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Korean Journal of Family Medicine Sep 2019It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine...
BACKGROUND
It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine hydrochloride help patients with such cancer pain. This study evaluated the efficacy of trigger point injections for alleviating pain in patients with advanced cancer.
METHODS
Twenty patients with advanced cancer who had a life expectancy of 6 months or less and had been diagnosed with myofascial pain syndrome were treated with trigger point injections. Prior to treatment, a Visual Analog Scale (VAS) was used to measure the resting pain level and discomfort upon application of pressure on the site of pain. These values were compared with last treatment measurements.
RESULTS
The mean pre-treatment VAS scores for pain at rest and upon application of pressure on the pain site were 7.3 and 9.0, respectively. These scores decreased significantly to 1.95 and 3.2, respectively, after the treatment (P<0.05).
CONCLUSION
Trigger point injection is an alternative and effective pain control modality for advanced cancer patients with myofascial pain syndrome.
PubMed: 31487973
DOI: 10.4082/kjfm.18.0065 -
Biochimica Et Biophysica Acta. General... Sep 2019Because ordered membrane domains, called lipid rafts, regulate activation of ion channels related to the nerve pulse, lipids rafts are thought to be a possible target...
BACKGROUND
Because ordered membrane domains, called lipid rafts, regulate activation of ion channels related to the nerve pulse, lipids rafts are thought to be a possible target for anesthetic molecules. To understand the mechanism of anesthetic action, we examined influence of representative local anesthetics (LAs); dibucaine, tetracaine, and lidocaine, on raft-like liquid-ordered (L)/non-raft-like liquid-disordered (L) phase separation.
METHODS
Impact of LAs on the phase separation was observed by fluorescent microscopy. LA-induced perturbation of the L and L membranes was examined by DPH anisotropy measurements. Incorporation of LAs to the membranes was examined by fluorescent anisotropy of LAs. The biding location of the LAs was indicated by small angle x-ray diffraction (SAXD).
RESULTS
Fluorescent experiments showed that dibucaine eliminated the phase separation the most effectively, followed by tetracaine and lidocaine. The disruption of the phase separation can be explained by their disordering effects on the L membrane. SAXD and other experiments further suggested that dibucaine's most potent perturbation of the L membrane is attributable to its deeper immersion and bulky molecular structure. Tetracaine, albeit immersed in the L membrane as deeply as dibucaine, less perturbs the L membrane probably because of its smaller bulkiness. Lidocaine hardly reaches the hydrophobic region, resulting in the weakest L membrane perturbation.
CONCLUSION
Dibcaine perturbs the L membrane the most effectively, followed by tetracaine and lidocaine. This ranking correlates with their anesthetic potency.
GENERAL SIGNIFICANCE
This study suggests a possible mechanistic link between anesthetic action and perturbation of lipid rafts.
Topics: Anesthetics, Local; Fluorescence Polarization; Hydrophobic and Hydrophilic Interactions; Lipid Bilayers; Membrane Microdomains
PubMed: 31207252
DOI: 10.1016/j.bbagen.2019.06.008 -
Contact Dermatitis Oct 2019
Topics: Adrenal Cortex Hormones; Anesthetics, Local; Dermatitis, Allergic Contact; Dermatitis, Atopic; Dibucaine; Female; Humans; Middle Aged; Patch Tests; Phenylephrine
PubMed: 30977131
DOI: 10.1111/cod.13290