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Items 1 - 13 of 13 |
One page. |
Effect of sumatriptan in different models of pain in rats.
Ottani A, Ferraris E, Giuliani D, Mioni C, Bertolini A, Sternieri E, Ferrari A.
Department of Biomedical Sciences, University of Modena and Reggio Emilia, Section of Pharmacology, Via G. Campi 287, 41100 Modena, Italy. alessandraottani@yahoo.it
The effect of sumatriptan in two standard algesimetric tests and in a model of cephalalgia was evaluated in rats. The pain threshold was measured by the hot-plate and the writhing tests; cephalalgia was produced by injecting bradykinin (10 microg in a volume of 10 microl) into a common carotid artery. Sumatriptan was subcutaneously (s.c.) injected at the doses of 4, 8, 24 or 42 mg/kg; morphine (5 or 10 mg/kg s.c.) and indomethacin (5 or 10 mg/kg s.c) were used as standard analgesic drugs. Sumatriptan had no analgesic activity either in the hot-plate test or in the writhing test. On the other hand, at 24 and 42 mg/kg it dose-dependently reduced the response to the intracarotid injection of bradykinin (vocalization and tachypnea), this effect being prevented by the 5-HT(1B) receptor antagonist, isamoltane. The 5-HT(1D) receptor antagonist BRL15572 prevented the effect of sumatriptan on bradykinin-induced tachypnea, but not the effect of sumatriptan on bradykinin-induced vocalization. These data demonstrate that sumatriptan is significantly effective in a reliable animal model of cephalalgia, while having no systemic analgesic activity.
PMID: 15306203 [PubMed - in process]
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Nimodipine for treatment of primary thunderclap headache.
Lu SR, Liao YC, Fuh JL, Lirng JF, Wang SJ.
Department of Neurology, Kaohsiung Medical University, Chung-Ho Memorial Hospital, Taiwan.
Eleven patients with primary thunderclap headache (TCH) were treated with oral nimodipine 30 to 60 mg every 4 hours or IV nimodipine 0.5 to 2 mg/h if the oral regimen failed or images showed cerebral vasospasm. With oral nimodipine, headache did not recur in the nine patients without vasospasm. IV nimodipine was given in two patients with vasospasm, including one who developed ischemic stroke. Nimodipine may be effective for TCH. Vasospasm may warrant IV nimodipine.
Publication Types:
PMID: 15111686 [PubMed - indexed for MEDLINE]
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Ask about prior and former pain, too.
Whitman SM.
Publication Types:
PMID: 15305271 [PubMed - in process]
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We need to educate about perioperative pain control and not just regional anesthesia.
McCartney CJ.
Publication Types:
PMID: 15305269 [PubMed - in process]
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A pain physician on every corner?
Hackbarth MA.
PMID: 15305262 [PubMed - in process]
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Patients' perception of pain during axillary and humeral blocks using multiple nerve stimulations.
Koscielniak-Nielsen ZJ, Rasmussen H, Nielsen PT.
Department of Anesthesia and Operative Services, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark . zjkn@rh.dk
BACKGROUND AND OBJECTIVES: Axillary or humeral blocks by multiple nerve stimulation (MNS) are used for ambulatory hand surgery. This double-blind study identified which of the three main components of the procedure (repeated needle passes, local anesthetic injections, or electrical stimulations) is most painful, quantified its intensity, and recorded patients' preferences for a future anesthetic. METHODS: Eighty unsedated ambulatory patients were randomized to 2 equal groups: axillary (A) and humeral (H). In each patient, 4 terminal motor nerves (musculocutaneous, median, ulnar, and radial) were electrolocated by use of an initial current of 2 mA, 0.1 ms and a target current of 0.1 to 0.5 mA. After block placement and before the start of surgery, patients were requested to identify which of the 3 main components of the block was most unpleasant and to quantify its intensity on a visual analog scale (VAS) of 0 to 100. Twenty minutes after completion of the block, the unblocked nerves were electrolocated at the elbow and supplemented. Patients were declared ready for surgery when they had complete analgesia of the hand and forearm. Before discharge from the hospital, patients indicated which anesthetic method (block alone, block plus sedation, or general anesthesia) they would choose for future hand surgery. RESULTS: Twenty-seven patients in group A vs. 17 patients in group H reported electrical stimulations as the most unpleasant block component (P =.03). No significant differences occurred in any of the VAS scores. Patients' request for the same anesthetic, 35 in group A and 37 in group H, were similar. Group A patients were ready for surgery sooner than group H patients (mean 26 minutes vs. mean 30 minutes for group H patients; P =.04). No serious complications were observed. CONCLUSIONS: This study found that more axillary-block patients compared with humeral-block patients reported electrical stimulation as the most unpleasant part of the block but failed to detect significant differences in the intensity of the 3 block components (repeated needle passes, local anesthetic injections, and electrical stimulations). Most patients in both groups would accept the same block for future hand operations. Patients were ready for surgery sooner after axillary block, but the clinical importance of this finding is doubtful.
PMID: 15305252 [PubMed - in process]
Re: Yelland MJ, Glasziou PP, Bogduk N, et al. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized study. Spine. 2003;29:9-16.
Kidd R.
Publication Types:
PMID: 15303039 [PubMed - in process]
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Re: Yelland MJ, Glasziou PP, Bogduk N, et al. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized study. Spine. 2003;29:9-16.
Linetsky F, Saberski L, Dubin JA, Miguel R, Wilkinson H.
Publication Types:
PMID: 15303038 [PubMed - in process]
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Re: Yelland MJ, Glasziou PP, Bogduk N, et al. Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized study. Spine. 2003;29:9-16.
Reeves KD, Klein RG, DeLong WB.
Publication Types:
PMID: 15303037 [PubMed - in process]
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The "myths" of low back pain: status quo in norwegian general practitioners and physiotherapists.
Ihlebaek C, Eriksen HR.
Norwegian Back Pain Network, Research Unit, Department of Biological and Medical Psychology, University of Bergen, Norway. camilla.ihlebaek@psych.uib.no
BACKGROUND: In 2001, several myths of low back pain still were alive in the general population in Norway, myths that were not in concordance with current guidelines. OBJECTIVES: To investigate perceptions about back pain in Norwegian general practitioners and physiotherapists and to compare these with perceptions in the general population. METHODS: During June 2001, 436 general practitioners (mean age 44.8, range 26-69 years) and 311 physiotherapists (mean age 47.6, range 25-70) were asked to rate their agreement with 7 statements, corresponding to Deyo's 7 myths that formulate 7 common misbeliefs on back pain. The corresponding data from the general population of 807 individuals (mean age 45.5, range 25-70) were sampled during early spring 2001. RESULTS: There were significant differences between the general population, general practitioners, and physiotherapists for all myths, the general population being more likely to agree with all myths. The differences were maintained even after controlling for educational level in the general population. There were no differences between general practitioners and physiotherapists except for the myths "radiographs and newer imaging tests can always identify the cause of pain" and "back pain is usually disabling," whereas general practitioners were less likely to disagree with the myths. Few gender and age differences were found in the professional groups. CONCLUSION: In Norwegian general practitioners and physiotherapists, Deyo's 7 myths mostly seem to be dead and buried. However, it does not seem that this has extended to the public yet, as many myths still are alive in the general population.
PMID: 15303028 [PubMed - in process]
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A longitudinal, community-based study of low back pain outcomes.
Jacob T, Baras M, Zeev A, Epstein L.
Physiotherapy Department, College of Judea and Samaria, Ariel.
OBJECTIVES: To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporting symptoms during an initial cross-sectional survey. STUDY DESIGN: A longitudinal community-based study. SUMMARY OF BACKGROUND DATA: The natural history of LBP is poorly understood. Different studies report various rates of persistent and recurrent symptoms as well as different predictors of outcomes. METHODS: Subjects from a single town in Israel reporting low back pain during the previous month were followed up after 2 and 12 months. The primary outcome was experiencing LBP and the secondary outcomes were pain and functional status as measured by the Roland & Morris Disability questionnaire and Pain Symptoms Frequency and Bothersomeness Indexes. RESULTS: More than three fourths reported LBP (different levels of severity) after 2 and 12 months. This group did not show an improvement in pain measures. Baseline pain characteristics and perception of general health were predictors of both primary and secondary outcomes. Work satisfaction and experiencing a negative event during the past months were also predictors of the secondary outcomes. CONCLUSIONS: In this community-based study, LBP symptoms after 1 year are common and symptoms of those experiencing LBP at follow up do not improve over time. Predictors of experiencing LBP and of LBP symptoms after 1 year included baseline pain characteristics and psychosocial factors.
PMID: 15303027 [PubMed - in process]
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Temperatures within the lumbar disc and endplates during intradiscal electrothermal therapy: formulation of a predictive temperature map in relation to distance from the catheter.
Bono CM, Iki K, Jalota A, Dawson K, Garfin SR.
Department of Orthopaedic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts 02118-2393, USA. bonocm@prodigy.net
STUDY DESIGN: Temperatures were measured in human cadaveric lumbar discs during intradiscal electrothermal therapy. OBJECTIVES: To determine if sufficient temperatures for collagen denaturation and nociceptive ablation can be achieved at clinically significant distances from the intradiscal electrothermal therapy heating catheter. SUMMARY OF BACKGROUND DATA: Previous cadaveric studies have contested the ability of the intradiscal electrothermal therapy catheter to produce sufficient temperatures to denature collagen and cause neural ablation within the posterior anulus of the disc. However, these experiments used clinically unrepresentative device placements along the anterolateral anulus. METHODS: Intradiscal electrothermal therapy was performed in 14 human cadaveric discs. Devices were inserted using a standard posterolateral approach to orient the heating catheter along the posterior anulus. Temperature recordings were collected using multiple sensors placed along the posterior anulus, anterior anulus, and endplates. RESULTS: Temperatures greater than 60 C and 65 C were achieved in 14 and 5 specimens, respectively, at distances up to 2 mm from the catheter. Between 2 and 4 mm, more than 60 C was achieved in all specimens. More than 45 C was achieved in all specimens at distances of 9 to 14 mm from the device. CONCLUSIONS: Temperatures sufficient for collagen denaturation and nociceptive ablation were detected at distances greater than previously documented. These data suggest that intradiscal electrothermal therapy's proposed heat-dependent mechanisms of action are achievable in most discs. Among other factors, interspecimen variability of maximum temperatures may help explain the somewhat inconsistent clinical results following intradiscal electrothermal therapy.
PMID: 15131441 [PubMed - indexed for MEDLINE]
Center median-parafascicular complex and pain control. Review from a neurosurgical perspective.
Weigel R, Krauss JK.
Department of Neurosurgery, University Hospital, Mannheim, Germany.
The center median-parafascicular (CM-Pf) complex, which constitutes the major portion of the intralaminar thalamus in man, has long been known to be involved in the processing of pain under normal and pathological conditions. Yet, these 'forgotten' nuclei with their rich connectivity to other thalamic nuclei, the basal ganglia and cortical areas have received only relatively little attention over the past two decades. With regard to the recent reinterest in functional stereotactic neurosurgery as a treatment option for chronic refractory pain, the CM-Pf complex has been reconsidered as a target. This review provides a systematic overview on the current knowledge about the anatomy and connectivity of the CM-Pf complex, neurophysiological studies, and on concepts of its role in pain processing under various conditions. We also review the previous experience with ablative surgery and deep brain stimulation of the CM-Pf complex. Studies in men and experimental animals indicate that the CM-Pf complex is part of a medial pain system, which appears to be involved primarily in affective and motivational dimensions of pain. Single-unit recordings from the CM-Pf complex have shown that the activity of CM-Pf cells is modified by painful stimuli. Under pathological conditions, bursting firing patterns and altered discharge rates were found. Thalamotomies targeting at the CM-Pf complex yielded beneficial results for chronic pain, but interpretation of the results is limited. With bifocal deep brain stimulation, short-term effects of CM-Pf stimulation were superior to those of somatosensory thalamic stimulation in neuropathic pain. There is evidence, that the CM-Pf complex might also be involved in the mediation of the beneficial effects of somatosensory thalamic stimulation and periventricular grey stimulation. Copyright 2004 S. Karger AG, Basel
Publication Types:
PMID: 15305084 [PubMed - indexed for MEDLINE]
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