Nasopharyngeal temperature measurement in sheep during general anesthesia.

The aim of this study was to compare nasopharyngeal and esophageal temperature measurements in anesthetized sheep with a range of fresh gas flows (1 to 6 L/min) through the breathing system. Data were compared using a Bland-Altman plot and correlation coefficients, and error measures were calculated. One hundred and ninety-five sets of data were collected from 20 sheep weighing 41 kg (31 to 51.5 kg). The bias (95% limit of agreement), correlation coefficient, and absolute error for nasopharyngeal compared to esophageal temperature were 0.04°C (-0.77°C to 0.85°C), 0.92, and 0.29°C ± 0.29°C, respectively. The percentage of nasopharyngeal readings within 0.5°C of the esophageal temperature was 77.44%. The error did not significantly increase with increasing fresh gas flow. Nasopharyngeal temperature measurement is suitable for estimation of esophageal temperature during general anesthesia of sheep when the fresh gas flow through the breathing system is between 1 and 6 L/min.

L'objectif de la présente étude était de comparer les mesures des températures nasopharyngiennes et oesophagiennes chez des moutons anesthésiés avec une variation du flux de gaz frais (1 à 6 L/min) à travers le système respiratoire. Les données ont été comparées à l'aide d'un graphique de Bland-Altman et des coefficients de corrélation, et les erreurs de mesure ont été calculées. Cent quatre-vingt-quinze paires de données ont été obtenues de 20 moutons pesant en moyenne 41 kg (31 à 51,5 kg). Le biais (limite d'accord de 95 %), le coefficient de corrélation, et l'erreur absolue de la température nasopharngienne comparée à la température oesophagienne étaient 0,04 °C (−0,77 °C à 0,85 °C), 0,92, et 0,29 °C ± 0,29 °C, respectivement. Le pourcentage de lecture de température nasopharyngienne à l'intérieur d'un écart de 0,5 °C de la température oesophagienne était de 77,44 %. L'erreur n'a pas augmenté de manière significative avec l'augmentation du flux de gaz frais. La mesure de la température nasopharyngienne est appropriée pour estimer la température oesophagienne lors de l'anesthésie générale de moutons lorsque le flux de gaz frais à travers le système respiratoire se situe entre 1 et 6 L/min.(Traduit par Docteur Serge Messier).

Glial Attenuation With Ibudilast in the Treatment of Medication Overuse Headache: A Double-Blind, Randomized, Placebo-Controlled Pilot Trial of Efficacy and Safety.

BACKGROUND: Medication overuse headache (MOH) is a condition bordering between a chronic pain condition and a substance dependence disorder. Activation of immunocompetent glial cells in the central nervous system has been linked to both pathological pain and drug addiction/reward. Preclinically, ibudilast attenuates glial activation and is able to reduce neuropathic pain and markers of substance dependence. We therefore hypothesized ibudilast would reduce headache burden and opioid analgesic requirements in patients with opioid overuse headache. OBJECTIVE: To determine if treatment with ibudilast provides a greater reduction in headache index than placebo in MOH patients consuming opioids. METHODS: Participants with MOH who were using opioids were randomized via computer-generated code to ibudilast 40 mg or placebo twice daily for 8 weeks in a double-blind, parallel groups study. Before randomization participants completed a 4-week baseline headache diary. During treatment, headache diary data collection continued and participants attended 4 study visits during which quantitative sensory testing was performed. Blood samples for immune biomarker analyses were collected before and after treatment in a subgroup of participants. RESULTS: Thirty-four participants were randomized, 13 of 15 randomized to ibudilast and 17 of 19 randomized to placebo completed treatment. Ibudilast was generally well-tolerated with mild, transient nausea reported as the most common adverse event (66.7% vs 10.5% in placebo group). Results are shown as mean (SD). At the end of treatment no differences in the primary outcome average daily headache index (placebo 62 [44] vs ibudilast 77 [72] groups, difference -15, CI -65 to 35 h × numerical rating scale), or secondary outcomes headache frequency (placebo 23 [8.1] vs ibudilast 24.5 [6.2], difference -1.5, CI -7.7 to 4.8 days/month) and opioid intake (placebo 20.6 [43] vs ibudilast 19 [24.3], difference 1.6, CI -31.5 to 34.8 mg morphine equivalent) were observed between placebo and ibudilast groups. CONCLUSIONS: Using the current dosing regimen, ibudilast does not improve headache or reduce opioid use in patients with MOH without mandated opioid withdrawal. However, it would be of interest to determine in future trials if ibudilast is able to improve ease of withdrawal during a forced opioid down-titration when incorporated into an MOH detoxification program.