Effects of hand catalepsy on subjective trance perception and relative parasympathetic tone in healthy volunteers during pleasant hypnotic session: a randomized controlled study.

This study was designed to evaluate the effects on hand catalepsy on parasympathetic tone assessed using Analgesia/Nociception Index (ANI) and on subjective rating of absorption, dissociation, and time perception among healthy volunteers. This was a randomized controlled trial including participants to a medical hypnosis congress in France. Ninety volunteers were randomized in two arms, all receiving a fifteen-minute positive hypnotic trance, with or without hand catalepsy.

HYPNOTIC GLOVE ANESTHESIA INDUCES SKIN TEMPERATURE CHANGES IN ADULT VOLUNTEERS: A Prospective Controlled Pilot Study.

This study assessed whether a focal glove hypnotic hand anesthesia induced thermal changes within the area of hypnotic protection. Skin temperature of hands, wrists, and forearms was continuously recorded bilaterally using infrared thermography in 30 volunteers. Thermal recordings were obtained prior to, after glove building, and after its withdrawal, with the contralateral upper limb serving as control side.

Effects of hypnosis on the relative parasympathetic tone assessed by ANI (Analgesia/Nociception Index) in healthy volunteers: a prospective observational study.

Hypnosis has shown an effect on the regulation of the autonomic nervous system by increasing parasympathetic activity. The Analgesia/Nociception Index (ANI) is derived from heart rate variability and represents the relative parasympathetic tone. We investigated the effects of hypnosis on ANI in healthy volunteers.

Impact of a Hypnotically-Based Intervention on Pain and Fear in Women Undergoing Labor.

The purpose of this study was to evaluate the effects of a hypnotically-based intervention for pain and fear in women undergoing labor who are about to receive an epidural catheter. A group of 155 women received interventions that included either (a) patient rocking, gentle touching, and hypnotic communication or (b) patient rocking, gentle touching, and standard communication. The authors found that the hypnotic communication intervention was more effective than the standard communication intervention for reducing both pain intensity and fear.

[Wound infiltration with local anesthetics for postoperative analgesia. Results of a national survey about its practice in France].

Background And Objective: Local wound infiltration is a component of multimodal postoperative (p.o.) analgesia.

Regional anaesthesia practice for total knee arthroplasty: French national survey - 2008.

Background And Objective: Improved pain management techniques and rehabilitation programs have significantly modified outcome for total knee arthroplasty (TKA).

Objective: The aim of the survey was to describe the French practice patterns in regional anaesthesia for TKA.

Methods: Twenty-item questionnaires were distributed to units with significant orthopaedic activity across France.

A randomized, observer-blinded determination of the median effective volume of local anesthetic required to anesthetize the sciatic nerve in the popliteal fossa for stimulating and nonstimulating perineural catheters.

Background And Objectives: Stimulating perineural catheters are developed to overcome technical problems of nonstimulating catheters, but their efficacy remains controversial. However, no volume-response study has compared success rates between stimulating and nonstimulating catheters. This study of stimulating versus nonstimulating catheters compares the minimal effective volume required to successfully block the sciatic nerve in 50% of patients scheduled for unilateral hallux valgus repair.

Ultrasound- or nerve stimulation-guided wrist blocks for carpal tunnel release: a randomized prospective comparative study.

Background And Objectives: We hypothesized that ultrasound-guided wrist blocks may be faster to perform, and may increase success rate, compared with nerve stimulation-guided wrist blocks.

Methods: Sixty patients undergoing ambulatory endoscopic carpal tunnel release were randomly allocated to receive median and ulnar nerve blocks using either sensory-motor nerve stimulation (n = 30) or ultrasound guidance (n = 30). Four mL of mepivacaine 1.

Time sequence of sensory changes after upper extremity block: swelling sensation is an early and accurate predictor of success.

Background: Sensory assessment to estimate spread and effectiveness of a peripheral nerve block is difficult because no clinical test is specific for small sensory fibers. Occurrence of a swelling illusion (SI) during a peripheral nerve block corresponds to the impairment of small sensory fibers. The authors investigated the usefulness of SI in predicting successful peripheral nerve block by assessing the temporospatial correlation between progression of sensory impairment in cutaneous distributions anesthetized and localization of SI during peripheral nerve block installation.

Influence of sensory and proprioceptive impairment on the development of phantom limb syndrome during regional anesthesia.

Background: The relation between impairment of sensorimotor function and occurrence of phantom limb syndrome (PLS) during regional anesthesia has not been described. This study assessed the temporal relation between PLS and the progression of sensorimotor impairment during placement of a brachial plexus nerve block.

Methods: Fifty-two patients had their arm randomly placed either alongside their body (group A) or in 90 degrees abduction (group B) immediately after brachial plexus nerve block placement.

An unusual case of painful phantom-limb sensations during regional anesthesia.

Objective: The objective of this article is to describe a late-onset phantom-limb pain during a continuous analgesic popliteal nerve block after foot surgery and its alleviation and recurrence when stopping and resuming the local anesthetic infusion.

Case Report: A 29-year-old woman undergoing a left hallux valgus repair received a continuous popliteal sciatic nerve block for postoperative analgesia. Postoperatively, 6 hours after the commencement of a ropivacaine 0.

What pain scales do nurses use in the postanaesthesia care unit?

Background And Objective: The visual analogue scale (VAS) is considered as the gold standard method for postoperative pain assessment. Nevertheless, in some clinical situations, this method may not be reliable. We performed an observational study to assess the use of the VAS and other pain scales by nurses in the postanaesthesia care unit.

Plasticity in action of intrathecal clonidine to mechanical but not thermal nociception after peripheral nerve injury.

Background: Intrathecal clonidine reduces tactile allodynia in animal models of neuropathic pain, and this effect is blocked by atropine. However, the role of tonic spinal cholinergic activity and its interaction with alpha2-adrenergic systems in normal and neuropathic conditions and to different sensory methods has not been systematically examined. The authors examined cholinergic receptor involvement in thermal and mechanical sensitivity in normal and neuropathic animals and its interaction with intrathecal clonidine.

The phenomenology of body image distortions induced by regional anaesthesia.

Patients with peripheral nerve or spinal cord lesions frequently report perceptual distortions related to position, shape, texture or temperature of the affected areas. This study aimed to describe the phenomenology of such body image alterations during the course of upper limb, lower limb or spinal anaesthetic blocks in patients (n = 36) undergoing orthopaedic surgery. Multimodal sensory testing and assessment of motor function were performed at regular intervals, and the relationship between the reported body image distortions and the progression of sensory and motor impairment was analysed.

Brachial plexus nerve block exhibits prolonged duration in the elderly.

Background: Upper limb trauma occurs frequently in elderly patients for whom peripheral nerve blocks are often preferred for anesthesia. The characteristics of such regional blocks have, however, never been described in an elderly population. Therefore, the authors assessed prospectively the onset and duration of upper extremity peripheral nerve block (the mid-humeral block) in elderly and young patients undergoing emergency upper extremity surgery.

Is morphine-induced sedation synonymous with analgesia during intravenous morphine titration?

Background: Postoperative morphine titration frequently induces sedation. The assumption is made that patients sleep when their pain is relieved. Some patients complain of persistent pain when they awake.

Detection of brain death onset using the bispectral index in severely comatose patients.

Objectives: To evaluate the accuracy of bispectral index (BIS) monitoring for the diagnosis of brain death in severely comatose patients.

Design: A prospective study in an intensive care unit of a university hospital.

Population: Fifty-six severely comatose patients (Glasgow Coma Score < or = 5) admitted to the ICU mainly because of intracerebral hemorrhage, head injury, or postanoxic coma.

The clinical efficacy and pharmacokinetics of intraperitoneal ropivacaine for laparoscopic cholecystectomy.

Unlabelled: Postoperative pain after laparoscopic surgery is less than after laparotomy, and patients may benefit from an intraperitoneal injection of local anesthetic. Thirty-seven ASA physical status I or II patients received in double-blinded fashion 20 mL of 0.9% saline solution (placebo), ropivacaine 0.

Activation of cardiac endothelium as a compensatory component in endotoxin-induced cardiomyopathy: role of endothelin, prostaglandins, and nitric oxide.

Background: In view of growing evidence of an important endothelial paracrine regulation of cardiac function, the present study investigated the role of cardiac endothelium-derived endothelin-1 (ET-1), prostaglandins, and nitric oxide (NO) during endotoxin-induced cardiomyopathy in rabbits.

Methods And Results: Immunohistochemical studies showed a marked transient coinduction of the inducible isoforms of NO synthase (NOS-2) and cyclooxygenase (COX-2) in endocardial endothelium and coronary arteriolar endothelium of hearts 12 hours after intravenous administration of lipopolysaccharide (LPS+12h); staining for both isoforms was much weaker 24 hours later (LPS+36h). Nitrotyrosine localization was similar to that of NOS-2, suggesting a NOS-2-related endothelial formation of peroxynitrite in septic hearts.

An obligatory role for spinal cholinergic neurons in the antiallodynic effects of clonidine after peripheral nerve injury.

Background: Indirect evidence supports a role of spinal cholinergic neurons in tonically reducing response to noxious mechanical stimulation and in effecting analgesia from alpha2-adrenergic agonists. This study directly assessed the role of cholinergic neurons in regulating the level of mechanical allodynia and in participating in the antiallodynic effect of the clinically used alpha2-adrenergic agonist, clonidine, in an animal model of neuropathic pain.

Methods: Allodynia was produced in rats by ligation of the left L5 and L6 spinal nerves.