Unlabelled: Although local anesthetics can, in some situations, alleviate neuropathic pain, currently available preparations are short-acting and nonselective, producing, for example, motor dysfunction. Clinical studies report that a novel suspension preparation of butamben has the advantage of a prolonged duration of action, and it can be used epidurally, without impairment of motor function. In this behavioral study, we investigated the effect of the epidural administration of a 5% butamben suspension on nerve injury-induced allodynia. Behavioral studies were performed using an established animal model of neuropathic pain, which involves a partial ligation of the sciatic nerve. Nociceptive thresholds to mechanical stimulation were determined by the paw withdrawal method. The allodynia to mechanical stimulation induced by partial nerve ligation was significantly attenuated by daily injections, for 5 days, of 10 microL of butamben suspension. The analgesia lasted at least 7 days after the final injection. Daily injections of 10 microL of vehicle, for 5 days, had no significant effect on allodynia. During the period of daily injections, both the butamben and vehicle treated rats had temporary impairment of motor coordination compared with untreated controls. Motor function recovered after the final injection. Neither daily injections of butamben for 2 or 3 days, nor smaller volumes for 5 days (2.5-5 microL), had a long-lasting effect. We conclude that repeated epidural administration of butamben suspension for several days provides long-lasting analgesia in rats with nerve injury-induced allodynia to mechanical stimulation.
Implications: In this animal behavioral study, using rats with nerve injury-induced pain, we examined the possible long-term analgesic effects of epidural administration of a suspension of the local anesthetic, butamben. We found that multiple doses for several days were required to provide a prolonged analgesia.
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http://dx.doi.org/10.1097/00000539-199910000-00031 | DOI Listing |
Cureus
January 2025
Anesthesiology and Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, NLD.
When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam and remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has a pharmacokinetic profile that is more suitable for titration during awake tracheal intubation than the long-acting midazolam.
View Article and Find Full Text PDFInt J Obstet Anesth
January 2025
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
Background: Disparities in labor epidural analgesia (LEA) management could reduce maternal satisfaction and increase risk. We compared times from the first administration of breakthrough pain medication (top-up) to LEA replacement to evaluate disparities across race.
Methods: In this retrospective cohort study (01-01-2018 to 12-31-2022), all patients with LEA and maternal race/ethnicity of non-Hispanic White or Black were eligible.
PLoS One
January 2025
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States of America.
Epidural steroid injections (ESIs) are often used to treat low back pain (LBP) due to lumbosacral radiculopathy as well as LBP without a clear component of radiculopathy, in some cases. While it is increasingly recognized that psychosocial factors are associated with pain outcomes, few studies have assessed the contribution of these factors to common pain interventions like ESIs. This study aimed to summarize the scope and nature of how psychosocial factors are accounted for in research on ESIs for the treatment of LBP with or without lumbosacral radiculopathy and to identify gaps and recommendations for future research.
View Article and Find Full Text PDFIntroduction: Pain control following Nuss thoracoplasty remains a challenge. Cryoanalgesia of the intercostal nerves has been demonstrated to reduce postoperative pain in these patients. The objective of this study was to understand how and how widely cryoanalgesia is used in pediatric patients undergoing funnel chest surgery in Spain.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Anesthesiology, Peking University First Hospital, Beijing, China
Objective: To investigate the impact of dexmedetomidine-ropivacaine combination versus sufentanil-ropivacaine combination for epidural labour analgesia on neonatal and maternal outcomes and test the feasibility of a future large, randomised trial.
Design: A randomised, double-blind, pilot clinical trial from 16 March 2023 to 15 June 2023.
Setting: A tertiary-care hospital in Beijing, China.
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