Life sciences
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Randomized Controlled Trial Clinical Trial
Effects of the opioid remifentanil on olfactory function in healthy volunteers.
The effects of opioids on human subjective olfactory function have rarely been investigated. This is despite the fact that opioid receptors are widely distributed throughout the olfactory systems. Using an established validated test of subjective olfactory function, olfactory threshold, odor discrimination and odor identification performance were tested in 16 healthy volunteers before opioid administration and at steady state after 3 hours remifentanil infusion. ⋯ However, remifentanil target plasma concentrations were also significantly correlated with the subjects' ratings of tiredness and drowsiness, although only drowsiness was significantly correlated with the differences in odor thresholds. We conclude that opioid administration leads to impaired olfactory function expressed in raised olfactory thresholds. This is compatible with previously reported opioidergic effects at the level of the olfactory bulb.
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Recent introduction of the intravenous anesthetic propofol as an ICU sedative has allowed a deeply sedated state to be maintained for extended periods in the ICU without delays in emergence. Although such sedation has been advocated to promote physiologic sleep, little evidence exists to support such a strategy. To explore propofol's effect on sleep regulation, we administered propofol directly into the medial preoptic area (MPA) of the rat, an anatomic site where administration of other sedatives (triazolam and phenobarbital) also induce sleep. ⋯ REM sleep times, intermittent waking times and number of transitions were not altered. Mean nonREM sleep bout length was increased significantly at the higher dose. These findings suggest that propofol may enhance sleep by acting at a hypothalamic site.
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Although mu opioids share many pharmacological characteristics, they also reveal many differences. Many approaches over the years have suggested the existence of multiple mu opioid receptors. ⋯ The cloning of a mu opioid receptor, MOR-1, provided a way of exploring this possibility at the molecular level. Recent studies have now identified a number of splice variants of this gene that appear to be important in the production of mu opioid analgesia.
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The excitatory amino acids (EAAs), glutamate and aspartate, acting predominantly on N-methyl-D-aspartate (NMDA) receptor, have been shown to be involved in the central regulation of the secretion of several anterior pituitary hormones including prolactin (PRL), whereas ketamine hydrochloride (KH), a widely used anesthetic, has been reported to antagonize a variety of NMDA receptor mediated actions of these EAAs. In the present study, the effect of KH on basal PRL levels as well as on N-methyl-D,L-aspartate (NMA), an agonist of NMDA receptor, induced plasma PRL secretion was investigated in the adult male rhesus monkey. ⋯ NMA induced an unequivocal increase in plasma PRL concentrations in both conscious chair-restrained and KH anesthetized monkeys, but the response was greater in anesthetized animals than the conscious monkeys. The present findings suggest that KH has stimulatory effects on both basal and NMA induced plasma PRL secretion.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Immediate effects of the serotonin antagonist granisetron on temporomandibular joint pain in patients with systemic inflammatory disorders.
The aim of this study was to investigate if the 5-HT3 antagonist granisetron reduces temporomandibular joint (TMJ) pain in patients with systemic inflammatory joint disorders. Sixteen patients with systemic inflammatory joint disease with pain localized over the TMJ region and tenderness to digital palpation of the TMJ were included. The current resting pain (VASRest) and the pain during maximum mouth opening (VAS(MVM)) of the TMJs were assessed with a 100 mm visual analogue scale. ⋯ In the saline group, VAS(MVM) was decreased after 20 min. In conclusion, granisetron has an immediate, short-lasting and specific pain reducing effect in TMJ inflammatory arthritis. The 5-HT3 receptor may therefore be involved in the mediation of TMJ pain in systemic inflammatory joint disorders.