Anesthesia and analgesia
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Anesthesia and analgesia · May 2007
Comparative StudyThe effects of general anesthetics on P2X7 and P2Y receptors in a rat microglial cell line.
Microglial cells play important roles in coordinating the inflammatory brain responses to hypoxia and trauma. Ionotropic P2X receptors and metabotropic P2Y receptors (P2YRs) expressed in microglia can be activated by extracellular adenosine triphosphate (ATP) derived from damaged cells or astrocytes, and participate in the signaling pathways evoked in brain insult. Although several inhaled and IV anesthetics produce neuroprotective effects through neuronal mechanisms, little is known about how general anesthetics modulate microglial responses in the pathological state. We examined the effects of various general anesthetics on purinergic responses in a rat microglial cell line. ⋯ Our results suggest that IV anesthetics, particularly thiopental and propofol, may modulate microglial functions through P2X7Rs in pathological conditions.
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Anesthesia and analgesia · May 2007
Comparative StudyPerineural resiniferatoxin prevents the development of hyperalgesia produced by loose ligation of the sciatic nerve in rats.
The vanilloid receptors (TRPV1) are found in peripheral nerve fibers; their stimulation by capsaicin leads to release of calcitonin gene-related peptide and other neuropeptides participating in neuroinflammation. On the other hand, various inflammatory mediators, released after nerve damage, can activate or sensitize the TRPV1 receptors. These findings together suggest a protective effect of TRPV1 receptor blockade in neuropathy. In the present study, we tested the hypothesis that perineural resiniferatoxin (RTX) can prevent the development of hyperalgesia caused by placing loosely constrictive ligatures around the sciatic nerve. ⋯ Perineural RTX prevents the development of neuropathy caused by placing loosely constrictive ligatures on the sciatic nerve. Perioperative use of drugs acting via the TRPV1 receptors may hold the promise for preventing neuropathic pain after surgery on peripheral nerves.
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Anesthesia and analgesia · May 2007
Comparative StudyAn ultrasonographic and histological study of intraneural injection and electrical stimulation in pigs.
In this study we evaluated the minimum stimulating current associated with intraneural needle placement and sonographic appearance of intraneural injection. ⋯ US may prove useful to detect intraneural injection, whereas a motor response above 0.5 mA may not exclude intraneural needle placement. The correlation between intraneural injection and neurological dysfunction remains unclear.
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Anesthesia and analgesia · May 2007
Case ReportsCesarean delivery in the interventional radiology suite: a novel approach to obstetric hemostasis.
The adjunctive use of interventional radiology procedures to minimize and control bleeding at the time of cesarean delivery has become increasingly common. These procedures require modern imaging equipment and supplies not available in traditional operating rooms. ⋯ We propose that this novel surgical location is feasible, and may offer advantages in select patients.
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Anesthesia and analgesia · May 2007
Case ReportsIntrathecal local anesthetic infusion as a treatment for complex regional pain syndrome in a child.
Diagnosis and treatment of complex regional pain syndrome in children is one of the most challenging clinical pain problems encountered in the chronic pain setting. Despite the intense and debilitating nature of the pain, referral to appropriate specialists often comes too late, thereby prolonging an already arduous (and controversial) course of treatment and risking long-term disability. On the contrary, full recovery can be expected with early diagnosis and prompt treatment. The following case study describes a novel and successful use of intrathecal catheter administration of ropivacaine in a child with early, rapidly progressing, and debilitating complex regional pain syndrome.