Synergistic Antinociceptive Interaction after Epidural Coadministration of Morphine and Lidocaine in Rats

Kaneko, Megumi; Saito, Yoji; Kirihara, Yumiko; Collins, J. G.; Kosaka, Yoshihiro

doi:10.1097/00000542-199401000-00021

Cited by 120 publications

(48 citation statements)

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“…The high quality of pain relief could be also related to the combination of the pre-emptive effect of inducing the epidural blockade before skin incision 18,19 with the synergism of multimodal analgesia. 20,21 Both groups showed a decrease in postoperative oxygen saturation compared with baseline values, but there were no differences between the groups. The clinical relevance of these observed decreases in oxygen saturation is questionable, because no patient required supplemental oxygen to maintain saturation > 90%.…”

Section: Discussionmentioning

confidence: 82%

Patient supplemented epidural analgesia after major abdominal surgery with bupivacaine/fentanyl or ropivacaine/fentanyl

Berti

Fanelli

Casati

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To compare analgesic efficacy and occurrence of motor block and other side effects during patient supplemented epidural analgesia (PSEA) with either ropivacaine/fentanyl or bupivacaine/fentanyl mixtures. Methods:In a prospective, randomized, double-blind study, 32 ASA I-III patients undergoing major abdominal surgery received an epidural catheter at the T 8 -T 10 , followed by integrated general epidural anesthesia. Postoperative epidural analgesia was provided using a patient controlled pump with either ropivacaine 0.2%/2 µg·ml -1 fentanyl (group Ropivacaine, n = 16) or bupivacaine 0.125%/2 µg·ml -1 fentanyl (group Bupivacaine, n = 16) [background infusion 4 -6 ml·hr -1 , 1.5 ml Incremental Doses and 20 min lock out]. Verbal pain rating score, number of incremental doses, consumption of epidural analgesic solution and rescue analgesics, sedation (four-point scale), and pulse oximetry were recorded by a blind observer for 48 hr after surgery. Conclusion: Using a ropivacaine 0.2% / 2 µg·ml -1 fentanyl mixture for patient supplemented epidural analgesia after major abdominal surgery provided similar successful pain relief as bupivacaine 0.125%/2 µg·ml -1 fentanyl, but patients receiving bupivacaine/fentanyl requested more supplemental.Objectif : Comparer l'efficacité analgésique, l'occurrence de blocage moteur et autres effets secondaires pendant une analgésie épidurale complétée (AEC) avec un mélange de ropivacaïne/fentanyl ou de bupivacaïne/fentanyl.Méthode : L'étude prospective, randomisée et à double insu a porté sur 32 patients d'état physique ASA I-III qui devaient subir une intervention chirurgicale abdominale majeure. Un cathéter épidural a été mis en place à T 8 -T 10 et une anesthésie générale/péridurale intégrée a suivi. L'analgésie épidurale postopératoire, administrée par une pompe contrôlée par le patient, comprenait soit un mélange de ropivacaïne à 0,2 %/2 µg·ml -1 de fentanyl (groupe Ropivacaïne, n = 16) soit un mélange de bupivacaïne à 0,125 %/2 µg·ml -1 de fentanyl (groupe Bupivacaïne, n = 16) [perfusion de base de 4-6 ml·h -1 , doses en incréments de 1,5 ml et période réfractaire de 20 min]. Le score verbal d'estimation de la douleur, le nombre de doses incrémentielles, la consommation d'analgésique épidural et de doses d'appoint, la sédation (selon une échelle en quatre points) et l'oxymétrie de pouls ont été enregistrés par un observateur impartial pendant 48 h après l'opération.Résultats : Aucune différence intergroupe n'a été observée quant au soulagement de la douleur, au blocage moteur, au degré de sédation, à l'oxymétrie de pouls et aux autres effets secondaires. Conclusion : Un mélange de ropivacaïne à 0,2 %/2 µg·ml -1 de fentanyl, comme analgésie épidurale d'appoint à la suite d'une intervention chirurgicale abdominale majeure, a fourni un soulagement de la douleur d'efficacité similaire à un mélange de bupivacaïne à 0,125 %/2 µg·ml -1 de fentanyl, mais ce dernier a nécessité plus de doses d'appoint.Patient supplemented epidural analgesia after major abdominal surgery with bupi...

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Section: Discussionmentioning

confidence: 82%

Patient supplemented epidural analgesia after major abdominal surgery with bupivacaine/fentanyl or ropivacaine/fentanyl

Berti

Fanelli

Casati

et al. 2000

Can J Anesth/J Can Anesth

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“…The motor blockade was measured by scoring each animal's capacity to carry its body weight [15]. The motor function was scored before administration of the drug (0, normal tone and posture, free movement of hind limbs; 1, weak hypotonia of hind limbs ⁄ body posture; 2, moderate hypotonia of hind limbs ⁄ body posture; and 3, inability to support the body on hind limbs, flat body posture), reassessed at 15, 30, 60, and 90 min and 5 days afterwards.…”

Section: Methodsmentioning

confidence: 99%

“…Similarly, persistent neurological deficits are reported with very high concentrations of bupivacaine [6,9,10]. Although previous studies have examined the effects of various drugs in the epidural space, very few studies have described the results of epidural drug injection techniques [7,[11][12][13][14][15][16][17][18][19][20][21]. In clinical practice, the two commonly used classes of epidural drugs are local anaesthetics and opioids and the common modes of administration are intermittent bolus injection and continuous infusion.…”

mentioning

confidence: 99%

Histopathological effects on epidural tissue of bolus or continuous infusions through an epidural catheter in ewes

Türe

Etı²,

Göğüş

et al. 2010

Anaesthesia

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SummaryThis study was performed to evaluate the histopathological effects of epidural drug injection given either by intermittent bolus or continuous infusion through a catheter on epidural tissue. Fourteen ewes received intermittent bolus injections of morphine with bupivacaine, or a bolus of the same drugs followed by continuous infusion for 5 days. After 5 days, histopathological examination of the epidural space revealed mild to moderate inflammatory changes, and focal fibrosis surrounding the catheter in all ewes. The similarity of the inflammatory reaction in the control and drug treated groups seems to indicate that neither intermittent bolus or continuous infusion after a bolus dose caused histopathological changes in the epidural space beyond that caused by the catheter itself.

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“…The tail flick (TF) test has been widely used to measure injury-related alterations in sensory threshold [20,21]. Briefly, a rat was placed in a plastic box (22×6.5×6.5 cm).…”

Section: Tail Flick Testmentioning

confidence: 99%

“…For this goal, the second experiment assessed TF latency and MWT. The TF test has been widely used to measure injury-related alterations in sensory threshold [20,21]. Forty adult female rats weighing 150-160 g were grouped evenly (10/group) and exposed to magnets rotating for 30 minutes at 6300, 6800, 7300, or 7800 circles/min, respectively.…”

Section: Rotating Magnets Increase Tail Flick Latency and Mechanical mentioning

confidence: 99%

Rotating Magnets Produce a Prompt Analgesia Effect in Rats

Chen¹,

Ye²,

Xu³

et al. 2012

PIER M

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Abstract-The beneficial effects of chronic/repeated magnetic stimulation on humans have been examined in previous studies. Although pain relief effects have been reported several weeks after magnetic treatment, no report is available regarding the prompt effect of magnetic stimulations. In this study, a novel apparatus was developed to generate time-varying magnetic fields with rotating magnets. Adult, conscious rats were exposed to the rotating magnets in a posture in which their spines were parallel to the induced electric current. The magnetic field suppressed the paw withdrawal reflex in the anesthetized rats, and the suppression effect disappeared 5 minutes after magnets stopped rotating. The tail flick (TF) latency and mechanic withdrawal thresholds (MWT) of the rats were significantly increased by the rotating magnets; the increases positively correlated with the velocity and period of the magnet rotating. These analgesia effects recovered to the baseline level 30 minutes after magnets stopped rotating. A biophysics model was proposed to qualitatively understand the mechanism of pain inhibition by the rotating field. The prompt analgesia effect of the rotating magnets and its rapid recovery encourage the application of this technique as a promising new analgesia and anesthesia method.

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Synergistic Antinociceptive Interaction after Epidural Coadministration of Morphine and Lidocaine in Rats

Cited by 120 publications

References 0 publications

Patient supplemented epidural analgesia after major abdominal surgery with bupivacaine/fentanyl or ropivacaine/fentanyl

Patient supplemented epidural analgesia after major abdominal surgery with bupivacaine/fentanyl or ropivacaine/fentanyl

Histopathological effects on epidural tissue of bolus or continuous infusions through an epidural catheter in ewes

Rotating Magnets Produce a Prompt Analgesia Effect in Rats

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