Abstract:
BACKGROUND:Amitriptyline (AMI) is a lipophilic, tricyclic antidepressant with analgesic properties that could potentially be used for epidural (EPI) analgesia. However, no pharmacokinetic data are available for AMI in spinal spaces. The objective of this study was to evaluate the spinal disposition and intrathecal (IT) bioavailability of AMI after IT and EPI administration. METHODS:Six Lacaune ewes received 3 consecutive administrations of AMI. They initially received 10 mg of AMI administered intravenously, then 5 mg of AMI administered intrathecally, and 50 mg of AMI injected into the EPI space. Consecutive administrations were separated by intervals of 2 hours. A simultaneous microdialysis technique was used to determine the EPI and IT concentrations of AMI. Population analysis with S-ADAPT software was used to evaluate the pharmacokinetic parameters. RESULTS:Following intravenous administration, the clearance and central compartment (Vc) in plasma were 1.32 L/min and 147 L, respectively. Concentration-time profiles for the IT and EPI compartments were highly variable after transmeningeal diffusion. The IT Vc after IT administration and the EPI Vc after EPI administration were 2.4 and 48.9 mL, respectively. Less AMI transferred from the EPI to the IT space than from the IT to the EPI compartment, with bioavailabilities of 1.3% and 55%, respectively. CONCLUSIONS:Simultaneous population analysis for AMI demonstrated differences in EPI and IT pharmacokinetics following the EPI and IT administration of this drug. The IT bioavailability of AMI after EPI administration is relatively low.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Ratajczak-Enselme M,Grégoire N,Estebe JP,Dollo G,Chevanne F,Bec D,Ecoffey C,Couet W,Le Corre Pdoi
10.1097/AAP.0000000000000322subject
Has Abstractpub_date
2015-11-01 00:00:00pages
681-6issue
6eissn
1098-7339issn
1532-8651journal_volume
40pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:Epinephrine, 25 microg and 200 microg, has been found to prolong the duration of intrathecal labor analgesia when added to an opioid. In our hospital we use the standard epidural mixture, prepared by the pharmacist, containing epinephrine 1:800,000; i.e., 1.25 microg/mL for both spinal and epi...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2001.24406
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Patients treated with regional anesthesia often require concomitant medication for comfort and sedation. Propofol is widely used for this purpose. Remifentanil, a new ultra-short-acting opioid, exhibits at low doses distinct sedative properties that may be useful for supplementation of regiona...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(98)90112-2
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epidural anesthesia (EA) is known to reduce postoperative thromboembolic complications, but mechanisms are incompletely understood. In this study, we tested the hypothesis that local anesthetics (LA) prevent postoperative hypercoagulability without affecting physiologic aggregation and coagula...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.23209
更新日期:2001-05-01 00:00:00
abstract::Reports exist of severe upper back pain of unknown etiology after administration of large volumes into the epidural space. We present a case of an otherwise healthy parturient who developed severe upper back and neck pain after receiving only a small volume of epidural medication. Magnetic resonance imaging revealed a...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000493
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Amputations of the lower extremity remain a common procedure in a high-risk population. Perioperative morbidity and mortality reach as high as 14.1% in below-knee amputations. We aimed to determine whether regional, or neuraxial, anesthesia, when compared with general anesthesia (GA), would be...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000687
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Success in performing ultrasound-guided peripheral nerve blockade (PNB) demands sound knowledge of sonoanatomy, good scanning techniques, and proper hand-eye coordination. The objectives of our study were to evaluate whether simulator training aids success of novice operators in ultrasound-gui...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e31823dc340
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Perineural dexamethasone or dexmedetomidine prolongs the duration of single-injection peripheral nerve block when added to the local anesthetic solution. In a randomized, controlled, double-blinded study in patients undergoing thoracoscopic pneumonectomy, we tested the hypothesis that combined...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100221
更新日期:2019-08-08 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Use of nonsteroidal anti-inflammatory drug (NSAIDs) analgesics is controversial because of cardiovascular risk, but perioperative use may be advantageous for total joint replacement. Thus, we performed this single-center observational cohort study to determine any association between NSAID use...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e31823354f5
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Concern for block-related injury and liability has dissuaded many anesthesiologists from using regional anesthesia for eye and extremity surgery, despite many studies demonstrating the benefits of regional over general anesthesia. To determine injury patterns and liability associated with eye ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.rapm.2008.01.016
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The posterior approach to performing a continuous brachial plexus block at the level of the nerve roots has been described using traditional superficial landmarks. We describe an ultrasound-guided approach for the placement of a continuous interscalene brachial plexus catheter at the level of ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/AAP.0b013e3181933a53
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In order to prolong labor analgesia, one may add intrathecal epinephrine to the combination of bupivacaine and fentanyl. In this study, we tested the hypothesis that the addition of intrathecal epinephrine would lessen the requirement for a rescue dose of epidural analgesia during labor. METH...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2003.50026
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Dorsal root ganglion stimulation is an emerging therapy in the treatment of chronic pain. Compared with traditional spinal cord stimulation, it allows a discretely targeted stimulation profile and may act via differing mechanisms of action. Despite these advantages, little is known about the c...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000007
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to determine whether an intrabursal morphine and bupivacaine mixed infusion provides useful analgesia for prolonged pain relief after subacromial arthroscopic operation. METHODS:A continuous intrabursal infusion catheter was inserted at the conclusion of the subacrom...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2002.31209
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Multimodal analgesia protocols have shortened hospitalizations after total joint arthroplasty. It is unclear whether individual components of these protocols are associated with respiratory depression during phase I postanesthesia recovery. OBJECTIVES:To test the hypothesis that sedating analgesics used in ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000257
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Local anesthetics in blood absorbed from the epidural space attenuate bronchial hyperreactivity to chemical stimuli. However, it is not documented whether local anesthetics at clinically relevant concentrations improve active wheezing in patients with bronchial asthma. CASE REPORT:We managed ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(99)90015-9
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Adenosine is an endogenous compound that may have analgesic effects. Results from clinical trials are not consistent, however, and there is a need for large-scale, randomized, placebo-controlled studies to clarify the role of adenosine in the treatment of pain states, including acute nocicepti...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2001.22256a
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter e...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AAP.0000000000000253
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Stimulation of the radial nerve at the axilla may cause either a proximal movement (forearm extension) or distal movements (supination, wrist or finger extension). In the most recent studies on axillary block, only a distal twitch was accepted as valid. However, this approach was based only on...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rapm.2005.06.002
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Interpretation of ultrasound images and knowledge of anatomy are essential skills for ultrasound-guided peripheral nerve blocks. Competency-based educational models promoted by the Accreditation Council for Graduate Medical Education require the development of assessment tools for the achievement of differen...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/AAP.0000000000000236
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Bupivacaine is a racemic mixture of S(-)- and R(+)-enantiomers. Both isomers have similar potency as local anesthetics, but the S(-)-enantiomer produces less central nervous system and cardiovascular toxicity. Local anesthetic-induced convulsion is likely to be associated with not only sodium ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2005.09.004
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:A variety of brachial plexus block techniques via the interscalene approach have been proposed. We describe here a new middle interscalene perivascular approach to the brachial plexus. To verify its effectiveness, we studied 719 patients scheduled for shoulder arthroscopy. Furthermore, to veri...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/j.rapm.2006.05.015
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Long-acting nociceptive-selective regional anesthesia has remained an elusive clinical goal. We aspired to identify a novel compound that would produce nociceptive-selective regional anesthesia through the transient receptor potential vanilloid 1 (TRPV1) channels. METHODS:We designed and synth...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-101057
更新日期:2020-06-01 00:00:00
abstract::Directors for Regional Anesthesiology and Acute Pain Medicine fellowships develop and maintain guidelines for fellowship training in the subspecialty. The first edition of the guidelines was published in 2005 with a revision published in 2010. This set of guidelines updates the 2010 revision. The guidelines address 3 ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,实务指引
doi:10.1097/AAP.0000000000000233
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Ivor-Lewis esophagectomy is associated with significant postoperative analgesic requirements and perioperative complications. A dual-epidural technique may improve perioperative outcomes compared with single thoracic epidural analgesia. METHODS:This study identified all cases of Ivor-Lewis esophagectomy ove...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e318276a714
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve blocks reduce postoperative pain and enhance recovery after total knee arthroplasty (TKA). This study aims to assess the benefits of addition of intravenous dexmedetomidine (DexM) to intravenous dexamethasone on the analgesic duration of quadruple nerve blocks. METHODS:This d...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101749
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surg...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000819
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Posterior lumbar plexus block is a well established anesthetic technique for lower limb surgeries. Both magnetic resonance imaging and clinical prospective studies were performed to verify if a new palpable landmark could be used for lumbar plexus block in pediatric patients. METHODS:Twenty-f...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.06.395
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Chronic pain is both prevalent and costly. Despite advances in understanding the anatomy, physiology, and biochemistry of nociception and development of potent analgesic agents and advanced technology, a significant number of people continue to experience pain and related disability. The perce...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1016/s1098-7339(03)00392-4
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study is to clarify the influence of acute cigarette smoking on vasodilation induced by sympathetic block. METHODS:We measured mean arterial pressure, heart rate, left brachial artery blood flow (BABF), right femoral artery blood flow (FABF), and plasma catecholamines in dogs ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.16163
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:0.1% bupivacaine for obstetric epidural analgesia is given by infusion, using a loading dose of a higher concentration alone or in combination with opioid analgesics. A single dose of 0.1% without any additive for relief of first-stage labor pain has not yet been documented. METHODS:Fifty-eig...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00115550-199823020-00004
更新日期:1998-03-01 00:00:00