Introduction: Antidepressant drugs are used in the treatment of pain as an adjuvant or alone. It has been shown that antidepressant drugs have analgesic effects in various diseases (diabetic neuropathy, low back pain, cancer pain etc.) Sertraline is a potent serotonin re-uptake inhibitor. Some antidepressant drugs inhibited both of the reuptake of serotonin and of noradrenaline. These drugs are called serotonin-noradrenaline re-uptake inhibitors (SNRIs). Milnacipran is a serotonin-noradrenaline re-uptake inhibitor. We have studied the analgesic effects of sertraline and milnacipran after acute and chronic application in tail-fl ick test in mice. Methods: The analgesic effects of milnacipran (10, 30, 50 mg/kg) and sertraline (10, 20, 50 mg/kg) were measured after acute and chronic application in tail fl ick test. The analgesic effects of milnacipran (30 mg/kg) or sertraline (50 mg/kg) were evaluated after the application of L-NAME (10 mg/kg), naloxone (5 mg/kg), prazosin (1 mg/kg), ondansetron (0.1 mg/kg) in tail fl ick test. Results: Milnacipran (30 mg/kg) and sertraline (50 mg/kg) produced statistically signifi cant analgesic effect compared to their control values after acute and chronic application in tail-fl ick test. The analgesic effects of both milnacipran (30 mg/kg) and sertraline (50 mg/kg) in the presence of L-NAME (10 mg/kg), naloxone (5 mg/kg), ondansetron (0.1 mg/kg) and prazosin (1 mg/kg) were inhibited in tail-fl ick test. Conclusion: These results indicate that the analgesic effects of milnacipran and sertraline are related to nitrergic, opioidergic, serotonergic and adrenergic system (Fig. 8, Ref. 23). Text in PDF www.elis.sk.
Title: Spinal cord injury induced hyperalgesia is associated with increased levels of Let-7 family of MicroRNAs.Background: Spinal cord injury (SCI) results in chronic pain syndromes that are often refractory to treatment with opioids, and may represent mu opioid receptor (MOR) dysfunction. MicroRNAs play a role in gene regulation by binding to target mRNA, causing translational repression or mRNA degradation. Let-7 family microRNAs have been shown to target MOR suggesting they may influence the development of pain states and opioid responsiveness. This study sought to determine temporal changes in Let-7 family miRNA and correlate them to the onset of pain behaviors in a rodent model of post-SCI pain.
Background – Patient education improves treatment plan compliance and outcomes. For anesthesiology residents, patient communication is highlighted on the obstetric subspecialty rotation. However, the clinical effectiveness of patient education on patient-controlled epidural analgesia (PCEA) dose requirements is unknown. We hypothesized that patients receiving care by residents who are formally instructed on patient education for PCEA, will have lower total local anesthetic consumption and higher satisfaction. Methods – A prospective, interrupted time series design was chosen. Residents participated in one of two sessions at the beginning of their two-month obstetric anesthesia rotation: 1) Education (E): residents taught how to educate patients on PCEA, followed by instructor-resident practice implementing a “teach-back” method for patient comprehension; 2) Control (C): no formal instruction on PCEA. Confidence in patient education was assessed at baseline and at the rotation end. The first 15–30 patients cared for by each resident after initiating epidural labor analgesia and PCEA were followed. Patient-level data included: total local anesthetic dose during labor, comprehension of PCEA goals, and satisfaction with childbirth experience using a validated questionnaire. The primary outcome was total local anesthetic medication consumed during labor. Results – A total of 285 patients (118 cared for by residents in Group E, 167 cared for by residents in Group C) were included. Local anesthetic dose consumption was similar between groups (Group E: mean bupivacaine dose (mg), 96.4 ± 58.2 vs. Group C: 105.4 ± 64.1, P = 0.23). Patient comprehension for PCEA goals and patient satisfaction with their childbirth experience were similar between groups. Residents in group E felt more comfortable teaching PCEA to patients by the end of their rotation (Group E self-efficacy scores: pre-rotation, 45.7 ± 7.5 v. post-rotation, 88.0 ± 9.2, P = 0.002). Conclusions – A resident teaching intervention to improve skills in patient education for PCEA did not reduce drug consumption or improve patient satisfaction, but educated residents felt more comfortable teaching patients by the end of their rotation. Teaching methods for patient education that improve not only clinician self-efficacy, but also clinical outcomes at the patient level, should be identified.
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