Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Mar 2012
In vitro antiseptic effects on viability of neuronal and Schwann cells.
Chlorhexidine is recommended by several anesthesiology societies for antisepsis before regional anesthesia, but there is concern it may be neurotoxic. We evaluated the cytotoxicity of chlorhexidine and povidone-iodine in human neuronal and rat Schwann cells. ⋯ Chlorhexidine gluconate and povidone-iodine were cytotoxic to SH-SY5Y (neuronal) and RSC96 (Schwann) cells. Chlorhexidine was more potent than povidone-iodine at more dilute concentrations. However, the toxicity of the two was not different at concentrations used clinically. When using either of these agents for antisepsis before regional anesthesia, it is prudent to allow adequate drying time after application.
-
Reg Anesth Pain Med · Mar 2012
The use of dye surrogates to illustrate local anesthetic drug sequestration by lipid emulsion: a visual demonstration of the lipid sink effect.
We hypothesized that by substituting a dye surrogate in place of local anesthetic, we could visually demonstrate dye sequestration by lipid emulsion that would be dependent on both dye lipophilicity and the amount of lipid emulsion used. ⋯ Our study provides a visual demonstration of the lipid sink effect. It supports the theory that lipid emulsion may reduce the amount of free drug present in plasma from concentrations associated with an invariably fatal outcome to those that are potentially survivable.
-
Reg Anesth Pain Med · Mar 2012
Electron-microscopic imaging of endothoracic fascia in the thoracic paravertebral space in rats.
Anesthesia and analgesia with paravertebral block are reportedly variable. Existence of an endothoracic fascia has been proposed as one of the possible mechanisms leading to variability. We undertook an electron-microscopy imaging study to investigate the endothoracic fascia in the thoracic paravertebral space (TPS) in rats. ⋯ The endothoracic fascia in rats appears to divide the TPS into EPC and SETC. These anatomic characteristics may have implications in thoracic paravertebral blockade.
-
Reg Anesth Pain Med · Mar 2012
Modulating pain in the periphery: gene-based therapies to enhance peripheral opioid analgesia: Bonica lecture, ASRA 2010.
This article provides a brief overview of earlier work of our group on the peripheral signaling of pain, summarizes more recent studies on the role of opioids in chronic neuropathic pain, and speculates on the future of gene-based therapies as novel strategies to enhance the peripheral modulation of pain. Neurophysiologic and psychophysical studies have revealed features of primary afferent activity from somatic tissue that led to improved understanding of the physiology and pathophysiology of pain signaling by nociceptive and nonnociceptive fibers. ⋯ Our work has focused on characterizing this peripheral opioid analgesia in chronic neuropathic pain such that it can be exploited to develop novel and potent peripheral analgesics for its treatment. Ongoing research on virus-mediated gene transfer strategies to enhance peripheral opioid analgesia is presented.
-
Reg Anesth Pain Med · Mar 2012
Prolongation of epidural analgesia using solid lipid nanoparticles as drug carrier for lidocaine.
Solid lipid nanoparticles (SLNs), as a drug carrier, are a very attractive strategy for sustained and controlled drug release. In this study, we investigated the feasibility of SLNs to prolong the action of lidocaine for potential application in epidural anesthesia and analgesia. ⋯ Solid lipid nanoparticles can be exploited as a promising drug carrier for extending the action of lidocaine.