Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2015
Observational StudyFibromyalgia Is Associated With Coronary Heart Disease: A Population-Based Cohort Study.
We examined whether patients with a diagnosis of fibromyalgia have an increased risk of coronary heart disease (CHD), compared with age- and sex-matched control patients. We hypothesized that patients diagnosed with fibromyalgia are at increased risk of adverse coronary events. ⋯ An association between fibromyalgia and CHD appears to exist.
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Reg Anesth Pain Med · Jan 2015
Retrospective Study of Epidural Blood Patch Use for Spontaneous Intracranial Hypotension.
Spontaneous intracranial hypotension (SIH) is characterized by a severe and disabling headache that is usually orthostatic in nature. Cisternography is a useful diagnostic test for evaluating the presence and location of cerebrospinal fluid (CSF) leakage, and a targeted epidural blood patch (EBP) based on the cisternography findings is a very effective treatment modality for SIH. However, the effects of EBPs are not predictable, making repeat EBPs essential in some cases. The aim of the present study was to find the relationship between the EBP response and cisternographic findings, hypothesizing that the number of required EBPs would increase with an increased number of CSF leakage levels as determined by radionuclide cisternography. ⋯ Our study suggests that the response to the EBP is related to the severity of symptoms but not to the number and locations of cisternographic CSF leakages.
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Reg Anesth Pain Med · Jan 2015
The Effect of Clinically Therapeutic Plasma Concentrations of Lidocaine on Natural Killer Cell Cytotoxicity.
Natural killer (NK) cells can induce death in cancer cells. Previous studies suggest that lidocaine may decrease the function of NK cells. However, it is unknown whether lower concentrations of lidocaine, usually found in patients managed with continuous infusions, also impair the function of NK cells. We hypothesized that lidocaine at low concentrations preserves the function of NK cells. ⋯ Our findings suggest that clinically relevant concentrations of lidocaine enhance the in vitro function of NK cells via the release of lytic granules.
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Reg Anesth Pain Med · Jan 2015
Comparative StudyEffects of Sodium Bisulfite With or Without Procaine Derivatives on Axons of Cultured Mouse Dorsal Root Ganglion Neurons.
Sodium bisulfite (NaHSO3) was clinically used as a preservative agent for local anesthetics but was later suspected to be neurotoxic. However, recent studies reported that NaHSO3 reduces the neurotoxicity of local anesthetics. The purpose of this study was to examine the effects of NaHSO3 with and without procaine on axonal transport in cultured mouse dorsal root ganglion (DRG) neurons. ⋯ NaHSO3 resulted in a dose-dependent damage to the cell membrane and axonal transport, especially when used in combination with procaine or chloroprocaine.
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Reg Anesth Pain Med · Jan 2015
A Wearable Epidural Catheter Infusion System for Patients With Intractable Spontaneous Intracranial Hypotension.
Spontaneous intracranial hypotension is an important cause of secondary headaches, and most patients respond well to epidural blood patching or direct repair of the underlying spinal cerebrospinal fluid leak. However, options are limited for those patients who have exhausted these traditional treatments, especially when spinal imaging is normal. We describe a wearable epidural catheter infusion system for patients with intractable spontaneous intracranial hypotension. ⋯ This wearable epidural catheter infusion system showed promising efficacy results but the high rate of complications limits its use to a very select group of patients.