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Morphine under dose

Ying Wang, Jianxun Lei, Mihir Gupta, Fei Peng, Sarah Lam, Ritu Jha, Ellis Raduenz, Al J Beitz, Kalpna Gupta
Integrative approaches such as electroacupuncture, devoid of drug effects are gaining prominence for treating pain. Understanding the mechanisms of electroacupuncture induced analgesia would benefit chronic pain conditions such as sickle cell disease (SCD), for which patients may require opioid analgesics throughout life. Mouse models are instructive in developing a mechanistic understanding of pain, but the anesthesia/restraint required to administer electroacupuncture may alter the underlying mechanisms. To overcome these limitations, we developed a method to perform electroacupuncture in conscious, freely moving, unrestrained mice...
September 30, 2016: Scientific Reports
Wei-Feng Liu, Hai-Hua Shu, Guo-Dong Zhao, Shu-Ling Peng, Jin-Fang Xiao, Guan-Rong Zhang, Ke-Xuan Liu, Wen-Qi Huang
OBJECTIVE: This multicenter, randomized, placebo-controlled study evaluated the efficacy and side effects of parecoxib during patient-controlled epidural analgesia (PCEA) after abdominal hysterectomy. METHODS: A total of 240 patients who were scheduled for elective abdominal hysterectomy under combined spinal-epidural anesthesia received PCEA plus postoperative intravenous parecoxib 40 mg or saline every 12 h for 48 h after an initial preoperative dose of parecoxib 40 mg or saline...
2016: PloS One
Huiping Ding, Paul W Czoty, Norikazu Kiguchi, Gerta Cami-Kobeci, Devki D Sukhtankar, Michael A Nader, Stephen M Husbands, Mei-Chuan Ko
Despite the critical need, no previous research has substantiated safe opioid analgesics without abuse liability in primates. Recent advances in medicinal chemistry have led to the development of ligands with mixed mu opioid peptide (MOP)/nociceptin-orphanin FQ peptide (NOP) receptor agonist activity to achieve this objective. BU08028 is a novel orvinol analog that displays a similar binding profile to buprenorphine with improved affinity and efficacy at NOP receptors. The aim of this preclinical study was to establish the functional profile of BU08028 in monkeys using clinically used MOP receptor agonists for side-by-side comparisons in various well-honed behavioral and physiological assays...
September 13, 2016: Proceedings of the National Academy of Sciences of the United States of America
Jin-Ning Zhao, Min Kong, Bin Qi, Dong-Jian Ge
Intraoperative dexmedetomidine (DEX) with or without loading dose both promote morphine-sparing effect in patient-controlled analgesia on postoperative acute pain. However, the contribution of the loading dose to this effect is largely unknown, especially in long-lasting surgeries. The present study was designed to investigate the role of a loading dose of DEX in this morphine-sparing effect in multiple-fracture patients following general anesthesia.Eighty-six patients scheduled multiple-fracture surgeries under general anesthesia were allocated into 3 groups which were maintained with propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/DEX with (PRDw), or without (PRDo) DEX loading dose before induction, respectively...
August 2016: Medicine (Baltimore)
Mehdi Sheikhi, Armin Shirzadian, Amir Dehdashtian, Shayan Amiri, Sattar Ostadhadi, Mehdi Ghasemi, Ahmad Reza Dehpour
Zolpidem is a hypnotic medication that mainly exerts its function through activating γ-aminobutyric acid (GABA)A receptors. There is some evidence that zolpidem may have anticonvulsive effects. However, the mechanisms underlying this effect have not been elucidated yet. In the present study, we used the pentylentetrazole (PTZ)-induced generalized seizure model in mice to investigate whether zolpidem can affect seizure threshold. We also further evaluated the roles of ATP-sensitive potassium (KATP) channels as well as μ-opioid receptors in the effects of zolpidem on seizure threshold...
September 2016: Epilepsy & Behavior: E&B
Rebecca S Hofford, Joshua S Beckmann, Michael T Bardo
BACKGROUND: Research has shown that previous experiences during development, especially if stressful, can alter an organism's response to opioids later in life. Given the previous literature on opioid modulation of cocaine self-administration, the current study raised rats in either an enriched condition (EC) or isolated condition (IC) and employed behavioral economics to study the effects of naltrexone and morphine on cocaine self-administration. METHODS: EC and IC rats were trained to lever press for cocaine using a within-session demand procedure...
October 1, 2016: Drug and Alcohol Dependence
J C G van Niel, J Schneider, T M Tzschentke
Buprenorphine and the mixed agonists/antagonists nalbuphine and pentazocine, formerly classified as µ-opioid (MOP) receptor antagonists, have more recently been shown to be partial to full agonists of the human MOP receptor. These receptors do not necessarily have to be maximally activated for a full physiological response. Partial agonists can also sufficiently stimulate signaling processes leading to a full analgesic response, as shown by the effectiveness of buprenorphine, nalbuphine and pentazocine in animal pain models and in clinical settings where these drugs induce analgesia with full efficacy without a ceiling effect...
August 9, 2016: Drug Research
Ana Maria Munteanu, Simona Cionac Florescu, Denisa Madalina Anastase, Cristian Ioan Stoica
BACKGROUND: Optimal postoperative analgesia is a challenge for the anaesthesiologist, with the ideal combination of methods, drugs, doses and timing of administration still the subject of research. The COX-2 inhibitors are a class of NSAIDs that may provide useful perioperative analgesia but the optimal timing of administration has not been elucidated. OBJECTIVE: We hypothesised that etoricoxib given 1 h before total knee arthroplasty under spinal anaesthesia will decrease the cumulative dose of intravenous and subcutaneous morphine required to maintain pain intensity of 3 or less on a 10-point numerical rating scale (NRS) during the first postoperative 48 h compared with the same dose of etoricoxib given after surgery...
November 2016: European Journal of Anaesthesiology
Héléne Staquet, Denis Dupoiron, Edmond Nader, Philippe Menei
Intracerebroventricular (ICV) administration of opioids for control of intractable cancer pain has been used since 1982. We present here our experience of intracerebroventricular administration of pain treatments including ziconotide associated with morphine and ropivacaine for patients resistant to a conventional approach, with nociceptive, neuropathic, or mixed pain. These clinical cases were conducted with patients suffering from refractory pain, more than 6/10 on a numerical pain rating scale (NPRS) while on high-dose medical treatment and/or intolerance with significant side effects from oral medication...
July 2016: Pain Physician
Qing Liu, Michael S Gold
BACKGROUND: Previous evidence suggests that opioid-tolerant patients are less responsive to local anesthetics (LAs) for postoperative pain management. METHODS: To determine whether this apparent loss of LA potency is due to an intrinsic change in the peripheral nerve, the effect of systemic morphine was assessed on the potency of lidocaine-induced block of the compound action potential in isolated rat sciatic nerves. Analgesic efficacy was assessed with the heat withdrawal assay...
October 2016: Anesthesiology
Petchara Sundarathiti, Jadesadha Thammasakulsiri, Supawadee Supboon, Supalak Sakdanuwatwong, Molruedee Piangjai
BACKGROUND: Unsatisfactory analgesia for major knee surgery with femoral nerve block (FNB) alone was reported and the additional benefit of sciatic block to continuous femoral nerve block (CFNB) was not conclusive. The aim of the present study was to find the benefit of the additional mini-dose spinal morphine (0.035 mg) to CFNB for postoperative pain control and to compare their associated side effects after total knee arthroplasty (TKA). METHODS: After written informed consent and with Institutional Ethics Committee approval, 68 American Society of Anesthesiologists (ASA) Physical Status I-III patients scheduled for elective unilateral TKA under spinal anesthesia (SA) were included in the present prospective, randomized controlled study...
2016: BMC Anesthesiology
Jing-yu Xu, Wei-feng Bai, Cheng-kai Qiu, Ping Tu, Shou-yang Yu, Su-yuan Luo
OBJECTIVE: To investigate the protective mechanism of Corydalis yanhuso and L-THP in morphine-dependent gastrointestinal injury rats. METHODS: 180 male rats were randomly divided into nine groups, 20 rats for each group: saline group (N), model group (M), NS treatment group and three different dosage of Corydalis yanhusuo and L-THP groups (low dose group,middle dose group and high dose group). The rat CPP (conditioned place preference) model was established by injecting the rats with an increasing dosage of morphine, all groups received CPP training in a black compartments and white ones (drug-paired compartment) for ten days...
December 2015: Zhong Yao Cai, Zhongyaocai, Journal of Chinese Medicinal Materials
Ross C Puffer, Kevin Tou, Rose E Winkel, Mohamad Bydon, Bradford Currier, Brett A Freedman
BACKGROUND CONTEXT: Postsurgical pain control is important in spine surgery as it can lead to earlier mobilization, decreased length of stay, decreased side effects from narcotic medications, and improved patient satisfaction. Liposomal bupivacaine (LB) is an injectable formulation of bupivacaine, providing prolonged local anesthesia, up to 72 hours postinjection. Although, LB has been used with increasing frequency following other musculoskeletal procedures, specifically total joint replacements, its pre-emptive analgesic effect following lumbar microdiskectomy has hitherto not been reported...
June 24, 2016: Spine Journal: Official Journal of the North American Spine Society
Pranjali Kurhekar, S Madan Kumar, D Sampath
BACKGROUND AND AIMS: Inrathecal opioids like morphine added to local anaesthetic agents have been found to be effective in achieving prolonged post-operative analgesia. Intrathecal dexmedetomidine may be devoid of undesirable side effects related to morphine and hence, this study was designed to evaluate analgesic efficacy, haemodynamic stability and adverse effects of both these adjuvants in patients undergoing gynaecological surgeries. METHODS: This was a prospective, randomised, double blind study involving 25 patients in each group...
June 2016: Indian Journal of Anaesthesia
Seira Doi, Tomohisa Mori, Naoki Uzawa, Takamichi Arima, Tomoyuki Takahashi, Masashi Uchida, Ayaka Yawata, Michiko Narita, Yasuhito Uezono, Tsutomu Suzuki, Minoru Narita
BACKGROUND: Methadone is a unique µ-opioid receptor agonist. Although several researchers have insisted that the pharmacological effects of methadone are mediated through the blockade of NMDA receptor, the underlying mechanism by which methadone exerts its distinct pharmacological effects compared to those of other µ-opioid receptor agonists is still controversial. In the present study, we further investigated the pharmacological profile of methadone compared to those of fentanyl and morphine as measured mainly by the discriminative stimulus effect and in vitro assays for NMDA receptor binding, µ-opioid receptor-internalization, and µ-opioid receptor-mediated β-arrestin recruitment...
2016: Molecular Pain
Er Birol Muhammet, İsmail Serhat Kocamanoğlu, Ayhan Bozkurt, Sırrı Bilge, Erhan Çetin Çetinoğlu
BACKGROUND: Some studies have suggested that the intrathecal use of cyclooxygenase enzyme inhibitors provides an anti-nociceptive effect. Therefore, the occurrence of side effects seen in systemic usage can be eliminated. AIMS: The primary objective of this experimental, randomized, controlled trial was to test the hypothesis asserting that intrathecal dexketoprofen trometamol would demonstrate an analgesic effect during postoperative period. STUDY DESIGN: Animal experimentation...
May 2016: Balkan Medical Journal
Josep Porta-Sales, Cristina Garzón-Rodríguez, Christian Villavicencio-Chávez, Silvia Llorens-Torromé, Jesús González-Barboteo
INTRODUCTION: Most clinical reports on methadone rotation describe outcomes in hospitalized patients. The few studies that have included outpatients are retrospective. The aim of this study was to assess the efficacy and safety of methadone as a second-line opioid in adult patients with advanced cancer after rotation in routine clinical practice at a palliative care outpatient clinic. PATIENTS AND METHODS: This was a prospective, open-label study of 145 patients whose treatment was rotated from other opioids to methadone...
August 2016: Oncologist
R V Nielsen, J S Fomsgaard, H Siegel, R Martusevicius, O Mathiesen, J B Dahl
BACKGROUND: Chlorzoxazone is a muscle relaxant administered for musculoskeletal pain, and as an analgesic adjunct for post-operative pain. Chlorzoxazone for low back pain is currently not advised due to the lack of placebo-controlled trials. We explored the effect of chlorzoxazone on acute pain after spine surgery. METHODS: One hundred and ten patients were randomly assigned to 500 mg oral chlorzoxazone or placebo in this blinded study of patients having spine surgery under general anaesthesia...
September 2016: Acta Anaesthesiologica Scandinavica
Pedro Hinarejos, Bruno Capurro, Xavier Santiveri, Pere Ortiz, Joan Leal, Xavier Pelfort, Raul Torres-Claramunt, Juan Sánchez-Soler, Joan C Monllau
PURPOSE: To evaluate the effect of the local infiltration of analgesics for pain after total knee arthroplasty in patients treated with femoral and sciatic peripheral nerve blocks. The secondary objective was to detect differences in analgesic consumption as well as blood loss after local infiltration of analgesics. METHODS: Prospective randomized double-blinded study in patients who underwent a TKA for knee osteoarthritis under spinal anesthesia and treated with femoral and sciatic nerve blocks...
June 14, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Eagle Yi-Kung Huang, Yuan-Hao Chen, Tzu-Ying Huang, Ying-Jie Chen, Lok-Hi Chow
LVV-hemorphin 7 (LVVYPWTQRF; LVV-H7), an N-terminal fragment of the β-chain of hemoglobin cleaved by cathepsin D/pepsin, is an atypical endogenous opioid peptide that is found in high concentration in blood. LVV-H7 acts as a μ-opioid agonist and an inhibitor of insulin-regulated aminopeptidase. Subchronic administration of anabolic androgenic steroids (AAS) has been clinically proven to induce the synthesis of erythrocytes and increase hemoglobin concentrations. Patients with a history of AAS abuse are more susceptible to opioid abuse...
May 26, 2016: Neuropeptides
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