When systemic analgesics or antispasmodics fail to control chronic pain or cause intolerable adverse effects, an intrathecal drug delivery system may be the best bet.
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A Comparison of Intrathecal Dexmedetomidine and Fentanyl as Adjuvants to 0.5% Hyperbaric Levobupivacaine for Lower Abdominal Surgeries: A Prospective, Double-Blinded, Randomized Controlled Trial.
Cureus
December 2024
Department of Anaesthesiology and Critical Care, Pacific Medical College and Hospital, Udaipur, IND.
Background Due to its affordability and ease of application, the subarachnoid block is the most frequently used method for lower abdominal procedures. Levobupivacaine has an onset of sensory and motor blockade comparable to that of bupivacaine and prolongs the duration of analgesia while facilitating quick recovery from motor block. Fentanyl and dexmedetomidine, when used as additives to intrathecal local anesthetic, can extend the duration of sensory and motor blockade and enhance postoperative analgesia.
View Article and Find Full Text PDFTransversus abdominis plane block combined with intrathecal fentanyl versus intrathecal morphine for post-cesarean analgesia: a randomized non-inferiority clinical trial.
Reg Anesth Pain Med
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Background: Intrathecal morphine is the standard for post-cesarean analgesia but often causes pruritus and may be unavailable in resource-limited settings. This study assessed whether a combination of bilateral transversus abdominis plane (TAP) block and intrathecal fentanyl provides non-inferior analgesia compared with intrathecal morphine following cesarean delivery within the multimodal analgesia context.
Methods: Eighty mothers were randomized to receive either intrathecal fentanyl 10 µg with bilateral TAP block using 15 mL of 0.
Can erector spinae plane block replace intrathecal morphine in cesarean section? A prospective randomized controlled study on opioid consumption.
Clin J Pain
January 2025
Associate Professor, Department of Anesthesiology and Reanimation, Istanbul Marmara University Hospital, Istanbul, Turkey.
Objectives: After cesarean, optimal analgesia is important for early mobilization, mitigating thromboembolic risks, and mother-infant communication. Our study aims to compare the postoperative analgesic effects of intrathecal morphine (ITM) and Erector Spinae Plane Block (ESPB) in elective cesarean section under spinal anesthesia.
Methods: 82 patients were randomized into ESPB and ITM groups.
Efficacy of GABA aminotransferase inactivator OV329 in models of neuropathic and inflammatory pain without tolerance or addiction.
Proc Natl Acad Sci U S A
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Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405.
Dysregulation of GABAergic inhibition is associated with pathological pain. Consequently, enhancement of GABAergic transmission represents a potential analgesic strategy. However, therapeutic potential of current GABA agonists and modulators is limited by unwanted side effects.
View Article and Find Full Text PDFUnderstanding the Physiopathology of Pain Pathways for a Practical Approach of Cancer Pain Management.
Cardiovasc Intervent Radiol
January 2025
Clinique de la Douleur., Hôpital de La Tour, Geneva, Suisse.
Pain associated with cancer is often the first symptom reported with major repercussions on patient's quality of life. Mechanical compression, release of algogenic substances by the tumor or the complications of oncologic treatment represent the major causes. Nociceptive and neuropathic pain are both induced by different mediators that give rise to a neuroinflammation creating a peripheral and central sensitization responsible of chronic pain.
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