Management of an Acute Exacerbation of Chronic Neuropathic Pain in the Emergency Department: A Case to Support Ultrasound-Guided Forearm Nerve Blocks

Canders, Caleb P.; Krishna, Pravin K.; Moheimani, Roya; Weaver, Catherine M

doi:10.1016/j.jemermed.2018.08.003

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…However, these drugs have many side effects, such as neurocognition, falls, and weight gain [ 18 ]. In addition, the management of neuropathic pain lasts for long-term, and most patients have not enough to relieve pain [ 19 , 20 ]. Therefore, it is particularly urgent and important to investigate more effective and novel therapeutic options for neuropathic pain.…”

Section: Introductionmentioning

confidence: 99%

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Xue

Sun

Xia

et al. 2020

IJMS

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Neuropathic pain is more complex and severely affects the quality of patients’ life. However, the therapeutic strategy for neuropathic pain in the clinic is still limited. Previously we have reported that electroacupuncture (EA) has an attenuating effect on neuropathic pain induced by spared nerve injury (SNI), but its potential mechanisms remain to be further elucidated. In this study, we designed to determine whether BDNF/TrκB signaling cascade in the spinal cord is involved in the inhibitory effect of 2 Hz EA on neuropathic pain in SNI rats. The paw withdrawal threshold (PWT) of rats was used to detect SNI-induced mechanical hypersensitivity. The expression of BDNF/TrκB cascade in the spinal cord was evaluated by qRT-PCR and Western blot assay. The C-fiber-evoked discharges of wide dynamic range (WDR) neurons in spinal dorsal horn were applied to indicate the noxious response of WDR neurons. The results showed that 2 Hz EA significantly down-regulated the levels of BDNF and TrκB mRNA and protein expression in the spinal cord of SNI rats, along with ameliorating mechanical hypersensitivity. In addition, intrathecal injection of 100 ng BDNF, not only inhibited the analgesic effect of 2 Hz EA on pain hypersensitivity, but also reversed the decrease of BDNF and TrκB expression induced by 2 Hz EA. Moreover, 2 Hz EA obviously reduced the increase of C-fiber-evoked discharges of dorsal horn WDR neurons by SNI, but exogenous BDNF (100 ng) effectively reversed the inhibitory effect of 2 Hz EA on SNI rats, resulting in a remarkable improvement of excitability of dorsal horn WDR neurons in SNI rats. Taken together, these data suggested that 2 Hz EA alleviates mechanical hypersensitivity by blocking the spinal BDNF/TrκB signaling pathway-mediated central sensitization in SNI rats. Therefore, targeting BDNF/TrκB cascade in the spinal cord may be a potential mechanism of EA against neuropathic pain.

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Section: Introductionmentioning

confidence: 99%

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Xue

Sun

Xia

et al. 2020

IJMS

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“…The worldwide literature confirms the important contribution of US in management of the NeP. Many studies underline its positive impact in guiding the treatment, especially for the nerve block or the intramuscular injection [25,26,30]. As seen in journal categories, in recent years, some specific diseases of neurological, orthopedic, and rehabilitation interest (in particular Morton's neuroma and piriformis syndrome) have been studied.…”

Section: Discussionmentioning

confidence: 77%

“…In the cases of herpes/postherpetic neuralgia, US was mainly used to guide the treatment, improving painful symptoms [ 29 ]. Patients with chronic pain were successfully treated with US-guided block [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

Neuropathic Pain and Ultrasonography: A Multiperspective Literature Evaluation

et al. 2021

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Among the tools useful for the management of neuropathic pain, ultrasound presents several advantages, shown by the literature. We assessed the scientific production about neuropathic pain and ultrasound from different points of view: general topics, journal categories, geographical origin and lexical analysis. We searched papers on PubMed using the Medical Subject Headings “neuropathic pain” AND “ultrasound”. We collected data about the journals where the papers were published, the country of the affiliation of the first author. For the lexical analysis, we evaluated the presence of selected words in the papers, and we built a graph representing the connections among words and papers. The papers were focused on the use of ultrasound as a diagnostic tool and guide for the therapy, assessing its application in different diseases such as Morton’s neuroma and piriformis syndrome. The most represented journal category was anesthesia while the most common country the United States of America. The lexical analysis confirmed the importance of ultrasound for diagnosis of specific disease and treatment of pain. The described approaches provide a multiperspective evaluation of the literature and may support the interpretation of the information contained by the papers.

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Regional Anesthesia in the Emergency Department: an Overview of Common Nerve Block Techniques and Recent Literature

Malik

Thom

Haber

et al. 2022

Curr Emerg Hosp Med Rep

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Purpose of Review This review seeks to discuss the use of RA in the ED including benefits of administration, types of RA by anatomic location, complications and management, teaching methods currently in practice, and future applications of RA in the ED. Recent Findings The early use of RA in pain management may reduce the transition of acute to chronic pain. Multiple plane blocks have emerged as feasible and efficacious for ED pain complaints and are now being safely utilized. Summary Adverse effects of opioids and their potential for abuse have necessitated the exploration of substitute therapies. Regional anesthesia (RA) is a safe and effective alternative to opioid treatment for pain in the emergency department (ED). RA can manage pain for a wide variety of injuries while avoiding the risks of opioid use and decreasing length of stay when compared to other forms of analgesia and anesthesia, without compromising patient satisfaction.

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Management of an Acute Exacerbation of Chronic Neuropathic Pain in the Emergency Department: A Case to Support Ultrasound-Guided Forearm Nerve Blocks

Cited by 6 publications

References 16 publications

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Neuropathic Pain and Ultrasonography: A Multiperspective Literature Evaluation

Regional Anesthesia in the Emergency Department: an Overview of Common Nerve Block Techniques and Recent Literature

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