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Sympathetic block

Michele Curatolo, Nikolai Bogduk
Many conditions associated with chronic pain have no detectable morphological correlate. Consequently, the source of pain cannot be established by clinical examination or medical imaging. However, for some such conditions, the source of pain can be established using diagnostic blocks. The aim of this paper is to review the available evidence concerning the validity and utility of diagnostic blocks, and to identify areas where research is needed. Diagnostic blocks for cervical and lumbar zygapophysial joint pain have been extensively studied...
December 29, 2017: Scandinavian Journal of Pain
Johan Hambræus, Hans Westergren
Introduction Patients exposed to whiplash trauma are at risk of developing pain and dysfunction of the neck and shoulder. Although rarely discussed in the literature, some patients also develop autonomic dysfunction. Case presentation A previously healthy 41-year-old woman was involved in a "head-on" car crash. During the following 3 years she developed severe and complex post-traumatic pain syndrome, which consisted of neck pain, lumbar pain, sensory-motor dysfunction, and myoclonic muscular contractions...
December 29, 2017: Scandinavian Journal of Pain
Yang Wang, Adriana A Zekveld, Dorothea Wendt, Thomas Lunner, Graham Naylor, Sophia E Kramer
OBJECTIVES: Pupil light reflex (PLR) has been widely used as a method for evaluating parasympathetic activity. The first aim of the present study is to develop a PLR measurement using a computer screen set-up and compare its results with the PLR generated by a more conventional setup using light-emitting diode (LED). The parasympathetic nervous system, which is known to control the 'rest and digest' response of the human body, is considered to be associated with daily life fatigue. However, only few studies have attempted to test the relationship between self-reported daily fatigue and physiological measurement of the parasympathetic nervous system...
2018: PloS One
Rebecca L Brindley, Mary Beth Bauer, L Anne Walker, Meagan A Quinlan, Ana M D Carneiro, Ji-Ying Sze, Randy D Blakely, Kevin P M Currie
Adrenal chromaffin cells comprise the neuroendocrine arm of the sympathetic nervous system and secrete catecholamines to coordinate the appropriate stress response. Deletion of the serotonin (5-HT) transporter (SERT) gene in mice (SERT-/- mice) or pharmacological block of SERT function in rodents and humans augments this sympathoadrenal stress response (epinephrine secretion). The prevailing assumption is that loss of CNS SERT alters central drive to the peripheral sympathetic nervous system. Adrenal chromaffin cells also prominently express SERT where it might coordinate accumulation of 5-HT for reuse in the autocrine control of stress-evoked catecholamine secretion...
June 9, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Evilin Naname Komegae, David George Stephen Farmer, Virginia Leah Brooks, Michael Joseph McKinley, Robin Michael McAllen, Davide Martelli
Electrical stimulation of the vagus nerve (VNS) is a novel strategy used to treat inflammatory conditions. Therapeutic VNS activates both efferent and afferent fibers; however, the effects attributable to vagal afferent stimulation are unclear. Here, we tested if selective activation of afferent fibers in the abdominal vagus suppresses systemic inflammation. In urethane-anesthetized rats challenged with lipopolysaccharide (LPS, 60 µg/kg, i.v.), abdominal afferent VNS (2 Hz for 20 min) reduced plasma tumor necrosis factor alpha (TNF) levels 90 min later by 88% compared with unmanipulated animals...
June 5, 2018: Brain, Behavior, and Immunity
Juan Martinez-Pinna, Sergi Soriano, Eva Tudurí, Angel Nadal, Fernando de Castro
Ca2+ -activated ion channels shape membrane excitability in response to elevations in intracellular Ca2+ . The most extensively studied Ca2+ -sensitive ion channels are Ca2+ -activated K+ channels, whereas the physiological importance of Ca2+ -activated Cl- channels has been poorly studied. Here we show that a Ca2+ -activated Cl- currents (CaCCs) modulate repetitive firing in mouse sympathetic ganglion cells. Electrophysiological recording of mouse sympathetic neurons in an in vitro preparation of the superior cervical ganglion (SCG) identifies neurons with two different firing patterns in response to long depolarizing current pulses (1 s)...
2018: Frontiers in Physiology
Mauricio Guzmán, Maximiliano S Miglio, Nadia R Zgajnar, Ana Colado, María B Almejún, Irene A Keitelman, Florencia Sabbione, Federico Fuentes, Analía S Trevani, Mirta N Giordano, Jeremías G Galletti
Immunological interdependence between the two eyes has been reported for the cornea and the retina but not for the ocular mucosal surface. Intriguingly, patients frequently report ocular surface-related symptoms in the other eye after unilateral ocular surgery. Here we show how unilateral eye injuries in mice affect the mucosal immune response of the opposite ocular surface. We report that, despite the lack of lymphatic cross-drainage, a neurogenic inflammatory reflex in the contralateral conjunctiva is sufficient to increase, first, epithelial nuclear factor kappa B signaling, then, dendritic cell maturation, and finally, expansion of effector, instead of regulatory, T cells in the draining lymph node, leading to disrupted ocular mucosal tolerance...
June 4, 2018: Mucosal Immunology
Marat Fudim, W Schuyler Jones, Richard L Boortz-Marx, Arun Ganesh, Cynthia L Green, Adrian F Hernandez, Manesh R Patel
The abdominal vascular compartment is the main storage of intravascular blood volume, and decreased abdominal vascular capacitance has been proposed as a major contributor to the complex pathophysiology of heart failure (HF) in animals and humans.1, 2 In HF, as a result of neurohormonal imbalance, the vascular capacitance ("storage-space") is decreased and acute sympathetic nerve activation can result in acute volume redistribution3 from the abdominal compartment to the thoracic compartment (heart and lungs), which increases intra-cardiac pressures and precipitates HF symptoms (Figure 1A)...
May 25, 2018: Circulation
Luis Figueira, Catarina Janeiro, Fatima Ferreirinha, Paula Serrao, Sara Perestrelo, Fernando Falcao-Reis, Paulo Correia-de-Sa, Daniel Moura
Having established a main neuronal origin for noradrenaline (NA) in the cornea, we set out to study the physiologic determinants of its release and to correlate functional findings with sympathetic nerve density and overall topography. Whole corneas were obtained from 3 to 4 month-old rabbits and human donors. Study of prejunctional effects was carried out after incubation with radiolabelled NA (3H-NA). Corneas were superfused with warm aerated amine-free medium with cocaine and hydrocortisone to block subsequent neuronal and extraneuronal NA uptake...
May 24, 2018: Experimental Eye Research
Sang-Keun Woo, Byung Seok Moon, Bom Sahn Kim, Min Hwan Kim, Yong Jin Lee, Jae Ho Jung, Kyo Chul Lee, Youngho Seo, Wook Kim, Sang Moo Lim, Byung Chul Lee, Sang Eun Kim
INTRODUCTION: Global and regional sympathetic activity in the heart can be evaluated using [123 I]meta-iodobenzylguanidine ([123 I]mIBG) imaging. However, [123 I]mIBG is associated with low image spatial resolution and sensitivity in cardiac imaging. We investigated the capability of an F-18-labeled mIBG derivative, meta-(3-[18 F]fluoropropyl)benzylguanidine ([18 F]mFPBG), for identifying ischemic and viable myocardium in a rat model of myocardial infarction. MATERIALS AND METHODS: The ex vivo biodistribution and in vivo metabolic stability of [18 F]mFPBG were investigated in Sprague-Dawley rats...
May 3, 2018: Nuclear Medicine and Biology
Yusuke Murahata, Yoshiaki Hikasa, Sho Hayashi, Koki Shigematsu, Natsuki Akashi, Tomohiro Osaki, Takeshi Tsuka, Yoshiharu Okamoto, Tomohiro Imagawa
Remifentanil is an ultra-short-acting μ-opioid receptor agonist. The purpose of this study was to determine the relationship of the minimum alveolar concentration (MAC) of sevoflurane and other MAC derivatives, including the MAC for blocking adrenergic responses (MAC-BAR) and the MAC at which tracheal extubation is occurred (MAC-extubation), with or without remifentanil infusion. Six healthy adult beagle dogs were randomly anesthetized three times for determining the MAC-BAR (SEVMAC-BAR ), MAC (SEVMAC ), and MAC- extubation (SEVMAC-extubation ) of sevoflurane under infusion of saline and remifentanil at rates of 0...
May 21, 2018: Journal of Veterinary Medical Science
Diana M Norden, John R Bethea, Jiu Jiang
BACKGROUND: Spinal cord injury (SCI) disrupts essential neuroimmune communication, leading to severe immune depression. Previous studies confirmed immune dysfunction in mice with chronic SCI and following high thoracic level injury where sympathetic innervation of the spleen is disrupted. Here, we induced a mid-thoracic injury where integrity of the sympathetic response is maintained and investigated the antiviral T cell response to influenza virus after acute SCI. METHODS: One week following a contusion SCI at thoracic level T9, mice were infected intranasally with influenza virus...
May 17, 2018: Journal of Neuroinflammation
Anita Gupta, Lucas First, Celeste A Swain
Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine infusions, and trigger point injections, resulted in a significant decrease in the patient's chronic pain symptoms...
May 18, 2018: Journal of Pain & Palliative Care Pharmacotherapy
Kazutoshi Kubota, Katsuhisa Sunada
Background: A stellate ganglion block (SGB) causes increased blood flow in the maxillofacial region, exhibiting the potential for regenerative effects in damaged tissue. The focus of this study was to understand the efficacy of SGB for regenerative effects against nerve damage. A rat model of the superior cervical ganglion block (SCGB) was created instead of SGB, and facial blood flow, as well as sympathetic nervous system function, were measured. Methods: A vertical incision was made on the left side of the neck of a Wistar rat, and a 5-mm resection of the superior cervical ganglion was performed at the back of the bifurcation of the internal and external branches of the left common carotid artery...
April 2018: Journal of Dental Anesthesia and Pain Medicine
Slobodan Mihaljevic, Milenko Bevanda, Kresimir Reiner, Krunoslav Sporcic, Ljiljana Mihaljevic, Marko Cacic
Objective: To detect changes in finger photoplethysmography after administration of epidural anaesthesia as a surrogate method for evaluating autonomic nervous system activity. Methods: We included a total of 46 patients scheduled for elective surgical procedures under lumbar epidural anaesthesia. A Biopac SS4LA pulse plethysmograph transducer was used for photoplethysmography recording, and the device was placed on the first toe of the right leg. The first standard lead of the electrocardiogram was simultaneously measured with the finger photoplethysmography...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
Semih Gungor, Rohit Aiyer, Buse Baykoca
RATIONALE: To present the successful treatment of complex regional pain syndrome type -1 utilizing sympathetic blocks. PATIENT CONCERNS: Severe pain interfering with activities of daily living and temporary disability secondary to complex regional pain syndrome. DIAGNOSES: Complex regional pain syndrome type-1 with involvement of lower extremity (2 patients), and upper extremity (1 patient). INTERVENTIONS: We report the management of 3 patients with diagnosis of complex regional pain syndrome type-1 by early institution of sympathetic blocks for diagnostic and therapeutic purposes...
May 2018: Medicine (Baltimore)
Yong Chen, Lian Guo, Haili Lang, Xiaolan Hu, Sun Jing, Mengsi Luo, Guohai Xu, Zhidong Zhou
A stellate ganglion block (SGB) is a clinical sympathetic block which can inhibit the body systemic inflammatory response. However, whether and how SGB can attenuate the sepsis-induced acute lung injury remains unclear. Here, we evaluated the effect of SGB on sepsis-induced acute lung injury in rats. Ninety healthy Sprague Dawley (SD) male rats were divided into three groups: the sham operation group (S group), sepsis group (Sep group), and SGB group. The sepsis model rats were produced by cecum ligation and puncture (CLP), and blood samples were taken from the abdominal aorta of the rats at different time points for evaluating the concentration of TNF-α, IL-6, and IL-10 by enzyme-linked immunosorbent assay (ELISA)...
May 8, 2018: Inflammation
Holly Careskey, Sanjeet Narang
This article reviews anesthetic interventional approaches to the management of pain in hematology and oncology patients. It includes a discussion of single interventions including peripheral nerve blocks, plexus injections, and sympathetic nerve neurolysis, and continuous infusion therapy through implantable devices, such as intrathecal pumps, epidural port-a-caths, and tunneled catheters. The primary objective is to inform members of hematology and oncology care teams regarding the variety of interventional options for patients with cancer-related pain for whom medical pain management methods have not been effective...
June 2018: Hematology/oncology Clinics of North America
Pascal Champéroux, Pierre Fesler, Sebastien Judé, Serge Richard, Jean-Yves Le Guennec, Jérôme Thireau
BACKGROUND AND PURPOSES: Increase in high-frequency (HF) beat-to-beat heart rate oscillations by torsadogenic hERG blockers appears to be associated with signs of parasympathetic and sympathetic co-activation which cannot be assessed directly using classic methods of heart rate variability (HRV) analysis. The present work aimed to find a translational model that would allow this particular state of heart rate autonomic control to be assessed. EXPERIMENTAL APPROACH: HF heart rate (HFHR) and heart period (HFRR) oscillations were analyzed within discrete 10-second intervals in a cohort of 200 healthy human subjects...
May 3, 2018: British Journal of Pharmacology
Rakesh Garg, Swati Bhan, Saurabh Vig
Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?...
April 2018: Indian Journal of Anaesthesia
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