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British Journal of Anaesthesia Mar 2022Findings from a population-based study using a sibling-matched analysis published in this issue of the British Journal of Anaesthesia indicate that epidural labour...
Findings from a population-based study using a sibling-matched analysis published in this issue of the British Journal of Anaesthesia indicate that epidural labour analgesia is not associated with an increased risk of autism spectrum disorder. These findings are consistent with those from three other population-based studies that used similar methodological approaches. Cumulatively, these robust, high-quality epidemiological data support the assertion that there is no meaningful association between epidural labour analgesia and autism spectrum disorder in offspring.
Topics: Analgesia, Epidural; Analgesia, Obstetrical; Analgesics; Autism Spectrum Disorder; Female; Humans; Labor, Obstetric; Pregnancy
PubMed: 35039173
DOI: 10.1016/j.bja.2021.12.017 -
PloS One 2023Postpartum depression is a significant episode of depression beginning after giving birth. The prevalence of postpartum depression is approximately 20% in Jeddah, Saudi... (Observational Study)
Observational Study
INTRODUCTION
Postpartum depression is a significant episode of depression beginning after giving birth. The prevalence of postpartum depression is approximately 20% in Jeddah, Saudi Arabia. Epidural analgesia is the gold standard for labour pain management. Conflicting results exist regarding the association between postpartum depression and epidural analgesia use during labour. Accordingly, this study assessed the association between epidural analgesia use and postpartum depression incidence.
METHODS
A prospective observational study of 170 mothers was conducted, with surveys administered after labour and at six weeks postpartum. Surveys included the following: mothers' demographics, obstetric history, postpartum depression (Edinburgh Postnatal Depression Scale), and pain severity (Visual Analogue Scale).
RESULTS
In the final analysis, 91 patients were enrolled. Epidural analgesia was administered to 48.4% of mothers during labour. Nearly two-thirds of mothers learned about EA via sources including family members and social media. However, more than half reported worries regarding epidural analgesia. Edinburgh Postnatal Depression Scale scores showed that 38 mothers (41.8%) likely had depressive symptoms within two days following delivery. Further, 35 (38.5%) met criteria for postpartum depression at six weeks postpartum. For both groups regardless use of analgesia, the mean Visual Analogue Scale score at two days postpartum was 4.16 ± 2.13. Data revealed no correlation between epidural analgesia use and Edinburgh Postnatal Depression Scale within two days and at six weeks postpartum. Multiple regression analysis showed Edinburgh Postnatal Depression Scale scores correlated with Visual Analogue Scale scores but not epidural analgesia use at 1-2 days postpartum.
CONCLUSION
This study showed that depressive symptoms resolved in three percent of participants. This suggests that institutions should increase postpartum depression awareness during the antenatal period and implement effective post-delivery screening systems for postpartum depression.
Topics: Pregnancy; Female; Humans; Analgesia, Epidural; Depression, Postpartum; Incidence; Labor, Obstetric; Pain Management; Pain; Analgesia, Obstetrical
PubMed: 37906559
DOI: 10.1371/journal.pone.0289595 -
Frontiers in Immunology 2023Neuropathic pain (NP) is a frequent condition caused by a lesion in, or disease of, the central or peripheral somatosensory nervous system and is associated with... (Review)
Review
Neuropathic pain (NP) is a frequent condition caused by a lesion in, or disease of, the central or peripheral somatosensory nervous system and is associated with excessive inflammation in the central and peripheral nervous systems. Repetitive transcranial magnetic stimulation (rTMS) is a supplementary treatment for NP. In clinical research, rTMS of 5-10 Hz is widely placed in the primary motor cortex (M1) area, mostly at 80%-90% RMT, and 5-10 treatment sessions could produce an optimal analgesic effect. The degree of pain relief increases greatly when stimulation duration is greater than 10 days. Analgesia induced by rTMS appears to be related to reestablishing the neuroinflammation system. This article discussed the influences of rTMS on the nervous system inflammatory responses, including the brain, spinal cord, dorsal root ganglia (DRG), and peripheral nerve involved in the maintenance and exacerbation of NP. rTMS has shown an anti-inflammation effect by decreasing pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α, and increasing anti-inflammatory cytokines, including IL-10 and BDNF, in cortical and subcortical tissues. In addition, rTMS reduces the expression of glutamate receptors (mGluR5 and NMDAR2B) and microglia and astrocyte markers (Iba1 and GFAP). Furthermore, rTMS decreases nNOS expression in ipsilateral DRGs and peripheral nerve metabolism and regulates neuroinflammation.
Topics: Humans; Transcranial Magnetic Stimulation; Neuroinflammatory Diseases; Neuralgia; Pain Management; Analgesia
PubMed: 37180127
DOI: 10.3389/fimmu.2023.1172293 -
Comparative Medicine Dec 2019Pain and its alleviation are currently a highly studied issue in human health. Research on pain and response to analgesia has evolved to include the effects of genetics,... (Review)
Review
Pain and its alleviation are currently a highly studied issue in human health. Research on pain and response to analgesia has evolved to include the effects of genetics, heritability, and sex as important components in both humans and animals. The laboratory mouse is the major animal studied in the field of pain and analgesia. Studying the inbred mouse to understand how genetic heritable traits and/or sex influence pain and analgesia has added valuable information to the complex nature of pain as a human disease. In the context of biomedical research, identifying pain and ensuring its control through analgesia in research animals remains one of the hallmark responsibilities of the research community. Advancements in both human and mouse genomic research shed light not only on the need to understand how both strain and sex affect the mouse pain response but also on how these research achievements can be used to improve the humane use of all research animal species. A better understanding of how strain and sex affect the response to pain may allow researchers to improve study design and thereby the reproducibility of animal research studies. The need to use both sexes, along with an improved understanding of how genetic heritability affects nociception and analgesic sensitivity, remains a key priority for pain researchers working with mice. This review summarizes the current literature on how strain and sex alter the response to pain and analgesia in the modern research mouse, and highlights the importance of both strain and sex selection in pain research.
Topics: Analgesia; Animals; Animals, Inbred Strains; Female; Humans; Mice; Nociception; Pain; Research Design; Sex Factors
PubMed: 31822324
DOI: 10.30802/AALAS-CM-19-000066 -
European Review For Medical and... Jan 2023The aim of the study was to investigate the impact of epidural analgesia on the stages of labor and maternal and neonatal outcomes.
OBJECTIVE
The aim of the study was to investigate the impact of epidural analgesia on the stages of labor and maternal and neonatal outcomes.
PATIENTS AND METHODS
A retrospective cohort study was conducted in the First Affiliated Hospital of Guangxi Medical University from January 1, 2020 to September 30, 2020. A total of 472 parturient met the inclusion criteria. Of them, 246 parturients received labor analgesia and 226 did not (control group). Their general characteristics, the length of labor, adverse reactions to analgesia, and maternal and neonatal outcomes between the two groups were compared to analyze and evaluate the feasibility of epidural analgesia in labor.
RESULTS
(1) The women in the analgesia group experienced a significantly longer (p<0.001) 1st stage, 2nd stage, and total stage during labor; (2) the usage rate of oxytocin, the rate of external cephalic version, and the success rate of external cephalic version were all significantly higher in the analgesia group (p<0.001); (3) there was no statistically significant difference between the vaginal delivery rate and transit cesarean section rate of the two groups; (4) compared with the control group, the incidence of intrapartum fever was significantly increased in the analgesia group (p<0.05); (5) there was no statistically significant difference between the two groups in postpartum hemorrhage, neonatal Apgar score, and neonatal asphyxia rate.
CONCLUSIONS
(1) Labor analgesia may prolong the 1st and 2nd stages of labor and increases the incidence of intrapartum fever, without increasing the rate of transit to cesarean section and postpartum hemorrhage; (2) labor analgesia does not negatively affect the Apgar score or increase the neonatal asphyxia rate.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Cesarean Section; Analgesia, Epidural; Postpartum Hemorrhage; Retrospective Studies; Asphyxia; China; Analgesia, Obstetrical
PubMed: 36647860
DOI: 10.26355/eurrev_202301_30863 -
British Journal of Anaesthesia Jun 2023Enhanced recovery after total hip arthroplasty aims to facilitate return to function and early hospital discharge, but the role of novel fascial plane block techniques...
Enhanced recovery after total hip arthroplasty aims to facilitate return to function and early hospital discharge, but the role of novel fascial plane block techniques in such pathways is uncertain. A randomised trial by Kukreja and colleagues describes superior quality of recovery after hip arthroplasty in patients receiving a pericapsular nerve group (PENG) block. We discuss the trial findings in the context of ongoing uncertainty regarding best analgesic practice for this surgical procedure.
Topics: Humans; Arthroplasty, Replacement, Hip; Pain, Postoperative; Pain Management; Analgesia; Nerve Block; Femoral Nerve
PubMed: 37105898
DOI: 10.1016/j.bja.2023.03.023 -
Archives of Razi Institute Apr 2022The current study aimed to investigate the effect of some of the analgesic drugs, such as Xylazine, Ketorolac, and Bupivacaine alone/mixed, on analgesia scores in the...
The current study aimed to investigate the effect of some of the analgesic drugs, such as Xylazine, Ketorolac, and Bupivacaine alone/mixed, on analgesia scores in the local breed goats. This research was performed on 35 male and female local breed goats within the age range of 6-8 months with an average weight of 17±3 Kg. The animals were divided into seven groups (n=5). The first group received Xylazine at a dose of 0.1 mg/kg BW through intramuscular injection (IM), while the second group was administered Ketorolac at a dose of 2 mg/kg BW through IM. The third group was administered Bupivacaine at a dose of 2 mg/kg BW through subcutaneous injection (SC). The fourth group was administered ketorolac at a dose of 2 mg/kg BW through IM and after 1 h was administered xylazine at a dose of 0.1 mg/kg BW through IM. The fifth group was administered Bupivacaine at a dose of 2 mg/kg BW through SC and after 1 h was administered xylazine at a dose of 0.1 mg/kg BW through IM. The sixth group was administered a mixture of Bupivacaine and ketorolac at the dose of 2 mg/kg BW through SC and 2 mg/kg BW through IM, respectively. The seventh group was administered Bupivacaine at a dose of 2 mg/kg BW through SC and ketorolac at the dose of 2 mg/kg BW through IM simultaneously. After 1 h, the seventh group was administered xylazine at the dose of 0.1 mg/kg BW through IM. Analgesia scores were evaluated every 10 min from the starting point for 180 min to determine values, such as respiratory and heart rate as well as rectal temperature. Moreover, the analgesic degree was examined for the head, flanks, hind limb, forelimb, and tail every 10 min. The recorded data in the current study revealed that the seventh group had a higher analgesic effect, compared to the other groups depending on the analgesia of the head, tail, flank, forelimb, and hindlimb. In the end, the group that received the mixture or combination of Bupivacaine (2 mg/kg BW-SC) and ketorolac (2 mg/kg BW-IM) followed by the administration of xylazine at a dose of 0.1 mg/kg BW after 1 h had a short period of onset of analgesia and showed long analgesia time and more depth, compared to other groups and without ataxia.
Topics: Male; Female; Animals; Xylazine; Bupivacaine; Ketorolac; Goats; Analgesia; Analgesics
PubMed: 36284962
DOI: 10.22092/ARI.2021.356859.1930 -
Comparative Medicine Dec 2019It is broadly accepted that, as part of the humane care and use of animals in research, the pain experienced by animals should be minimized to the extent possible,...
It is broadly accepted that, as part of the humane care and use of animals in research, the pain experienced by animals should be minimized to the extent possible, consistent with the goals of the research. In some cases, pain may be the subject under study, whereas in other cases, the use of some types of analgesics may interfere with the experimental objectives of the work. This issue of provides reviews related to the recognition and treatment of pain, the interaction of pain and pain relief on experimental outcomes, and ethical perspectives on the need to reduce pain in research rodents, whenever possible.
Topics: Analgesia; Animal Experimentation; Animals; Pain; Pain Management; Rodentia
PubMed: 31146798
DOI: 10.30802/AALAS-CM-19-000039 -
The Journal of Neuroscience : the... Apr 2022As a predominately positive emotion, nostalgia serves various adaptive functions, including a recently revealed analgesic effect. The current fMRI study aimed to explore...
As a predominately positive emotion, nostalgia serves various adaptive functions, including a recently revealed analgesic effect. The current fMRI study aimed to explore the neural mechanisms underlying the nostalgia-induced analgesic effect on noxious thermal stimuli of different intensities. Human participants' (males and females) behavior results showed that the nostalgia paradigm significantly reduced participants' perception of pain, particularly at low pain intensities. fMRI analysis revealed that analgesia was related to decreased brain activity in pain-related brain regions, including the lingual and parahippocampal gyrus. Notably, anterior thalamic activation during the nostalgia stage predicted posterior parietal thalamus activation during the pain stage, suggesting that the thalamus might play a key role as a central functional linkage in the analgesic effect. Moreover, while thalamus-PAG functional connectivity was found to be related to nostalgic strength, periaqueductal gray-dorsolateral prefrontal cortex (PAG-dlPFC) functional connectivity was found to be associated with pain perception, suggesting possible analgesic modulatory pathways. These findings demonstrate the analgesic effect of nostalgia and, more importantly, shed light on its neural mechanism. Nostalgia is known to reduce individuals' perception of physical pain. The underlying brain mechanisms, however, are unclear. Our study found that the thalamus plays a key role as a functional linkage between nostalgia and pain, suggesting a possible analgesic modulatory mechanism of nostalgia. These findings have implications for the underlying brain mechanisms of psychological analgesia.
Topics: Analgesia; Analgesics; Brain Mapping; Female; Humans; Magnetic Resonance Imaging; Male; Pain; Pain Perception
PubMed: 35232762
DOI: 10.1523/JNEUROSCI.2123-21.2022 -
Annual Review of Neuroscience Jul 2023Treatment outcomes are strongly influenced by expectations, as evidenced by the placebo effect. Meta-analyses of clinical trials reveal that placebo effects are... (Review)
Review
Treatment outcomes are strongly influenced by expectations, as evidenced by the placebo effect. Meta-analyses of clinical trials reveal that placebo effects are strongest in pain, indicating that psychosocial factors directly influence pain. In this review, I focus on the neural and psychological mechanisms by which instructions, learning, and expectations shape subjective pain. I address new experimental designs that help researchers tease apart the impact of these distinct processes and evaluate the evidence regarding the neural mechanisms by which these cognitive factors shape subjective pain. Studies reveal that expectations modulate pain through parallel circuits that include both pain-specific and domain-general circuits such as those involved in affect and learning. I then review how expectations, learning, and verbal instructions impact clinical outcomes, including placebo analgesia and responses to pharmacological treatments, and discuss implications for future work.
Topics: Humans; Motivation; Pain; Analgesia; Learning; Placebo Effect
PubMed: 36917820
DOI: 10.1146/annurev-neuro-101822-122427