Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2014
Phα1β, a Peptide from the Venom of the Spider Phoneutria nigriventer Shows Antinociceptive Effects after Continuous Infusion in a Neuropathic Pain Model in Rats.
Neuropathic pain is a severe painful pathology that is difficult to treat. One option for its management is the continuous intrathecal (i.t.) infusion of ziconotide (the Conus magnus peptide ω-conotoxin MVIIA), which, in addition to being effective, produces serious adverse effects at analgesic doses. Single i.t. administration of Phα1β, a peptide purified from the venom of the spider Phoneutria nigriventer, has antinociceptive effects with a greater therapeutic window than ziconotide in rodents. To further evaluate its analgesic potential, we investigated the antinociceptive and toxic effects of Phα1β after single or continuous i.t. infusion in a rat model of neuropathic pain. ⋯ Thus, we have shown for the first time that the continuous i.t. delivery of Phα1β produces analgesia disconnected from toxicity in a relevant model of neuropathic pain, indicating that it is an effective and safe drug with a great potential to treat pain.
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Anesthesia and analgesia · Jul 2014
The Effect of Intrathecal Administration TRPA1 Antagonists in a Rat Model of Neuropathic Pain.
The fact that transient receptor potential ankyrin 1 (TRPA1) on the peripheral terminals could attenuate hyperalgesia is widely accepted, but the effect of spinal TRPA1 in the modulation of hyperalgesia has not been fully demonstrated. In the present study, we investigated the effect of intrathecal (i.t.) administration TRPA1 antagonists on chronic pain and expression of TRPA1 and phosphorylation N-methyl-D-aspartate receptor 2B subunit (p-NR2B) in the spinal cord with chronic compression of the dorsal root ganglia (CCD) in rats. ⋯ These data demonstrated that the i.t. administration of TRPA1 antagonists could attenuate neuropathic pain in CCD rats, and this effect could be partially reduced by p-NR2B receptor expression in spinal cord.
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Anesthesia and analgesia · Jul 2014
The Sevoflurane Washout Profile of Seven Recent Anesthesia Workstations for Malignant Hyperthermia-Susceptible Adults and Infants: A Bench Test Study.
Preoperative flushing of an anesthesia workstation is an alternative for preparation of the anesthesia workstation before use in malignant hyperthermia-susceptible patients (MHS). We studied in vitro, using a test lung, the washout profile of sevoflurane in 7 recent workstations during adult and, for the first time, pediatric ventilation patterns. ⋯ This descriptive study strongly suggests that washout profiles may differ for each anesthesia workstation. We advise the use of maximal FGF during preparation and anesthesia. Required flushing times are longer when preparing an anesthesia workstation before providing anesthesia for MHS infants.
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Anesthesia and analgesia · Jul 2014
Recent Advances in and Limitations of Cardiac Output Monitoring by Means of Electrical Impedance Tomography.
Currently, the monitoring of cardiac output (CO) and stroke volume (SV) is mainly performed using invasive techniques. Therefore, performing CO monitoring noninvasively by means of electrical impedance tomography (EIT) would be advantageous for intensive care. Our hypothesis was that, by means of EIT, it is possible to assess heart rate (HR) and to quantify changes in SV due to changes in ventilator settings. ⋯ The hypothesis that EIT can be used to monitor CO and SV was confirmed, but further studies are required before this technique can be applied in clinical practice. HR was determined robustly and accurately. For SV monitoring, promising results were obtained in 80% of the experiments. However, unexpected scaling of the cardiac EIT signal causing inaccurate estimation of SV remains an issue. Before robust assessment of SV by EIT is suitable for clinical practice, the cause of and compensation for undesired scaling effects need to be investigated.