Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2020
Effect of pterygopalatine blockade on perioperative stress and inflammatory outcomes following paediatric cataract surgery.
General anesthesia is required to perform pediatric cataract surgery. To reduce severity of surgical intervention and postoperative complications, regional techniques have been concomitantly used. The traditional regional ophthalmic techniques are retrobulbar, peribulbar and sub-Tenon blocks, which present some technical difficulties and associated complication risks. The pterygopalatine blockade has been exempt of many of these concerns as it is performed out of the orbit. The purpose of this study was to compare the analgesic and anti-inflammatory effects of the pterygopalatine blockade with retrobulbar block in children undergoing elective congenital cataract surgery. ⋯ The use of the pterygopalatine blockade as a component of anesthesia in pediatric cataract surgery allows reduction of the severity of surgical stress during surgical intervention, providing intraoperative hemodynamic stability and prolonged analgesia.
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Reg Anesth Pain Med · Mar 2020
Clinical TrialLongitudinal neural exposure to local anesthetic and nerve block duration: a retrospective analysis of experimental data from healthy volunteer trials.
Characteristics of a nerve block depend on the distribution of local anesthetic (LA) close to the nerve. The relationship between longitudinal distribution of LA and nerve block characteristics has not been investigated in viv o, but one in vitro study showed decrements in action potential amplitudes with increasing exposure length. We describe the influence of longitudinal neural exposure to LA on nerve block duration adjusted for other likely influential factors. ⋯ Longitudinal neural exposure to LA was significantly associated with nerve block duration. LA dose was the strongest determinant for block duration whereas LA volume had no influence.
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Reg Anesth Pain Med · Mar 2020
Social media for the regional anesthesiologist: can we use it in place of medical journals?
The regional anesthesia community regularly uses social media for advocacy and education. Well-known leaders in the field are willing to share their opinions with colleagues in a public forum. ⋯ Does a lack of online regulation along with a bias towards self-promotion cloud meaningful discussion? In order to avoid the pitfalls of social media, thoughtful communication will help regional anesthesiologists promote their subspecialty. Mindful dialog, promotion of academic journals, and professional etiquette will help maintain a collegial environment.
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Reg Anesth Pain Med · Mar 2020
Levo-corydalmine attenuates microglia activation and neuropathic pain by suppressing ASK1-p38 MAPK/NF-κB signaling pathways in rat spinal cord.
Neuropathic pain is partially refractory to currently available treatments. Although some studies have reported that apoptosis signal-regulating kinase 1 (ASK1) may inhibit chronic pain, the mechanisms underlying this process have not been fully elucidated. ⋯ This study showed that the expression of ASK1 in spinal microglia and ASK1 inhibitor suppressed microglia activation via suppression of p38 MAPK/NF-κB, which ultimately attenuated CCI-induced neuropathic pain. l-CDL also inhibited the ASK1-P38 MAPK/NF-κB axis to attenuate CCI-induced neuropathic pain.
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Reg Anesth Pain Med · Mar 2020
Sphingosine 1-phosphate receptor modulation attenuate mechanical allodynia in mouse model of chronic complex regional pain syndrome by suppressing pathogenic astrocyte activation.
FTY720 ((2-amino-2-)2-[4-octylphenyl]ethyl)-1,3-propanediol) is an Food and Drug Administration (FDA)-approved immunomodulatory drug for treating multiple sclerosis. It inhibits lymphocyte egression from lymphoid tissues by downregulating sphingosine-1 phosphate receptor (S1PR). To date, there has been no study on the effects of FTY720 on the chronic stage of the complex regional pain syndrome (CRPS) rodent model, despite its antiallodynic effect in previous studies. Thus, the aim of this study is to investigate the effect of FTY720 in a chronic stage of the CRPS mouse model. ⋯ Collectively, these results demonstrate that intrathecally administered FTY720 attenuates mechanical allodynia in the chronic stage of the CRPS mouse model.