Anesthesia and analgesia
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Anesthesia and analgesia · May 2007
Comparative Study Clinical TrialThe influence of stellate ganglion transcutaneous electrical nerve stimulation on signal quality of pulse oximetry in prehospital trauma care.
Accurate monitoring of the peripheral arterial oxygen saturation has become an important tool in the prehospital emergency medicine. This monitoring requires an adequate plethysmographic pulsation. Signal quality is diminished by cold ambient temperature due to vasoconstriction. Blockade of the stellate ganglion can improve peripheral vascular perfusion and can be achieved by direct injection or transcutaneous electrical nerve stimulation (TENS) stimulation. We evaluated whether TENS on the stellate ganglion would reduce vasoconstriction and thereby improve signal detection quality of peripheral pulse oximetry. ⋯ The data indicate that blockade of the stellate ganglion with TENS improves signal quality of pulse oximeters in the prehospital setting.
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Anesthesia and analgesia · May 2007
Comparative StudyPerineural resiniferatoxin prevents the development of hyperalgesia produced by loose ligation of the sciatic nerve in rats.
The vanilloid receptors (TRPV1) are found in peripheral nerve fibers; their stimulation by capsaicin leads to release of calcitonin gene-related peptide and other neuropeptides participating in neuroinflammation. On the other hand, various inflammatory mediators, released after nerve damage, can activate or sensitize the TRPV1 receptors. These findings together suggest a protective effect of TRPV1 receptor blockade in neuropathy. In the present study, we tested the hypothesis that perineural resiniferatoxin (RTX) can prevent the development of hyperalgesia caused by placing loosely constrictive ligatures around the sciatic nerve. ⋯ Perineural RTX prevents the development of neuropathy caused by placing loosely constrictive ligatures on the sciatic nerve. Perioperative use of drugs acting via the TRPV1 receptors may hold the promise for preventing neuropathic pain after surgery on peripheral nerves.
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Anesthesia and analgesia · May 2007
Case ReportsIntrathecal local anesthetic infusion as a treatment for complex regional pain syndrome in a child.
Diagnosis and treatment of complex regional pain syndrome in children is one of the most challenging clinical pain problems encountered in the chronic pain setting. Despite the intense and debilitating nature of the pain, referral to appropriate specialists often comes too late, thereby prolonging an already arduous (and controversial) course of treatment and risking long-term disability. On the contrary, full recovery can be expected with early diagnosis and prompt treatment. The following case study describes a novel and successful use of intrathecal catheter administration of ropivacaine in a child with early, rapidly progressing, and debilitating complex regional pain syndrome.
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Anesthesia and analgesia · May 2007
Comparative StudyRefinement of symptoms of neuropathic pain measurements after various transections of the nerve endings of the sciatic and femoral nerve in rats: an exploratory behavioral analysis.
Many animal models can be used to study the underlying pathophysiological mechanisms of neuropathic pain. Most of these models rely on a partial denervation of the limb of the animal by ligating a selected nerve. In this study, we performed nerve lesions on three peripheral nerves supplying the plantar side of the rat hindpaw by differentially transecting the saphenous, the tibial, and the sural nerves alone or in paired combinations. ⋯ The overlapping innervation of nerve distribution can complicate the interpretation of nerve ligation studies of peripheral neuropathies.
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Anesthesia and analgesia · May 2007
Comparative StudyDextromethorphan or dextrorphan have a local anesthetic effect on infiltrative cutaneous analgesia in rats.
Dextromethorphan blocks sodium channels, the site of action of local anesthetics. In this study we evaluated whether dextromethorphan has a local anesthetic effect. ⋯ Dextromethorphan and dextrorphan were more potent local anesthetics than lidocaine, but with higher systemic safety indices. Coadministration of dextromethorphan or dextrorphan with lidocaine produced an additive effect.