effective against pain. However, whether and how duloxetine can attenuate oxaliplatin-induced allodynia in rodents is not clearly understood. A single injection of oxaliplatin (6 mg/kg, intraperitoneal; i.p.) induced a cold and mechanical allodynia, which was assessed by acetone and von Frey filament tests, respectively. When significant allodynic signs were observed, three different doses of duloxetine (10, 30, and 60 mg/kg, i...
December 5, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29200947/hspb8-promotes-the-fusion-of-autophagosome-and-lysosome-during-autophagy-in-diabetic-neurons
#12
Xiao-Cheng Li, Qi-Kuan Hu, Ling Chen, Si-Yang Liu, Shi Su, Hong Tao, Lin-Na Zhang, Tao Sun, Lan-Jie He
Although autophagy has been proposed to play an emerging role in diabetic neuropathy, autophagy and its possible role remains unclear. Moreover, only few studies about diabetes have explored the autophagy mediated by heat shock protein beta-8 (HSPB8) and Bcl-2 associated athanogene 3 (BAG3). In the present study, we examined the autophagy induced by high glucose levels in an in vivo rat model of diabetes induced by streptozotocin (STZ) and an in vitro model of retinal ganglion cell-5 (RGC5) cells under high glucose conditions...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29200909/the-efficacy-of-combination-treatment-of-gabapentin-and-electro-acupuncture-on-paclitaxel-induced-neuropathic-pain
#13
Min Joon Kim, Ji Hwan Lee, Jo Ung Jang, Fu Shi Quan, Sun Kwang Kim, Woojin Kim
Paclitaxel, a chemotherapeutic drug, induces severe peripheral neuropathy. Gabapentin (GBT) is a first line agent used to treat neuropathic pain, and its effect is mediated by spinal noradrenergic and muscarinic cholinergic receptors. Electro-acupuncture (EA) is used for treating various types of pain via its action through spinal opioidergic and noradrenergic receptors. Here, we investigated whether combined treatment of these two agents could exert a synergistic effect on paclitaxel-induced cold and mechanical allodynia, which were assessed by the acetone drop test and von Frey filament assay, respectively...
November 2017: Korean Journal of Physiology & Pharmacology
https://www.readbyqxmd.com/read/29200657/reduction-of-progressive-thoracolumbar-adolescent-idiopathic-scoliosis-by-chiropractic-biophysics%C3%A2-cbp%C3%A2-mirror-image%C3%A2-methods-following-failed-traditional-chiropractic-treatment-a-case-report
#14
Joshua S Haggard, Jennifer B Haggard, Paul A Oakley, Deed E Harrison
[Purpose] To present a case demonstrating the reduction of progressive thoracolumbar scoliosis by incorporating Chiropractic BioPhysics® (CBP®) technique's mirror image® exercises, traction and blocking procedures based on the 'non-commutative properties of finite rotation angles under addition' engineering law. [Subject and Methods] A 15-year-old female presented with a right thoracolumbar scoliosis having a Cobb angle from T5-L3 of 27° and suffering from headaches and lower back pains. Her curve had progressed over the last two years despite being under traditional chiropractic care...
November 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29196938/the-hemodynamic-and-pain-impact-of-peripheral-nerve-block-versus-spinal-anesthesia-in-diabetic-patients-undergoing-diabetic-foot-surgery
#15
Hou Yee Lai, Li Lian Foo, Siu Min Lim, Chen Fei Yong, Pui San Loh, Sook Hui Chaw, Mohd Shahnaz Hasan, Chew Yin Wang
PURPOSE: Comparison of hemodynamic profiles and pain scores in diabetic patients undergoing diabetic foot surgery receiving peripheral nerve block (PNB) or spinal anesthesia [subarachnoid block (SAB)]. METHODS: This was a prospective, randomised controlled trial. We recruited diabetic patients aged > 18 years, American Society of Anesthesiologists class II-III, who were scheduled for unilateral diabetic foot surgery below the knee. All patients were assessed for autonomic dysfunction using the Survey of Autonomic Symptoms score...
December 1, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29196315/phosphorylated-ccaat-enhancer-binding-protein-%C3%AE-contributes-to-rat-hiv-related-neuropathic-pain-in-vitro-and-in-vivo-studies
#16
Hyun Yi, Shue Liu, Yuta Kashiwagi, Daigo Ikegami, Wan Huang, Hirotsugu Kanda, Takafumi Iida, Ching-Hang Liu, Keiya Takahashi, David A Lubarsky, Shuanglin Hao
Chronic pain is increasingly recognized as an important comorbidity of HIV-infected patients, however, the exact molecular mechanisms of HIV-related pain are still elusive. CCAAT/enhancer binding proteins (C/EBPs) are expressed in various tissues, including the central nervous system. C/EBPβ, one of C/EBPs is involved in the progression of HIV/AIDS, but the exact role of C/EBPβ and its upstream factors are not clear in HIV pain state. Here, we used a neuropathic pain model of perineural HIV envelope glycoprotein gp120 application onto the rat sciatic nerve to test the role of phosphorylated C/EBPβ (pC/EBPβ) and its upstream pathway in the spinal cord dorsal horn (SCDH)...
December 1, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29196042/multilayer-polyion-complex-nanoformulations-of-superoxide-dismutase-1-for-acute-spinal-cord-injury
#17
N V Nukolova, A D Aleksashkin, T O Abakumova, A Y Morozova, I L Gubskiy, Е А Kirzhanova, M A Abakumov, V P Chekhonin, N L Klyachko, A V Kabanov
As one of the most devastating forms of trauma, spinal cord injury (SCI) remains a challenging clinical problem. The secondary processes associated with the primary injury, such as overproduction of reactive oxygen species (ROS) and inflammation, lead to concomitant compression of the injured spinal cord and neuronal death. Delivery of copper-zinc superoxide dismutase (SOD1), an efficient ROS scavenger, to the site of injury can mitigate SCI-induced oxidative stress and tissue damage. Towards this goal catalytically active nanoformulations of SOD1 ("nanozymes") are developed as a modality for treatment of SCI...
November 28, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29192639/intrathecal-ropivacaine-in-cesarean-delivery
#18
R Y Ateser, N Kayacan
OBJECTIVE: The aim of the present study was to evaluate the optimum dose of ropivacaine by comparing three different dosing regimens of isobaric ropivacaine 1% (naropin 10 mg/ml, Astra Zeneca) administered intrathecally and to demonstrate the effects of anesthesia in pregnant women scheduled for cesarean section. PATIENTS AND METHODS: Sixty ASA grade I-II patients were scheduled to undergo elective cesarean sections under spinal anesthesia. The patients were randomly assigned into three groups...
October 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29190367/early-experience-with-bilateral-continuous-femoral-nerve-block-and-single-injection-spinal-anesthesia-for-bilateral-total-knee-arthroplasty-a-case-series
#19
Matthew R Patrick, Hari K Parvataneni, Donald S Bohannon, André P Boezaart
Objective: Total knee arthroplasty (TKA) is a commonly performed surgery in the United States, with demand for unilateral and simultaneous bilateral TKAs (BTKAs) expected to increase significantly over the coming decades. This study reports the authors' early experience in a consecutive series of simultaneous BTKAs performed under regional anesthesia and mild sedation. Methods: In this retrospective case series, the authors examined all simultaneous BTKAs performed over two years by a single surgeon...
November 28, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29190137/high-risk-gastric-pathology-and-prevalent-autoimmune-diseases-in-patients-with-pernicious-anemia
#20
Jing W Hughes, Brian D Muegge, Garry S Tobin, Marina Litvin, Lulu Sun, Jose B Saenz, C Prakash Gyawali, Janet B McGill
OBJECTIVE: Pernicious anemia (PA) develops from atrophic gastritis due to autoimmune destruction of parietal cells and results in achlorhydria, vitamin B12 and iron deficiencies, anemia, neurologic deficits, and premalignant and malignant stomach lesions. We report the presentation, diagnosis and gastric complications of PA in patients from an endocrinology practice. METHODS: Thirty-four patients (31 female, 3 male) with PA who underwent esophagogastroduodenoscopy (EGD) or gastrectomy were identified...
November 2017: Endocrine Practice
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