Background: Fos expression in the lumbar spinal cord, resulting from a noxious electrical stimulus at the hindpaw, is hypothesized to originate from three sources: direct sensory input of the noxious stimulus, local interactions in the spinal cord, and input of modulating signals from supraspinal regions. Our aim in this study was to discriminate among these sources by eliminating the supraspinal input.
Methods: Therefore, a spinal block was administered in male Wistar rats by administering a local anesthetic (bupivacaine) through an intrathecal catheter at the mid-thoracic level. This thoracic spinal block completely suppressed the noxious stimulation-induced withdrawal reflex that is normally elicited by electrical stimulus. Fos immunoreactivity (Fos-IR) was quantified in all laminae of the L4 segment of the spinal cord.
Results: Noxious stimulation resulted in a general and strong increase in Fos-IR in the ipsilateral dorsal horn, mainly in Laminae I, II, and V. Thoracic spinal block caused a remarkable increase in the amount of Fos-IR in Lamina V, but had no significant effect on the Fos-IR in Laminae I and II.
Conclusions: The increase in Fos-IR in Lamina V may have resulted from the interruption of a pain-modulating descending mechanism from the brain. A known modulating descending mechanism is the serotonergic system, controlled by the periaqueductal gray. This system inhibits the neurons in the superficial laminae. Another nonserotonergic system originates in the anterior pretectal nucleus. The latter facilitates neurons in the superficial laminae, while neurons in Lamina V are inhibited. We conclude that both systems are probably involved in the observed effects of the peripheral noxious stimulation given in the present model.
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http://dx.doi.org/10.1213/ANE.0b013e3181b5a1eb | DOI Listing |
J Perioper Pract
January 2025
Department of Anaesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, India.
Introduction: Patient positioning for spinal anaesthesia in patients with femur fracture is extremely painful and various methods have been tried to reduce mobilisation pain.
Aim: To compare the analgesic efficacy of intravenous dexmedetomidine, ketamine and femoral nerve block in patients posted for fractured femur for alleviating the positional pain before spinal anaesthesia.
Materials And Methods: A total of 75 patients (25 per group) of American Society of Anaesthetists Grade I-III patients of age group 18-80 years with fractured femur scheduled for elective surgery.
CNS Neurosci Ther
January 2025
Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Aims: Communication within glial cells acts as a pivotal intermediary factor in modulating neuroimmune pathology. Meanwhile, an increasing awareness has emerged regarding the detrimental role of glial cells and neuroinflammation in morphine tolerance (MT). This study investigated the influence of crosstalk between astrocyte and microglia on the evolution of morphine tolerance.
View Article and Find Full Text PDFJ Oral Facial Pain Headache
June 2024
Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA 71103, USA.
The occipital nerve block involves the injection of a local anesthetic and possibly a corticosteroid near the occipital nerves at the base of the skull and aims at providing relief from chronic headaches by temporarily numbing or reducing inflammation around the occipital nerves. It has proven to be efficacious in treating chronic headaches, especially those that are refractory to medication; it is both diagnostic and therapeutic with symptom abatement from weeks to months. Occipital nerve blocks can be utilized alone or with standard-of-care therapy for various other headache conditions, such as cluster headaches, episodic headaches or chronic migraines.
View Article and Find Full Text PDFActa Anaesthesiol Scand
February 2025
Department of Anesthesiology and perioperative medicine, University Hospital of Brussels, Free University of Brussels, Brussels, Belgium.
Background: The use of local anesthetics (LA) in individuals with Brugada syndrome (BrS) remains a subject of debate due to the lack of large-scale studies confirming their potential risks. This study primarily aimed to evaluate the incidence of new malignant arrhythmias or defibrillation events in patients diagnosed with BrS during the perioperative period, following the administration of local anesthetics, and within 30 days postoperatively. The secondary objective was to analyze the occurrence of adverse effects during hospitalization, as well as 30-day readmission and mortality rates.
View Article and Find Full Text PDFJ Oral Facial Pain Headache
September 2024
Department of Anesthesiology & Algology, Adnan Menderes University Medical Faculty, 09100 Aydin, Turkey.
The aim of this study was to compare the effectiveness of greater occipital nerve (GON) block and pulsed radiofrequency (PRF) treatment in chronic migraine patients. Seventy patients admitted to the Neurology and Algology outpatient clinic between September 2023 and December 2023 and diagnosed with chronic migraine according to The International Classification of Headache Disorders 3rd Edition (ICHD-3) criteria were included in the study. Patients were randomized into 2 groups to receive ultrasound-guided repeated GON block and PRF.
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