Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jun 2019
Response to BotulinumtoxinA in a migraine cohort with multiple comorbidities and widespread pain.
The phase III research evaluating migraine prophylaxis therapy (PREEMPT) protocol was developed in low-risk migraine patients. We studied longitudinal response to treatment in a sequential retrospective observational cohort to evaluate predictors of effectiveness in patients with multiple overlapping pain syndromes treated in a quaternary pain management clinic. ⋯ Our findings point to the importance of identifying and addressing pain interference and depression early in chronic migraine management and, more broadly, highlights the importance of multidisciplinary evaluation and treatment in chronic migraine.
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Reg Anesth Pain Med · Jun 2019
Antihyperalgesia effect of AMP-activated protein kinase (AMPK) activators in a mouse model of postoperative pain.
AMP-activated protein kinase (AMPK) activator drugs decrease hypersensitivity in mice with pain. This study examines if postsurgery treatment with the prototype AMPK activator metformin and a new mechanism-specific AMPK activator, O304, after plantar hindpaw incision in mice, would reduce mechanical hypersensitivity and produce changes in the AMPK pathway in the dorsal root ganglion (DRG). ⋯ Early treatment with the mechanism-specific AMPK activator O304 or the prototype AMPK activator metformin reduces mechanical hypersensitivity in a postoperative pain model in mice. These drugs also normalize the AMPK pathway in the DRG.
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Reg Anesth Pain Med · Jun 2019
Correlation between gestational age and level of sensory block in spinal anesthesia.
To identify a specific correlation between progression of gestational age and level of sensory block in spinal anesthesia in patients undergoing cervical cerclage. ⋯ Results demonstrated that as the gestational age progressed, sensory block level increased, blood pressure was decreased, and length of PACU stay increased after spinal anesthesia. Sensory block increased by 0.28 dermatomes when the pregnancy progressed 1 week. Further controlled prospective studies are needed to support this relationship.
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Reg Anesth Pain Med · Jun 2019
Enhanced needle visibility by microbubbles generated with negative pressure using an in-plane technique.
Our previous work found that needle visibility could be improved by introducing microbubbles into needles. The primary aim of this study was to test the hypothesis that the negative pressure method is superior to two other methods for enhancing needle visibility by introducing microbubbles into needles. The secondary aim was to evaluate the impacts of three factors on the visibility of microbubble-filled needles. ⋯ Needle visibility can be significantly improved by microbubbles generated with the negative pressure method when insertion angles are 40°, 50° and 60° in porcine meat.