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69 papers 25 to 100 followers
By Xander Zuidema MD, pharmD, Anesthesiologist, intensivist, pain specialist
https://read.qxmd.com/read/30876975/d2-like-receptor-agonist-synergizes-the-%C3%AE-opioid-agonist-spinal-antinociception-in-nociceptive-inflammatory-and-neuropathic-models-of-pain-in-the-rat
#1
Jonathan Mercado-Reyes, Angélica Almanza, Pedro Segura-Chama, Francisco Pellicer, Francisco Mercado
Opioids are potent analgesic drugs, but their use has been limited due to their side effects. Antinociceptive effects of D2-like receptor agonists such as quinpirole have been shown at the spinal cord level; however, their efficacy is not as high as that of opioids. Dopaminergic agonists are long-prescribed and well-tolerated drugs that have been useful to treat clinically and experimentally painful conditions. Because current pain treatments are not completely effective, the aim of this work was to determine if a D2-like receptor agonist improves the antinociceptive effects of a μ-opioid receptor agonist...
March 12, 2019: European Journal of Pharmacology
https://read.qxmd.com/read/30877520/spinal-orexin-2-receptors-are-involved-in-modulation-of-the-lateral-hypothalamic-stimulation-induced-analgesia
#2
Laleh Rezaee, Sakineh Salehi, Amir-Mohammad Alizadeh, Soheila Fazli-Tabaei, Abbas Haghparast
Role of the orexinergic system in pain modulation is well studied and involvement of the spinal orexin-1 receptors is well documented. In this study, we examined role of the spinal orexin-2 receptors in modulation of inflammatory pain in rat. Fifty-one adult male Wistar rats were implanted unilaterally with a guide cannula into the LH and intrathecal tubing in the lumbar space between L4 and L5. Chemical stimulation of LH by carbachol (250 nM/0.5 µL saline) induced remarkable analgesia during the two phases of formalin test and Intrathecal administration of different doses of TCS OX2 29 (10, 30 and 100 µM/ 0...
March 15, 2019: Neurochemical Research
https://read.qxmd.com/read/30868934/-express-longitudinal-fdg-pet-scan-study-of-brain-changes-in-mice-with-cancer-induced-bone-pain-and-after-morphine-analgesia
#3
Wen-Ying Lin, Wen-Hua Chu, Tzu-Hao Harry Chao, Wen-Zen Sun, Chen-Tung Yen
Morphine is the most commonly used drug for treating physical and psychological suffering caused by advanced cancer. Although morphine is known to elicit multiple supraspinal analgesic effects, its behavioral correlates with respect to the whole brain metabolic activity during cancer-induced bone pain have not been elucidated. We injected 4T1 mouse breast cancer cells into the left femur bone marrow cavity of BALB/c mice. All mice developed limb use deficits, mechanical allodynia, and hypersensitivity to cold, which were effectively suppressed with morphine...
March 14, 2019: Molecular Pain
https://read.qxmd.com/read/30840355/conversion-of-intrathecal-opioids-to-fentanyl-in-chronic-pain-patients-with-implantable-pain-pumps-a-retrospective-study
#4
David Daewhan Kim, Ankit Patel, Nabil Sibai
OBJECTIVES: Conversion between routes such as intravenous (IV), epidural (EP), and intrathecal (IT) routes for morphine is well established. Conversion ratios for IV:EP:IT fentanyl and conversion from IT morphine/hydromorphone to IT fentanyl have been challenging given the lipophilic nature of fentanyl. Our study reviews the outcomes and conversion ratios reached after converting IT opioids from morphine/hydromorphone to fentanyl in patients with IT pumps. METHODS: After Institutional Review Board approval at Henry Ford Health System, a chart review was performed on all patients who had Synchromed II IT pumps implanted 2009-2016 and were converted from morphine/hydromorphone to fentanyl...
March 6, 2019: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/30794333/characterization-of-analgesic-actions-of-the-chronic-intrathecal-infusion-of-h-dmt-d-arg-phe-lys-nh2-in-rat
#5
Shinichi Kokubu, Kelly A Eddinger, Shigeki Yamaguchi, Lena Libertad Huerta-Esquivel, Peter W Schiller, Tony L Yaksh
OBJECTIVES: DMT-DALDA (H-Dmt-D-Arg-Phe-Lys-NH2; Dmt = 2',6'-dimethyltyrosine) is a selective mu opioid agonist. We sought to characterize efficacy, tolerance, dependence and side-effect profile when given by continuous intrathecal infusion. MATERIALS AND METHODS: Adult male Sprague Dawley rats were prepared with chronic intrathecal catheters and osmotic mini-pumps to deliver vehicle (saline), DMT-DALDA or morphine. Hind paw thermal escape latencies were assessed...
February 22, 2019: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/30536525/intrathecal-betamethasone-for-cancer-pain-a-study-of-its-analgesic-efficacy-and-safety
#6
Hitoshi Taguchi, Keiko Oishi, Koh Shingu, Hideo Matsumoto, Munehiro Masuzawa
BACKGROUND: A preliminary study has shown effective cancer pain relief by intrathecal betamethasone (ITB). However, further evidence is needed to support this new approach. METHODS: Cancer patients with opioid-resistant pain received lumbar intrathecal administration of betamethasone 2 or 3 mg once a week for 28 days. Immediate and short-term analgesia (using a percentage pain reduction scale and a numerical rating scale, NRS) and long-term analgesia (using NRS) were assessed...
December 7, 2018: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/30378724/perioperative-and-periprocedural-care-of-patients-with-intrathecal-pump-therapy
#7
REVIEW
Weston Nadherny, Brooke Anderson, Alaa Abd-Elsayed
INTRODUCTION: There are an ever-increasing number of patients who have implanted devices for targeted delivery of drug therapy to the intrathecal space for the management of spasticity or chronic pain. This leads to a growing number of people with implanted pumps presenting for procedures and surgeries, yet there is a paucity of consolidated information available to describe the appropriate precautions and patient management during this period. METHODS: This was a systematic review to provide a summary of existing literature on intrathecal drug delivery system (IDDS) management in the perioperative and procedural period, and to highlight additional areas that require further research...
October 31, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/30367811/-characterization-of-the-antinociceptive-effects-of-intrathecal-dalda-peptides-following-bolus-intrathecal-delivery
#8
Shinichi Kokubu, Kelly A Eddinger, Thi M-D Nguyen, Lena Libertad Huerta-Esquivel, Shigeki Yamaguchi, Peter W Schiller, Tony L Yaksh
Background and aims We systematically characterized the potency and side effect profile of a series of small opioid peptides with high affinity for the mu opioid receptor. Methods Male Sprague Dawley rats were prepared with intrathecal (IT) catheters, assessed with hind paw thermal escape and evaluated for side effects including Straub tail, truncal rigidity, and pinnae and corneal reflexes. In these studies, DMT-DALDA (dDAL) (H-Dmt-D-Arg-Phe-Lys-NH2 MW=981), dDALc (H-Dmt-Cit-Phe-Lys-NH2 MW=868), dDALcn (H-Dmt-D-Cit-Phe-Nle-NH2 MW=739), TAPP (H-Tyr-D-Ala-Phe-Phe-NH2 MW=659), dDAL-TICP ([Dmt1]DALDA-(CH2)2-NH-TICP[psi]; MW=1519), and dDAL-TIPP (H-Dmt-D-Arg-Phe-Lys(Nε-TIPP)-NH2 were examined...
October 25, 2018: Scandinavian Journal of Pain
https://read.qxmd.com/read/30366152/pharmacological-modulation-of-endogenous-opioid-activity-to-attenuate-neuropathic-pain-in-rats
#9
Nai-Jiang Liu, Emiliya M Storman, Alan R Gintzler
We previously showed that spinal mGluR1 signaling suppresses or facilitates (depending on stage of estrous cycle) analgesic responsiveness to intrathecal endomorphin 2 (EM2), a highly mu-opioid receptor (MOR)-selective endogenous opioid. Spinal EM2 antinociception is suppressed during diestrus by mGluR1 when it is activated by membrane estrogen receptor alpha (mERα), and facilitated during proestrus when mGluR1 is activated by glutamate. In the current study, we tested the hypothesis that in female rats subjected to spinal nerve ligation (SNL), inhibition of spinal estrogen synthesis or blockade of spinal mERα/mGluR1 would be anti-allodynic during diestrus, whereas during proestrus mGluR1 blockade would worsen the mechanical allodynia...
October 23, 2018: Journal of Pain: Official Journal of the American Pain Society
https://read.qxmd.com/read/30267637/opioid-induced-hyperalgesia-with-intrathecal-infusion-of-high-dose-fentanyl
#10
Antranig Kalaydjian, Fadi Farah, Yuen Cheng, Martin A Acquadro, Frederic J Gerges
INTRODUCTION: Despite being reported since 1943 as well as being the subject of a large body of literature since that time, no consensus has been reached regarding the etiology of opioid induced hyperalgesia (OIH). It is often described as a paradoxical increased pain response to noxious stimuli due to increased sensitization or an acute tolerance to opioids. CASE: We report the case of a 60 year old patient on chronic Intrathecal combined fentanyl and Bupivacaine who had worsening pain with increasing doses and improved after weaning off intrathecal opioids...
February 2019: Pain Practice: the Official Journal of World Institute of Pain
https://read.qxmd.com/read/30267781/sustained-release-hydromorphone-microparticles-produced-by-supercritical-fluid-polymer-encapsulation
#11
Felicity Y Han, Andrew Whittaker, Steven M Howdle, Andrew Naylor, Anjumn Shabir-Ahmed, Maree T Smith
Chronic cancer pain remains prevalent and severe for many patients, particularly in those with advanced disease. The effectiveness of analgesic/adjuvant drug treatments in routine practice has changed little in the last 30 years. To address these issues herein, we have developed sustained-release poly(lactic-co-glycolic acid) microparticles of hydromorphone for intrathecal injection aimed at producing prolonged periods of satisfactory analgesia in patients, as a novel strategy for alleviation of intractable cancer-related pain...
September 26, 2018: Journal of Pharmaceutical Sciences
https://read.qxmd.com/read/30238550/refill-procedures-of-intrathecal-drug-delivery-systems-with-a-recessed-fill-port-on-the-pump-surface-a-prospective-comparison-study-of-ultrasound-guided-vs-blind-refill-technique
#12
Paolo Maino, Sander M J van Kuijk, Roberto S G M Perez, Eva Koetsier
OBJECTIVES: Structural differences of implantable drug delivery systems (IDDSs) might have an impact on the efficiency of needle access to the reservoir fill port (RFP). The aim of this study was to assess the efficiency of RFP needle access with an ultrasound (US)-guided vs. a blind refill technique in IDDSs with a Recessed RFP (Recessed-RFP-IDDS). MATERIALS AND METHODS: The primary outcome was the number of attempts needed to enter the RFP with a needle comparing the US-guided technique vs...
September 20, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/30137539/intrathecal-therapy-for-chronic-pain-a-review-of-morphine-and-ziconotide-as-firstline-options
#13
Timothy R Deer, Jason E Pope, Michael C Hanes, Gladstone C McDowell
Objectives: To evaluate the evidence for morphine and ziconotide as firstline intrathecal (IT) analgesia agents for patients with chronic pain. Methods: Medline was searched (through July 2017) for "ziconotide" or "morphine" AND "intrathecal" AND "chronic pain," with results limited to studies in human populations. Results: The literature supports the use of morphine (based primarily on noncontrolled, prospective, and retrospective studies) and ziconotide (based on randomized controlled trials and prospective observational studies) as first-choice IT therapies...
August 22, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://read.qxmd.com/read/30086115/morphine-effects-within-the-rodent-anterior-cingulate-cortex-and-rostral-ventromedial-medulla-reveal-separable-modulation-of-affective-and-sensory-qualities-of-acute-or-chronic-pain
#14
Lusine Gomtsian, Kirsty Bannister, Nathan Eyde, Dagoberto Robles, Anthony H Dickenson, Frank Porreca, Edita Navratilova
Modulation of pain may result from engagement of opioid receptors in multiple brain regions. Whether sensory and affective qualities of pain are differentially affected by brain opioid receptor circuits remains unclear. We previously reported that opioid actions within the rostral anterior cingulate cortex (ACC) produce selective modulation of affective qualities of neuropathic pain in rodents, but whether such effects may occur in other areas of the ACC is not known. Here, morphine was microinjected into 3 regions of the ACC or into the rostral ventromedial medulla (RVM), and pain behaviors in naive, sham, or spinal nerve ligated (SNL) rats were evaluated...
December 2018: Pain
https://read.qxmd.com/read/30092121/removal-of-intrathecal-catheters-used-in-drug-delivery-systems
#15
Leonardo A Frizon, Navin C Sabharwal, Tanmoy Maiti, Joshua Golubovsky, Francis May, Jianning Shao, Andre G Machado, Sean J Nagel
INTRODUCTION: Implanted intrathecal drug delivery systems (IDDS) are increasingly used in the treatment of spasticity and in patients with refractory pain. Literature discussing complications associated with intrathecal pump placement is widely available. However, reports of complications following the removal of chronically placed catheters are scarce. We reviewed our series of patients who had surgery to remove the intrathecal catheter. METHODS: Retrospective review was performed for all patients who underwent surgery to remove a catheter linked to an IDDS between 2010 and 2016...
October 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://read.qxmd.com/read/30091274/antinociception-by-intrathecal-delivery-of-the-novel-non-opioid-1-amino-1-cyclobutanecarboxylic-acid
#16
T Fung, Y I Asiri, K Taheri, R Wall, S K W Schwarz, E Puil, B A MacLeod
BACKGROUND: Neuraxial opioids are widely used for intraoperative and postoperative analgesia. The risk of severe adverse effects including respiratory depression accompanies this analgesia, prompting the need for effective non-opioid alternatives. Systemic 1-amino-1-cyclobutanecarboxylic acid showed promise in preliminary studies to produce antinociception without observable toxicity. However, the effects of 1-amino-1-cyclobutanecarboxylic acid after intrathecal administration are unknown...
August 9, 2018: European Journal of Pain: EJP
https://read.qxmd.com/read/30004934/a-systematic-review-evaluating-neuraxial-morphine-and-diamorphine-associated-respiratory-depression-after-cesarean-delivery
#17
Nadir Sharawi, Brendan Carvalho, Ashraf S Habib, Lindsay Blake, Jill M Mhyre, Pervez Sultan
The prevalence of neuraxial opioid-induced clinically significant respiratory depression (CSRD) after cesarean delivery is unknown. We sought to review reported cases of author-reported respiratory depression (ARD) to calculate CSRD prevalence. A 6-database literature search was performed to identify ARD secondary to neuraxial morphine or diamorphine, in parturients undergoing cesarean delivery. "Highest" (definite and probable/possible) and "lowest" (definite) prevalences of CSRD were calculated...
December 2018: Anesthesia and Analgesia
https://read.qxmd.com/read/29978517/synergistic-antinociception-between-zc88-an-n-type-voltage-dependent-calcium-channel-blocker-and-ibuprofen-in-mouse-models-of-visceral-and-somatic-inflammatory-pain
#18
W-Z Zhou, T-Y Zhao, Z-Y Wang, G-Y Lu, S-Z Zhang, C Zhang, N Wu, J Li
BACKGROUND: A combination of analgesic agents with different mechanisms can induce additive or synergistic analgesia. The N-type voltage-dependent calcium channel (N-VDCC) is a novel therapeutic target for pain control. In addition to providing effective pain relief when used alone, N-VDCC blockers produce synergistic analgesia when used in combination with opiates. However, the interaction between N-VDCC blockers and nonsteroidal anti-inflammatory drugs (NSAIDs) remains unclear. METHODS: Using isobolographic analysis and composite additive curve analysis, the antinociceptive interaction between ZC88, a selective N-VDCC blocker and ibuprofen, a classical NSAID, was investigated in two mouse models of visceral and somatic inflammatory pain...
July 5, 2018: European Journal of Pain: EJP
https://read.qxmd.com/read/29889241/long-term-outcomes-using-intrathecal-drug-delivery-systems-in-complex-regional-pain-syndrome
#19
Eric Z Herring, Leonardo A Frizon, Olivia Hogue, Jay U Mejia, Richard Rosenquist, Robert B Bolash, Andre G Machado, Sean J Nagel
Objective: Providing durable long-term pain control for patients with complex regional pain syndrome (CRPS) is challenging. A multidisciplinary approach focused on physical therapy is frequently prescribed, with opioids and invasive procedures reserved for those challenged by functional progression. In this study, we examined the long-term efficacy of intrathecal drug delivery systems (IDDS) in patients with CRPS at our institution. Methods: Patients with CRPS implanted with an IDDS between 2000 and 2013 who had four or more years of continuous follow-up were included in the analysis...
June 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://read.qxmd.com/read/29635804/do-the-potential-benefits-outweigh-the-risks-an-update-on-the-use-of-ziconotide-in-clinical-practice
#20
REVIEW
E Bäckryd
Ziconotide is a selective and potent blocker of N-type voltage-gated calcium channels. It was approved by the Food and Drug Administration in 2004 and by the European Medicines Agency in 2005 for the treatment of severe chronic pain in patients needing intrathecal analgesia (ITA). The aim of this paper is to provide a practitioner-oriented, educational, narrative, up-to-date review on the use of ziconotide in clinical pain medicine. Of special concern regarding safety is the partial incongruity between dosing statements in the Summary of Product Characteristics and novel low-dosage, slow uptitration recommendations...
August 2018: European Journal of Pain: EJP
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