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One essential component of the neurovascular system is known as the blood-brain barrier (BBB). This highly effective biological barrier plays a pivotal role in regulating the brain's internal microenvironment and carefully controlling the passage of various chemicals into and out of the brain. Notably, it serves as a safeguard for the brain, particularly when it comes to the selective transportation of drugs like opioids and non-steroidal anti-inflammatory medications (NSAIDs), which are commonly used in the management of chronic pain. It's important to note that during the development of chronic pain, the activation of microglia and astrocytes can potentially disrupt or damage the integrity of the BBB. In this comprehensive review, we aim to delve into the intricate interplay between the blood-brain barrier and the transportation of pain-relieving drugs, shedding light on the challenges and mechanisms involved in this process.
RESUMO
During an elective cesarean section, the choice of method of anesthesia is critical for maternal and fetal outcomes. However, the anesthesiologist's decision is dependent on the patient's desire. This study aimed to determine the choice of general and spinal anesthesia among women undergoing elective cesarean sections and the factors affecting their choice. Methods: In this descriptive study, pregnant women who had the ability to undergo both spinal and general anesthesia were referred to public and private hospitals in (Sari Imam Khomeini Hospital, Mazandaran University of Medical Sciences). A questionnaire recorded the patient's demographic data, education and occupation, history of anesthesia, choice of anesthetic method, and reason for selection. Results: A total of 384 women were included in the study, of whom 60% selected general anesthesia and 40% selected spinal anesthesia. Among the reasons for not choosing spinal anesthesia, most common were fear of injury to the spinal cord (64.3%) and fear of seeing and hearing during the surgery (53.3%), and among the reasons for not choosing general anesthesia, most common were fear of not waking (54.3%) and a desire to be alert at the time of infant birth (40.7%). Most of the women with a history of spinal anesthesia selected spinal anesthesia (53%), and 62% of those without a history of spinal anesthesia selected general anesthesia. Factors such as age, nonmedical staff advice, and being employed were significantly correlated with the choice of anesthesia (P<0.005). Conclusion: The rate of general anesthesia selection was higher than spinal anesthesia. More attention and efforts are required to educate patients regarding the method of anesthesia prior to the surgery.
RESUMO
AIM: This study aims to evaluate the antinociceptive effect of combined Achillea millefolium and Origanum extract encapsulated in liposome. METHODS: The effect of Achillea millefolium and Origanum vulgare L. extract, and their liposome-incorporated form was assessed using 3% formalin test in rat. 12 male Wistar rats, 4 in each group, were used in this study, and increasing doses of Achillea millefolium (31.6, 100, 178, and 316 mg/kg) and Origanum vulgare L. extract (5.6, 10, 17.8, and 31.6 mg/kg), and co-administered extract were i.p. administered 10 min before 3% formalin. The mechanisms of action were evaluated for the liposomal encapsulated co-administered extract using N(G)-nitro-l-arginine methyl ester (L-NAME) (3 mg/kg) and naloxone (1 mg/kg). RESULTS: The interaction index and isobolographic analysis revealed a synergistic effect of the extracts. We observed a lower experimental ED30 as compared to the theoretical ED30. Naloxone also reduced the antinociceptive effect of the liposome encapsulated co-administered extract. CONCLUSION: These data suggest that the Achillea millefolium and Origanum vulgare L. extract encapsulated in liposome gave a synergistic effect.
