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Analgesic combination

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https://www.readbyqxmd.com/read/28935293/designing-safer-analgesics-via-%C3%AE-opioid-receptor-pathways
#1
REVIEW
H C Stephen Chan, Dillon McCarthy, Jianing Li, Krzysztof Palczewski, Shuguang Yuan
Pain is both a major clinical and economic problem, affecting more people than diabetes, heart disease, and cancer combined. While a variety of prescribed or over-the-counter (OTC) medications are available for pain management, opioid medications, especially those acting on the μ-opioid receptor (μOR) and related pathways, have proven to be the most effective, despite some serious side effects including respiration depression, pruritus, dependence, and constipation. It is therefore imperative that both academia and industry develop novel μOR analgesics which retain their opioid analgesic properties but with fewer or no adverse effects...
September 18, 2017: Trends in Pharmacological Sciences
https://www.readbyqxmd.com/read/28934792/effects-of-pulsed-versus-conventional-versus-combined-radiofrequency-for-the-treatment-of-trigeminal-neuralgia-a-prospective-study
#2
Abdelraheem Elawamy, Esam Eldein Mohamed Abdalla, Ghaydaa A Shehata
BACKGROUND: During radiofrequency bursts of energy are applied to nervous tissue. The clinical advantages of this treatment remain unclear. OBJECTIVES: We compared the effectiveness and pain relief for idiopathic trigeminal neuralgia (TN) after continuous radiofrequency (CRF), pulsed radiofrequency (PRF), and combined continuous and pulsed radiofrequency (CCPRF) treatment of the Gasserian ganglion (GG). STUDY DESIGN: We conducted a randomized prospective study...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28932352/novel-technique-of-abdominal-wall-nerve-block-for-laparoscopic-colostomy-rectus-sheath-block-with-transperitoneal-approach
#3
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel...
August 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28928572/comparison-of-bupivacaine-plus-magnesium-sulfate-and-ropivacaine-plus-magnesium-sulfate-infiltration-for-postoperative-analgesia-in-patients-undergoing-lumbar-laminectomy-a-randomized-double-blinded-study
#4
Rajib Hazarika, Samit Parua, Dipika Choudhury, Rajesh Kumar Barooah
AIM: The objective of this study was to assess and compare the analgesic duration of local infiltration of bupivacaine plus magnesium sulfate and ropivacaine plus magnesium sulfate for postoperative analgesia in patients undergoing lumbar laminectomy. STUDY DESIGN: A randomized, prospective, double-blinded single hospital, comparative study. METHODS: Sixty adult patients of the American Society of Anesthesiologists physical Status I and II were randomly allocated into two Groups BM and RM, comprising 30 and 31 patients...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928571/dexmedetomidine-as-adjuvant-to-lower-doses-of-intrathecal-bupivacaine-for-lower-limb-orthopedic-surgeries
#5
Taznim Mohamed, Indu Susheela, Beena P Balakrishnan, Suvarna Kaniyil
BACKGROUND: Dexmedetomidine, an α2 adrenergic agonist, has been found to be a useful adjuvant to local anesthetics. It has been found to produce satisfactory block with lower doses of spinal bupivacaine. AIM: The aim of this study is to compare the difference in spinal block characteristics and hemodynamic effects of 7, 8, and 9 mg hyperbaric bupivacaine combined with 5 μg dexmedetomidine and to find out the optimum dose that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28925091/counting-the-cost-of-over-the-counter-codeine-containing-analgesic-misuse-a-retrospective-review-of-hospital-admissions-over-a-5-year-period
#6
Deanna Mill, Jacinta L Johnson, Victoria Cock, Emily Monaghan, Elizabeth D Hotham
INTRODUCTION AND AIMS: Combination analgesics containing codeine (CACC) are currently available over-the-counter (OTC) in many countries following a pharmacist's advice. Published case reports detail life-threatening morbidities associated with OTC-CACC misuse, although the cost of treating such patients has not been quantified. This study aims to: (i) identify and detail patients admitted to an Australian tertiary teaching hospital over a 5 year period with sequelae of OTC-CACC misuse; and (ii) estimate the costs of identified hospital admissions...
September 18, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28924366/effects-of-dexmedetomidine-in-combination-with-fentanyl-based-intravenous-patient-controlled-analgesia-on-pain-attenuation-after-open-gastrectomy-in-comparison-with-conventional-thoracic-epidural-and-fentanyl-based-intravenous-patient-controlled-analgesia
#7
Na Young Kim, Tae Dong Kwon, Sun Joon Bai, Sung Hoon Noh, Jung Hwa Hong, Haeyeon Lee, Ki-Young Lee
Background: This study was investigated the effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on pain attenuation in patients undergoing open gastrectomy in comparison with conventional thoracic epidural patient-controlled analgesia (E-PCA) and IV-PCA. Methods: One hundred seventy-one patients who planned open gastrectomy were randomly distributed into one of the 3 groups: conventional thoracic E-PCA (E-PCA group, n = 57), dexmedetomidine in combination with fentanyl-based IV-PCA (dIV-PCA group, n = 57), or fentanyl-based IV-PCA only (IV-PCA group, n = 57)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28923480/impact-of-morphine-on-the-expression-of-insulin-receptor-and-protein-levels-of-insulin-igfs-in-rat-neural-stem-cells
#8
Sadegh Salarinasab, AliReza Nourazarian, Masoud Nikanfar, Nima Abdyazdani, Masoumeh Kazemi, Navid Feizy, Reza Rahbarghazi
Alzheimer's disease is correlated with neuronal degeneration and loss of neuronal precursors in different parts of the brain. It has been found disturbance in the homeostasis neural stem cells (NSCs) can cause neurodegeneration. Morphine, an analgesic agent, can disrupt the dynamic and normal state of NSCs. However, more investigations are required to clearly address underlying mechanisms. The current experiment aimed to investigate the effects of morphine on the cell distribution of insulin factor and receptor and insulin-like growth factors (IGF1, IGF2) in NSCs...
September 15, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28923307/association-between-opioid-use-and-risk-of-erectile-dysfunction-a-systematic-review-and-meta-analysis
#9
REVIEW
Shankun Zhao, Tuo Deng, Lianmin Luo, Jiamin Wang, Ermao Li, Luhao Liu, Futian Li, Jintai Luo, Zhigang Zhao
BACKGROUND: Opioid analgesics have been widely used to relieve chronic pain conditions; however, a connection between opioid analgesic administration and increased susceptibility to erectile dysfunction (ED) has been hypothesized. AIM: To evaluate whether opioid use was a risk factor for ED in a systematic review and meta-analysis. METHODS: The PubMed, Cochrane Library, and Embase databases were searched to identify eligible studies concerning opioid use and risk of ED from inception to April 2017...
September 8, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28920461/discovery-and-development-of-tramadol-for-the-treatment-of-pain
#10
Lidia Bravo, Juan Antonio Mico, Esther Berrocoso
Tramadol is an opioid drug that, unlike classic opioids, also modulates the monoaminergic system by inhibiting noradrenergic and serotoninergic reuptake. For this reason, tramadol is considered an atypical opioid. These special pharmacological characteristics have made tramadol one of the most commonly prescribed analgesic drugs to treat moderate to severe pain. Areas covered: The aim of this review is to provide a historical description of the biochemistry, pharmacokinetics and particularly, the mechanisms of action of tramadol...
September 17, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28920149/efficacy-and-safety-of-153-sm-edtmp-as-treatment-of-painful-bone-metastasis-a-large-single-center-study
#11
Hélène Kolesnikov-Gauthier, Nathalie Lemoine, Emmanuelle Tresch-Bruneel, Anaïs Olivier, Aurore Oudoux, Nicolas Penel
PURPOSE: The purpose of this study is to assess the efficacy of (153)Sm-EDTMP (Quadramet®) in a clinical setting. METHODS: We have conducted a retrospective study of all consecutive patients (pts) treated with (153)Sm-EDTMP for painful bone metastases. At each visit (before and after treatment), four parameters were collected: (i) pain assessment according to the 10-step visual analogue scale (VAS), (ii) sleep disturbance related to pain, (iii) dose of analgesic medication, and (iv) answer to the following closed question "Do you think you obtained a benefit from treatment?" Success of treatment was defined by the combination of these four parameters...
September 17, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#12
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28915426/intravenous-dexamethasone-as-an-adjunct-to-improve-labor-analgesia-a-randomized-double-blinded-placebo-controlled-clinical-trial
#13
Pratibha Dube, Sukanya Mitra, Jasveer Singh, Richa Saroa, Reeti Mehra
OBJECTIVE: To study the role of intravenous (i.v.) dexamethasone as an analgesic adjunct in labor analgesia. DESIGN: Double-blinded randomized controlled trial. SETTING: Labor analgesia in a tertiary-care teaching hospital. PATIENTS: Eighty consenting ASA I-II parturients, age>18year, nulliparous, single gestation, cephalic presentation at ≥36 wk. of gestation, in early spontaneous labor (cervical dilatation≤5cm) requesting epidural analgesia...
September 12, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28914647/effect-of-an-intravenous-dexamethasone-added-to-caudal-local-anesthetics-to-improve-postoperative-pain-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#14
Hiromasa Kawakami, Takahiro Mihara, Nobuhito Nakamura, Koui Ka, Takahisa Goto
BACKGROUND: Caudal anesthesia has been used for postoperative pain control in pediatric surgical patients, but the duration of the analgesic effect is occasionally unsatisfactory. Intravenous steroids have been shown to be effective for postsurgical pain management after certain surgeries. The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the analgesic effect of steroids in patients administered with caudal anesthesia. METHODS: This study was a systematic review and meta-analysis...
September 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28913502/regional-anesthesia-for-a-total-knee-arthroplasty-on-an-adult-patient-with-spastic-diplegia-and-an-intrathecal-baclofen-pump
#15
Elird Bojaxhi, David R Salek, Courtney E Sherman, Roy A Greengrass
We describe the clinical presentation of a patient with spastic diplegia, and its unique perioperative challenges. Opioids and antispasmodic medications are the primary therapy for managing pain and spasticity in the perioperative setting. However, such combination results in several side-effects and their sedative properties are synergistic. A 64-year-old woman with a history of spastic diplegia and an intrathecal baclofen pump for the treatment of her lower extremity spasticity was scheduled for a third elective left knee arthroplasty...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912639/comparison-of-the-perioperative-and-postoperative-effects-of-levobupivacaine-and-of-levobupivacaine-adrenaline-in-pediatric-tonsillectomy-a-double-blind-randomized-study
#16
Faruk Cicekci, Cigdem Sizer, Sait Selcuk Atici, Sule Arican, Adnan Karaibrahimoglu, Inci Kara
OBJECTIVES: We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. METHODS: A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg·kg(-1) or levobupivacaine (0.5%) 0.4 mg·kg(-1) + adrenaline (1 : 200.000) administered by means of peritonsillar infiltration...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28904559/cartilage-protection-and-analgesic-activity-of-a-botanical-composition-comprised-of-morus-alba-scutellaria-baicalensis-and-acacia-catechu
#17
Mesfin Yimam, Teresa Horm, Laura Wright, Ping Jiao, Mei Hong, Lidia Brownell, Qi Jia
Although there have been augmented advances in drug discovery, current OA management is inadequate due to the lack of successful therapies proven to be effective in modifying disease progression. For some, the risk outweighs the benefit. As a result, there is a desperate need for safe and efficacious natural alternatives. Here we evaluated a composition from Morus alba, Scutellaria baicalensis, and Acacia catechu in maintaining joint structural integrity and alleviating OA associated symptoms in monoiodoacetate- (MIA-) induced rat OA disease model...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28900175/dynamic-and-kinetic-elements-of-%C3%A2%C2%B5-opioid-receptor-functional-selectivity
#18
Abhijeet Kapoor, Gerard Martinez-Rosell, Davide Provasi, Gianni de Fabritiis, Marta Filizola
While the therapeutic effect of opioids analgesics is mainly attributed to µ-opioid receptor (MOR) activation leading to G protein signaling, their side effects have mostly been linked to β-arrestin signaling. To shed light on the dynamic and kinetic elements underlying MOR functional selectivity, we carried out close to half millisecond high-throughput molecular dynamics simulations of MOR bound to a classical opioid drug (morphine) or a potent G protein-biased agonist (TRV-130). Statistical analyses of Markov state models built using this large simulation dataset combined with information theory enabled, for the first time: a) Identification of four distinct metastable regions along the activation pathway, b) Kinetic evidence of a different dynamic behavior of the receptor bound to a classical or G protein-biased opioid agonist, c) Identification of kinetically distinct conformational states to be used for the rational design of functionally selective ligands that may eventually be developed into improved drugs; d) Characterization of multiple activation/deactivation pathways of MOR, and e) Suggestion from calculated transition timescales that MOR conformational changes are not the rate-limiting step in receptor activation...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28899770/use-of-non-prescription-analgesics-and-male-reproductive-function
#19
B B Høyer, C H Ramlau-Hansen, J P Bonde, S B Larsen, G Toft
We studied the association between intake of non-prescription analgesics and semen quality and male reproductive hormone levels in a cross-sectional study among 1493 men. The men provided one semen (n=1493) and blood sample (n=1056) and filled in questionnaires on use of non-prescription analgesics (paracetamol, NSAIDs and combination drugs (yes/no)). Adjusting for age, study and other covariates, we observed no association between intake of non-prescription analgesics and markers of semen quality. Adjusting for age and time of day of blood sampling, users of non-prescription analgesics had a 10...
September 9, 2017: Reproductive Toxicology
https://www.readbyqxmd.com/read/28899726/benefit-risk-of-corticosteroids-in-acute-gout-patients-an-updated-meta-analysis-and-economic-evaluation
#20
Dehong Sun, Xiaosong Ma, Chuansheng Li, Jie Ying, Youde Yan
The efficacy, safety and health-economic outcomes were compared between corticosteroid and non-corticosteroid treatments in acute gout patients. All electronic literatures comparing the curative effects or full economic evaluations of corticosteroids versus non-corticosteroids on acute pain in acute gout patients and published until June 30, 2017 in any language were searched through PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. Pooled oddsratios with 95% confidence intervals and standard(or weighted) mean difference were calculated using random-or fixed-effects models according to the I(2) statistic test of heterogeneity...
September 9, 2017: Steroids
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