Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2014
Mechanisms of Lidocaine's Action on Subtypes of Spinal Dorsal Horn Neurons Subject to the Diverse Roles of Na+ and K+ Channels in Action Potential Generation.
Superficial dorsal horn neurons of the spinal cord receive sensory information from Aδ and C fibers. According to their response to sustained depolarization, these cells can be divided into 3 groups: tonic (TFN), adapting (AFN), and single spike firing (SSN) neurons. During spinal and systemic administration of lidocaine, these neurons are exposed to different concentrations of the local anesthetic lidocaine. In this study, we explored its effect on the excitability of sensory neurons. ⋯ Lidocaine at low concentrations suppresses tonic firing neurons by interacting with voltage-gated potassium channels. The effects on adapting firing neurons can be explained by an interaction with voltage-gated sodium channels. In contrast, the firing pattern of SSN is not affected at the administered concentrations. This different sensitivity to low concentrations of sodium and particularly of potassium channel blockers might represent a novel approach for a differentiated blockade of different spinal dorsal horn neurons.
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Anesthesia and analgesia · Aug 2014
Prolonged Opioid Use After Knee Arthroscopy in Military Veterans.
Chronic postoperative pain occurs with an appreciable incidence after elective surgery. Known risk factors include perioperative pain and posttraumatic stress disorder (PTSD). Military veterans are a population at particular risk for PTSD and hence may be at increased risk for chronic pain after surgery. Our goal was to identify risk factors for chronic postoperative pain in young veterans after minor elective surgery, including the contribution of PTSD. ⋯ This single-center retrospective study suggests that the most important predictor of chronic postoperative pain is preoperative opioid use. For patients not taking opioids preoperatively, PTSD may increase the risk of prolonged postoperative opioid prescriptions and chronic postoperative pain, potentially related to patient age.
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Anesthesia and analgesia · Aug 2014
Historical ArticleAn essay on 35 years of the society of cardiovascular anesthesiologists.
This is an historical account of the accomplishments of the Society of Cardiovascular Anesthesiologists from its founding in 1989 to the present. It is written on the occasion of the 35th anniversary of the founding of this organization. ⋯ The society publishes a section within Anesthesia & Analgesia and supports investigation by providing a forum for the discussion of research and funding peer-reviewed projects. The first 35 years of the Society of Cardiovascular Anesthesiologists has been remarkable in all that has been accomplished.
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Anesthesia and analgesia · Aug 2014
Hydrogen-Rich Saline Improves Survival and Neurological Outcome after Cardiac Arrest and Cardiopulmonary Resuscitation in Rats.
Sudden cardiac arrest is a leading cause of death worldwide. Three-fourths of cardiac arrest patients die before hospital discharge or experience significant neurological damage. Hydrogen-rich saline, a portable, easily administered, and safe means of delivering hydrogen gas, can exert organ-protective effects through regulating oxidative stress, inflammation, and apoptosis. We designed this study to investigate whether hydrogen-rich saline treatment could improve survival and neurological outcome after cardiac arrest and cardiopulmonary resuscitation, and the mechanism responsible for this effect. ⋯ Hydrogen-rich saline treatment improved survival and neurological outcome after cardiac arrest/resuscitation in rats, which was partially mediated by reducing oxidative stress, inflammation, and apoptosis.
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Anesthesia and analgesia · Aug 2014
Comparative StudyNovel Use of Perineural Pregabalin Infusion for Analgesia in a Rat Neuropathic Pain Model.
The anticonvulsant drugs pregabalin and gabapentin are often used systemically to treat some forms of chronic neuropathic pain. However, many patients report side effects serious enough to cause discontinuation of the drug. Here we present evidence that pregabalin may block neuropathic pain when applied to the site of nerve injury in a rat neuropathic pain model. ⋯ Perineural pregabalin administration produced superior analgesia compared with that of systemic pregabalin in this neuropathic pain model. Perineural pregabalin treatment may provide a useful alternative to systemic pregabalin treatment for neuropathic pain.