Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2021
Protein kinase G signaling pathway is involved in sympathetically maintained pain by modulating ATP-sensitive potassium channels.
Sympathetically maintained pain (SMP) involves an increased excitability of dorsal root ganglion (DRG) neurons to sympathetic nerve stimulation and circulating norepinephrine. The current treatment of SMP has limited efficacy, and hence more mechanistic insights into this intractable pain condition are urgently needed. ⋯ Our findings suggest an important role of cGMP-PKG signaling pathway in the increased excitability of small-diameter DRG neurons to norepinephrine after CTT, which involves an inhibition of the ATP-sensitive potassium currents through PKG-induced phosphorylation. Accordingly, drugs targeting this pathway may help to treat SMP.
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Reg Anesth Pain Med · Nov 2021
Bariatric surgery and total knee/hip arthroplasty: an analysis of the impact of sequence and timing on outcomes.
Patients with morbid obesity may require both bariatric surgery and total knee/hip arthroplasty (TKA/THA). How to sequence these two procedures with better outcomes remains largely unstudied. ⋯ Patients who require both bariatric surgery and TKA/THA should consider bariatric surgery before TKA/THA as it is associated with improved outcomes. Procedures should be staged beyond 6 months.