Articles: anesthetics.
-
Myofascial pain syndrome (MPS) caused by trigger points in muscles is a common cause of local or generalized pain, which is clinically common, has a high incidence, and has no specific cure. The most popular and widely used clinical method mainly targets the trigger point for treatment, i.e. trigger point injection (TPI) therapy. ⋯ This method is low cost and less invasive, and early clinical applications have shown good efficacy. In this paper, we have reviewed clinical research progress in treating MPS with TPI therapy.
-
Anesthesia and analgesia · Oct 2024
Anesthetic Techniques and Cancer Outcomes: What Is the Current Evidence?
It is almost 2 decades since it was first hypothesized that anesthesia technique might modulate cancer biology and thus potentially influence patients' long-term outcomes after cancer surgery. Since then, research efforts have been directed towards elucidating the potential pharmacological and physiological basis for the effects of anesthetic and perioperative interventions on cancer cell biology. In this review, we summarize current laboratory and clinical data. ⋯ With the sole exception of peritumoral lidocaine infiltration in breast cancer surgery, these RCTs have indicated a neutral effect of anesthetic technique on long-term oncologic outcomes. Therefore, unless there are significant new findings from a few ongoing trials, future investigation of how perioperative agents interact with tumor genes that influence metastatic potential may be justified. In addition, building multidisciplinary collaboration to optimize perioperative care of cancer patients will be important.
-
Anesthesia and analgesia · Oct 2024
Comparative Electroencephalographic Profile of a New Anesthetic and Anticonvulsant That Is Selective for the GABAAR Slow Receptor Subtype.
Anesthetics like propofol increase electroencephalography (EEG) power in delta frequencies (0.1-4 Hz), with a decrease of power in bandwidths >30 Hz. Propofol is nonselective for gamma amino butyric acid type A receptor subtypes (GABA A R) as it enhances all 3 GABA A R subtypes (slow, fast, and tonic). Our newly developed anesthetic class selectively targets GABA A R-slow synapses to depress brain responsiveness. We hypothesized that a selective GABA A R-slow agonist, KSEB 01-S2, would produce a different EEG signature compared to the broad-spectrum GABA A R agonist (propofol), and tested this using rat EEG recordings. ⋯ KSEB 01-S2 produced a markedly different EEG pattern, with a selective increase observed in the theta frequency range. KSEB 01-S2 also differs markedly in its activity at the GABA A R-slow receptor subtype, suggesting a possible mechanistic link between receptor subtype specificity and EEG frequency band signatures. Increased theta together with depressed gamma frequencies is interesting because GABA A R slow synapses have previously been suggested to underlie theta frequency oscillations, while fast synapses control gamma activity. These reciprocal effects support a previous model for theta and nested gamma oscillations based on inhibitory connections between GABA A R fast and slow interneurons. Although each anesthetic produced a unique EEG response, propofol and KSEB 01-S2 both increased slow wave activity and flattened chaotic attractor plots at the point of LOC.
-
Neurologic disorders and complications during pregnancy are common, but guidelines and data are sparse. This review aims to give an overview of recent developments in neuroanesthesia and management of neuropathology during pregnancy, with the hope that these may fill the gaps in current guidelines and recommendations, as well as their implications for an anesthetic approach. ⋯ While clinical trials remain sparse, larger population-based studies offer insight into the optimal approach to the parturient with neurologic disease.
-
Randomized Controlled Trial Comparative Study
Addition of liposomal bupivacaine to standard bupivacaine versus standard bupivacaine alone in the supraclavicular brachial plexus block: a randomized controlled trial.
The analgesic effect of adding liposomal bupivacaine to standard bupivacaine in supraclavicular brachial plexus block is not known. The authors hypothesized that addition of liposomal bupivacaine would reduce acute postoperative pain compared to standard bupivacaine alone. ⋯ Liposomal bupivacaine given via supraclavicular brachial plexus block reduced pain at rest in the early postoperative period.