Antiallodynic Effects of Electroacupuncture Combined with MK-801 Treatment through the Regulation of p35/p25 in Experimental Diabetic Neuropathy

The anti-allodynic effect of NMDA receptor antagonist and acupuncture treatments were explored through spinal p35 regulation of diabetic neuropathic rat. We evaluated the change over time of p35/p25 protein levels in the spinal cord compared with behavioral responses to thermal and mechanical stimulation in streptozotocin (STZ)-induced diabetic rats. Additionally, we studied p35 expression when electroacupuncture (EA) and a sub-effective dose of NMDA (N-methyl-D-aspartate) receptor antagonist (MK-801) were used to treat hyperalgesia in the diabetic neuropathic pain (DNP). Thermal paw withdrawal latency (PWL) and mechanical paw withdrawal threshold (PWT) were significantly decreased in the early stage of diabetes in rats. p35 expression after STZ injection gradually decreased from 1 week to 4 weeks compared to normal controls. p25 expression in 4-week diabetic rats was significantly higher than that of 2-week diabetic rats, and thermal PWL in 4-week diabetic rats showed delayed responses to painful thermal stimulation compared with those at 2 weeks. EA applied to the SP-9 point (2 Hz frequency) significantly prevented the thermal and mechanical hyperalgesia in the DNP rat. Additionally, EA combined with MK-801 prolonged anti-hyperalgesia, increased p35 expression, and decreased the cleavage of p35 to p25 during diabetic neuropathic pain. In this study we show EA combined with a sub-effective dose of MK-801 treatment in DNP induced by STZ that is related to p35/p25 expression in spinal cord.

Ondansetron Reduces Postoperative Nausea and Vomiting after a Laparoscopic Cholecystectomy / 대한마취과학회지

BACKGROUND: The aim of the study was to evaluate the prophylactic effect of ondansetron on the postoperative nausea and vomiting (PONV) after a laparoscopic cholecystectomy (LC). METHODS: In this prospective, randomized, double-blind, placebo-controlled study, 77 healthy female patients, who underwent a LC under general anesthesia using sevoflurane were investigated. Patients were randomly divided into two groups; the ondansetron group (n = 39) was administered 4 mg ondansetron, and the placebo group (n = 38) 2 ml of normal saline before the end of surgery. The incidence and severity of PONV, and the need for rescue antiemetics during the first 6 h and 24 h after surgery were evaluated. RESULTS: The incidence of nausea in the ondansetron was significantly lower than in the placebo group during the 0-6 h (early nausea, P<0.05), but not in the 6-24 h (late nausea) postoperative period. However, the total incidence of nausea over the whole 24 h postoperative period was significantly lower in the ondansetron (36%) than in the placebo group (61%)(P<0.05), due to the low incidence of early nausea in the former. The incidence of vomiting was significantly lower in the ondansetron than in the placebo group during the 0-6 h and 6-24 h postoperative period. Therefore the total incidence of vomiting was significantly lower in the ondansetron (5%) than in the placebo group (46%)(P<0.001) over the whole 24 h postoperative period. The severity of nausea was also significantly lower in the ondansetron than in the placebo group. CONCLUSIONS: Ondansetron significantly reduces the PONV in female patients undergoing a LC during the first 24 h after surgery, and has a greater anti-vomiting than anti-nausea effect.