ABSTRACT
Abstract We aimed to evaluate the orofacial antinociceptive effect of geraniol in mice and its molecular anchorage mechanism. Seven mice per group (probabilistic sample) were treated with geraniol (12.5, 25 and 50 mg/kg, i.p.), morphine (6 mg/kg, i.p.) and vehicle (saline + Tween 80 at 0.2%, i.p.) 30 minutes prior to the beginning of the experiment. Injecting glutamate (25 μM), capsaicin (2.5 μg) and formalin (2%) into the right upper lip (perinasal) of the mouse induced nociception. Behavioral analysis of the animals considered the friction time (in seconds) of the mentioned region using hind or front paws by a researcher blinded to the treatment groups. The statistical analysis was performed blindly, considering α = 5%. The results showed that in the glutamate and capsaicin tests, concentrations of 25 mg/kg and 50 mg/kg presented antinociceptive activity (p < 0.005, power> 80%). In the formalin test, geraniol was able to reduce nociception at a concentration of 50 mg/kg (p < 0.005, power> 80%). In the molecular anchorage study, high values of binding between the evaluated substance and receptors of glutamate were observed (metabotropic glutamate receptor, -87.8501 Kcal/mol; N-methyl-D-aspartate, -86.4451 Kcal/mol; α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, -85.6755 Kcal/mol). Geraniol presented orofacial antinociceptive activity, probably by interacting with glutamate-related receptors.
Subject(s)
Animals , Mice , Facial Pain , Terpenes , Pain Measurement , Acyclic Monoterpenes , AnalgesicsABSTRACT
Opioid free anesthesia (OFA) is defined as an anesthesiologic technique where opioids are not used in the intraoperative and postoperative period. Although the mainstay of intra-operative analgesia may be opioids, current challenges are focus on reducing them and preventing the adverse effects of opioids, by rationalizing and even suspending their perioperative use, specifically at risk populations such as Obstructive Sleep Apnea Syndrome (OSAHS), obesity, Chronic Obstructive Pulmonary Disease (COPD) and cancer surgery. We present this case of OFA in a susceptible patient with complications from the use of opioids undergoing an extended right hemicolectomy. Multimodal analgesia was performed with a thoracic peridural and subanesthetic doses of intravenous agents including dexmedetomidine, ketamine and propofol, accompanied by short and long-lasting local periglotic anesthetics. The patient had given an intraand postoperative analgesia without presenting any adverse events, good recovery, early deambulation and extubation.
La anestesia libre de opioides (OFA) es una técnica anestésica donde no hay administración de opioides, tanto en el intraoperatorio como en el postoperatorio. Aunque una de las bases de la analgesia intraoperatoria podrían ser los opioides, los desafíos actuales están enfocados en reducir su uso perioperatorio, previniendo sus efectos adversos, racionalizando y limitando su empleo específicamente en poblaciones de riesgo como síndrome de apnea obstructiva del sueño (SAHOS), obesidad, enfermedad pulmonar obstructiva crónica (EPOC) y cirugía oncológica. Presentamos este caso de OFA en un paciente susceptible de complicaciones por uso de opioides sometido a una hemicolectomía derecha extendida. Se realizó analgesia multimodal con peridural torácica y dosis subanestésicas de agentes endovenosos como dexmedetomidina, ketamina y propofol, acompañado de anestésicos locales periglóticos de corta y larga duración. Se otorgó una adecuada analgesia intra y postoperatoria, el paciente no tuvo eventos adversos, presentando una buena recuperación, deambulación y extubación precoz.
Subject(s)
Humans , Aged, 80 and over , Colectomy/methods , Colonic Neoplasms/surgery , Anesthesia/methods , Anesthetics/administration & dosage , Sleep Apnea, Obstructive , Analgesics, Opioid/adverse effects , Intraoperative Complications/prevention & control , ObesityABSTRACT
Oxycodone,an opioid receptor agonist,is one of potent narcotic analgesics. Despite its potent analgesic effect,the tolerant and dependent liability of oxycodone as well as its inhibition on gas-trointestinal motility strongly restricts its clinical application. Since the end of the last century,antipyretic, opioid receptor agonist,opioid receptor antagonist and dopamine receptor antagonist have been used to in combination with oxycodone at different ratios as complex prescriptions,the aim of which is to enhance the effect of oxycodone,decrease the dosage of oxycodone,and prevent the adverse effect and the tendency for misuse. Here we reviewed the development of oxycodone compositions in the recent years,hoping to provide more data for its potential clinical application.
ABSTRACT
Objective To clinically analyze the feature of paroxysmal hemicrania in order to improve our cognition toward it.Methods Eight patients,3 men,5 women,aging 17 to 74 years old,were prospectively analyzed over the past 2 years in our hospital.Results Their age of onset was from 9 to 60years old(mean 42.5±16.3).Seven of the 8 cases were treated with indomethacin,out of whom 5 got an immediate and complete response and one of them remitted partially.Another stopped taking indomethacin because of gastroenteric side effects.She was treated with verapamil and prednisone and partial relief was gained.Conclusions Paroxysmal hemicranial is a rare benign disorder.which needs our improved understanding.The patient who is diagnosed with paroxysmal hemicranial should firsfly receive indomethacin.and standard anti-cluster headache medications or other non-steroid anti-inflammatory drugs is used if she/he can not get relief and (or)tolerate the adverse effects.
ABSTRACT
Spinal gabapentin has been known to show the antinociceptive effect. Although several assumptions have been suggested, mechanisms of action of gabapentin have not been clearly established. The present study was undertaken to examine the action mechanisms of gabapentin at the spinal level. Male SD rats were prepared for intrathecal catheterization. The effect of gabapentin was assessed in the formalin test. After pretreatment with many classes of drugs, changes of effect of gabapentin were examined. General behaviors were also observed. Intrathecal gabapentin produced a suppression of the phase 2 flinching, but not phase 1 in the formalin test. The antinociceptive action of intrathecal gabapentin was reversed by intrathecal NMDA, AMPA, D-serine, CGS 15943, atropine, and naloxone. No antagonism was seen following administration of bicuculline, saclofen, prazosin, yohimbine, mecamylamine, L-leucine, dihydroergocristine, or thapsigargin. Taken together, intrathecal gabapentin attenuated only the facilitated state. At the spinal level, NMDA receptor, AMPA receptor, nonstrychnine site of NMDA receptor, adenosine receptor, muscarinic receptor, and opioid receptor may be involved in the antinociception of gabapentin, but GABA receptor, L-amino acid transporter, adrenergic receptor, nicotinic receptor, serotonin receptor, or calcium may not be involved.