Abstract:
:The development of chronic pain is a complex mechanism that is still not fully understood. Multiple somatic and visceral afferent pain signals, when experienced over time, cause a strengthening of certain neural circuitry through peripheral and central sensitization, resulting in the physical and emotional perceptual chronic pain experience. The mind-altering qualities of psychedelics have been attributed, through serotonin 2A (5-HT2A) receptor agonism, to 'reset' areas of functional connectivity (FC) in the brain that play prominent roles in many central neuropathic states. Psychedelic substances have a generally favorable safety profile, especially when compared with opioid analgesics. Clinical evidence to date for their use for chronic pain is limited; however, several studies and reports over the past 50 years have shown potential analgesic benefit in cancer pain, phantom limb pain and cluster headache. While the mechanisms by which the classic psychedelics may provide analgesia are not clear, several possibilities exist given the similarity between 5-HT2A activation pathways of psychedelics and the nociceptive modulation pathways in humans. Additionally, the alterations in FC seen with psychedelic use suggest a way that these agents could help reverse the changes in neural connections seen in chronic pain states. Given the current state of the opioid epidemic and limited efficacy of non-opioid analgesics, it is time to consider further research on psychedelics as analgesics in order to improve the lives of patients with chronic pain conditions.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Castellanos JP,Woolley C,Bruno KA,Zeidan F,Halberstadt A,Furnish Tdoi
10.1136/rapm-2020-101273subject
Has Abstractpub_date
2020-07-01 00:00:00pages
486-494issue
7eissn
1098-7339issn
1532-8651pii
rapm-2020-101273journal_volume
45pub_type
杂志文章,评审abstract:OBJECTIVE:Femoral nerve block (FNB) is increasingly used as an analgesic modality in patients with femoral fracture both in the emergency department and preoperatively. We describe an occurrence of unexpected dislocation of the fracture after FNB. CASE REPORT:An FNB was administered to treat pain in a 48-year-old pati...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000049
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Ultrasound-guided regional anesthesia is a rapidly growing field. There exists little information regarding the competencies involved with such a practice. The objective of this exploratory study was to characterize the behavior of novices as they undertook the challenges of learning a new tec...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2006.11.006
更新日期:2007-03-01 00:00:00
abstract::The past century has seen immense progress in the advancement of methodology to evaluate efficacy of treatment interventions for acute and chronic pain. Continuing challenges revolve around how to best select and measure primary efficacy outcomes for a given analgesic trial. Recognizing the complex, multidimensional, ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0b013e318217a635
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The transversus abdominis plane (TAP) block can be used as part of a multimodal analgesia protocol after abdominal surgery. This study investigated whether a pneumoperitoneum during abdominal surgery influences the spread of local anesthetics. METHODS:Nine fresh frozen cadavers were used for ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000260
更新日期:2015-07-01 00:00:00
abstract::This study aimed to describe the anatomical distribution of dye injected in the erector spinae plane (ESP) in a porcine living model, which could aid to reveal factors potentially relevant to the unexplained clinical effects of the ESP block. Six pigs received 0.6 mL/kg of 0.25% new methylene blue at the level of the ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100964
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Calciphylaxis is a painful complication of end-stage renal disease and secondary hyperparathyroidism. Calcification most commonly affects skin and soft tissue of the lower extremities resulting in excruciatingly painful skin ulcers. Treatment involves correction of hypercalcemia and hyperphosph...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(00)90018-x
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Cervical erector spinae plane (ESP) block has been described to anesthetize the brachial plexus (BP), however, the mechanism of its clinical effect remains unknown. As the prevertebral fascia encloses the phrenic nerves, BP and erector spinae muscles to form a prevertebral compartment, a local anesthetic inj...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-101154
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Ultrasound-guided infiltration of the interspace between the popliteal artery and capsule of the knee (iPACK) block, a new regional analgesic technique, is believed to relieve posterior knee pain, after total knee arthroplasty, by targeting the articular branches innervating posterior aspect o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100355
更新日期:2019-05-06 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The acetylcholinesterase inhibitor neostigmine has shown peripherally mediated analgesic action in recent preclinical and clinical studies. The present study investigates the effectiveness of adding neostigmine to a local anesthetic, mepivacaine, in patients receiving axillary brachial plexus ...
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(99)90005-6
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:We report the first prospective sonoanatomic study in neonates with the aim to perform ultrasonographic-guided epidural catheter placement in this age group. METHOD:One hundred forty-five neonates with a body weight < or =4 kg (0.53-4 kg) were included in this prospective study. The study was divided into 3...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2006.10.008
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Robotic and hand-assisted laparoscopic nephrectomies are often associated with moderate to severe postoperative pain. The aim of the current study was to investigate the analgesic efficacy of the transmuscular quadratus lumborum (TQL) block for patients undergoing robotic or hand-assisted laparoscopic nephre...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101745
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing sta...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000588
更新日期:2017-05-01 00:00:00
abstract::Perioperative outcomes research has gained widespread interest and is viewed as increasingly important among different specialties, including anesthesiology. Outcomes research studies serve to help in the adjustment of risk, allocation of resources, and formulation of hypotheses to guide future research. Pursuing high...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0000000000000110
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Paresthesia occasionally occurs during dural puncture or injection of local anesthetic for spinal anesthesia. Although the incidence of neurologic complications after spinal anesthesia is extremely low, the significance of paresthesia is unknown. The influence of known lumbar spine pathology o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(98)90081-5
更新日期:1998-11-01 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 OBJECTIVES:There is increasing interest in local infiltration analgesia (LIA) to reduce postoperative pain with knee surgery. Despite widespread use of LIA, wide variations in drug combinations, infiltration techniques, and the concomitant use of systemic analgesics have made it difficult to determine th...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000353
更新日期:2016-05-01 00:00:00
abstract::Abrupt cessation of intrathecal baclofen (ITB) administration can cause a life-threatening withdrawal syndrome that requires prompt diagnosis and urgent treatment. The current therapy for this condition is administration of propofol, benzodiazepines, paralytics and supportive care. This study reports a 53-year-old pat...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3181b4cc6b
更新日期:2009-11-01 00:00:00
abstract::The introduction of ultrasound guidance for regional anesthesia has resulted in an explosion of interest in its use for postoperative analgesia, particularly for orthopedic surgery. Regional anesthesia demonstrates unequivocal superiority compared with systemic opioids with respect to analgesia, reduced opioid consump...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e318295d973
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Approximately 15% of patients report persistent knee pain despite surgical success following total knee arthroplasty (TKA). The purpose of this study was to determine the association of acute-postsurgical pain (APSP) with chronic postsurgical pain (CPSP) 6 months after TKA controlling for patient, surgical a...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100036
更新日期:2019-02-15 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:In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinica...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100673
更新日期:2019-08-21 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The interscalene brachial plexus block (ISB) is an effective and well-established anesthetic technique for shoulder surgery. Using nerve stimulation as an aid in block placement, a motor response (twitch) in the biceps or a more distal upper limb muscle has been recommended to indicate accurat...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1053/rapm.2000.7597
更新日期:2000-07-01 00:00:00
abstract::Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. This article helps practitioners to identify those pain patients who would be prone to difficult behavior and sheds light on some of the reasons behind the behavior t...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rapm.2004.11.005
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:We tested the hypothesis that an opioid-free local anesthetic alone is able to provide comparable analgesia to the opioid supplemented epidural application of local anesthetics using thoracic epidural catheters after major abdominal surgery. METHODS:In a prospective, randomized, and double-bl...
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.2002.32583
更新日期:2002-07-01 00:00:00
abstract::Omission of a confidence interval (CI) associated with the risk of a serious complication can lead to inaccurate interpretation of risk data. The calculation of a CI for a risk or a single proportion typically uses the familiar Gaussian (normal) approximation. However, when the risk is small, "exact" methods or other ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2002.30708
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Arthroscopic anterior cruciate ligament (ACL) reconstruction of the knee is a painful procedure requiring intensive postoperative pain management. This prospective study investigates analgesic quality after a femoral block as compared with intra-articular injection of local anesthetic. METHOD...
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.2003.50019
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We present an unusual complication of epidural analgesia used to facilitate postoperative pain relief while allowing mobilization of the patient. CASE REPORT:A 65-year-old woman with a history of chronic obstructive pulmonary disease, atherosclerotic cardiovascular disease, chronic renal failu...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.22993
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Transversus abdominis plane (TAP) blocks have been shown to reduce postoperative pain after various abdominal surgical procedures in several studies. The motor nerves of the abdominal wall are located in the same plane as the sensory nerves affected by the TAP block. The aim of this study was ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3182330b95
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The ideal spread of local anesthetic for effective, rapid, and safe sciatic nerve block is debated. We hypothesized that subparaneural ultrasound-guided injection results in faster onset and has a better success rate than extraneural circumferential spread. METHODS:Patients undergoing elective tibial, foot,...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000095
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study goal was to compare the effect of epinephrine in different doses on pulmonary gas exchange in a rat model of bupivacaine-induced cardiac depression. METHODS:Twenty-four adult male Sprague-Dawley rats were divided into 4 groups (n = 6), and each group received a bupivacaine infusion (...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000541
更新日期:2017-05-01 00:00:00