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Rapid modulation of GABA in sensorimotor cortex induced by acute deafferentation

ANNALS OF NEUROLOGY 2002年第6期52卷 755-761页

作者： Levy, LM Ziemann, U Chen, R Cohen, LG Natl Inst Neurol Disorders & Stroke Neuroimaging Branch NIH Bethesda MD 20892 USA George Washington Univ Med Ctr Neuroradiol Sect Washington DC 20037 USA Natl Inst Neurol Disorders & Stroke Human Cort Physiol Sect NIH Bethesda MD 20892 USA Goethe Univ Frankfurt Neurol Clin D-60590 Frankfurt Germany Toronto Western Hosp Div Neurol Toronto ON M5T 2S8 Canada

Recovery of function after acute injury to the central nervous system may be controlled by the availability of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in the cerebral cortex. Acute lesions as well as manipulation of sensory inputs can lead to rapid reorganization of the cerebral cortex, occurring within minutes to hours. Reduction of cortical inhibitory tone through a decrease in the availability of GABA has been suggested as a possible mechanism;however, the degree and temporal course of the changes in brain GABA are not known. A novel method using two-dimensional J-resolved magnetic resonance spectroscopy showed that GABA levels in the human sensorimotor cortex are quickly reduced within minutes of deafferentation. This finding strongly supports the view that the release of latent corticocortical projections from tonic inhibition through decreased GABA availability is a mechanism of rapid cortical plasticity. Reduction of brain GABA can play a pivotal role in regulating the extent of rapid cortical reorganization after lesions or changes in sensory input.

关键词：传入通路/生理学方差分析大脑皮质/代谢前臂/生理学磁共振波谱学/方法神经传导阻滞/方法 γ氨基丁酸/分析 γ氨基丁酸/代谢成年人女(雌)性人类男(雄)性

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健康教育在颈椎病神经节阻滞治疗中的作用

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中国组织工程研究 2002年第22期6卷 3463页

作者：张洪梅 Rongjun General Hospital of Shandong Jinan 250013 China

Background:Blocking of cervical nerve ganglion is an effective method in treatment of cervical *** education before and after operation could solve many nursing ***: To investigate effect of health education in treatment of cervical spondylopathy by blocking of nerve ***:Rongjun General Hospital of ***:88 cases of cervical spondylopathy were diagnosed for cervical stifness,painess and numb of upper limbs,Including 61 males,27 females,aged 31-78 years *** plexus puling test and intervertebral foramen pulling test were both positive,and X-ray showed varying degrees of *** divided into A group and B ***:A group:routine test and preparing before operation,answering questions asked;B group:reading case data,grasping condition,acknowledge of patients,mastering of information,and mental state,which was the base for health *** education varied with each individual.(1) Mental prepairing:Before blocking,besides answering requirement,the following must be explained:therapeutic method,aim,operational process,possible reaction,feelings in puncture and *** must be noted that patient shouldn't move body.(2)Position prepairing:To peridural anesthesia,patients were helped to exercise repeatedly embracing knees with two hands,flexing of head towards chest,flexing of knees towars abdomen.(3)Importance of determining “pressure pain point” which was often the location of lession.(4) Prevention of infection:Besides strict aseptic manipulation,patients were told to keep puncture position clean.(5) After treatment,patients were instructed to press back cervical vertebral joint,extending neck fully *** were instructed massotherapy to prevent ***:Effect of pain relieving in two groups was satisfying,but increasing of blood pressure,speeding of pulse,hematoma at puncture portion appeared,in A group,11 cases in 45cases(24%),in B group 3 cases in 43

关键词：健康教育颈椎病/护理颈椎病/治疗神经传导阻滞/护理神经传导阻滞/方法人类

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Obstetric analgesia

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PRIMARY CARE 2000年第1期27卷 203-+页

作者： Stephens, MB Fenton, LA Fields, SA Uniformed Serv Univ Hlth Sci Dept Family Med Bethesda MD 20814 USA

Several analgesic options are available for patients during labor. Selection of the appropriate technique must be individualized. Education and preparation begins during prenatal care. If medications are to be used, the risks and benefits to the mother and infant must be considered. Continued patient-doctor communication throughout labor is essential. Patient preferences, tempered by sound medical judgement, should guide the selection of the optimal modality for pain control during labor.

关键词：镇痛硬膜外/方法镇痛产科/历史镇痛药阿片类/治疗应用麻醉/方法神经传导阻滞/方法疼痛/药物疗法疼痛/病理生理学疼痛/治疗女(雌)性历史 19世纪历史 20世纪人类妊娠

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Dental nerve blocks - Toothache remedies for the acute-care setting

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POSTGRADUATE MEDICINE 2000年第1期107卷 229-+页

作者： Powell, SL Robertson, L Doty, BJ Alaska Family Practice Residency Anchorage AK 99508 USA

Ideally, tooth pain is managed by a competent dentist, who can provide definitive care. However, timely access to such care may not be available late at night, on weekends, or in rural practice settings. This article introduces primary care physicians to dental nerve blocks that can be learned without extensive training and used in the acute-care setting to provide temporary relief of oral, dental, and facial pain.

关键词：知情同意神经传导阻滞/方法病人遴选初级卫生保健牙痛/治疗人类

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The management of cancer pain

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CA-A CANCER JOURNAL FOR CLINICIANS 2000年第2期50卷 70-116页

作者： Cherny, NI Shaare Zedek Med Ctr Dept Med Oncol Jerusalem Israel

Any therapeutic strategy developed for patients experiencing cancer pain depends on the goals of care, which can be broadly categorized as prolonging survival, optimizing comfort, and optimizing function. The relative priority of these goals for any individual should direct therapeutic decision-making. By combining primary treatments, systemic analgesic agents, and other techniques, most cancer patients can achieve satisfactory relief of pain. In cases where pain appears refractory to these interventions, invasive anesthetic or neurosurgical maneuvers may be necessary, and sedation may be offered to those with unrelieved pain at the end of life. The principles of analgesic therapy are presented, as well as the practical issues involved in drug administration, ranging from calculating dosage to adverse effects, and, when necessary, how to switch and/or combine therapies. Adjuvant analgesics, which are drugs indicated for purposes other than relief of pain but which may have analgesic effects, are also listed and discussed in some detail. Surgical and neurodestructive techniques, such as rhizotomy or cordotomy, although not frequently required or performed, represent yet other options for patients with unremitting pain and diminished hope of relief. Although cancer pain can be a complex medical problem arising from multiple sources, patients should be assured that suffering is not inevitable and that relief is attainable.

关键词：肾上腺皮质激素类/投药和剂量抗菌药/投药和剂量消炎药非甾类/投药和剂量消炎药非甾类/副作用抗肿瘤药/投药和剂量中枢神经系统抑制药/投药和剂量剂型投药途径用药计划表肾疾病/并发症肝疾病/并发症肿瘤/并发症肿瘤/外科学肿瘤/治疗神经传导阻滞/方法疼痛/病因学疼痛管理病人遴选物质相关性障碍/预防和控制人类

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Combined fluphenazine and lidocaine for pain relief in head and neck cancers

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TROPICAL DOCTOR 2000年第2期30卷 69-70页

作者： Desai, PM Desai, KP Savitribai Fule Municipal Hosp Kolhapur 416002 Maharashtra India

A successful method of treating intractable neoplastic pain in 12 cases is discussed. A completely new method was tried combining long-acting phenothiazine and lidocaine to achieve long-lasting pain relief. This combi... 详细信息

关键词：麻醉药局部/治疗应用多巴胺拮抗剂/治疗应用药物疗法联合氟奋乃静/治疗应用头颈部肿瘤/并发症注射病灶内利多卡因/治疗应用神经传导阻滞/方法疼痛测定疼痛顽固性/病因学疼痛顽固性/预防和控制治疗结果女(雌)性人类男(雄)性

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Computed tomography-guided pudendal block for treatment of pelvic pain due to pudendal neuropathy

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OBSTETRICS AND GYNECOLOGY 2000年第2期95卷 306-309页

作者： McDonald, JS Spigos, DG Univ Calif Los Angeles Sch Med Dept Obstet & Gynecol Los Angeles CA USA Ohio State Univ Dept Radiol Columbus OH 43210 USA

Background: Severe pelvic pain secondary to pudendal neuropathy can be treated with repeated local anesthetic nerve blocks or with. surgical decompression of the nerve. Computed tomographic (CT) needle guidance to identified reliable anatomic points might be useful for improved success rates. Technique: A CT scan is used to determine baseline anatomy and identify the sacrospinous process. A metallic marker is used to create a perpendicular pathway from the sacrospinous process upward to the skin surface, where a local anesthetic is injected. A 22-gauge, 5-inch needle is inserted downward in a perpendicular direction to the target. Deep penetration and direction are confirmed by serial CT scans. Medication is injected and the needle is removed. Experience: Twenty-six women with diagnoses of pudendal neuropathy were treated with injection therapy once per month, for five total treatments each. About three-quarters experienced improvement. There were no complications in this series. Outcomes were gratifying considering the complex patient population, all having failed multiple therapeutic trials. Conclusion: We believe this technique warrants further evaluation and application in instances where noninvasive therapy of pudendal neuropathy is indicated. (Obstet Gynecol (C) 2000;95:306-9. (C) 2000 by The American College of Obstetricians and Gynecologists.).

关键词：注射脊髓神经传导阻滞/方法疼痛测定骨盆痛/诊断显像骨盆痛/病因学骨盆痛/治疗周围神经系统疾病/并发症体层摄影术 X线计算机/方法治疗结果女(雌)性人类

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The diagnostic validity and therapeutic value of lumbar facet joint nerve blocks with or without adjuvant agents.

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Current review of pain 2000年第5期4卷 337-344页

作者： Manchikanti, L. Pampati, V. Fellows, B. Bakhit, C.E. Pain Management Center 2831 Lone Oak Road Paducah 42003 KY United States

Facet joints have been described as an important source of low back pain. The value of medial branch blocks in the diagnosis of facet joint mediated pain is considered important. However, the therapeutic value of medial branch blocks has not been determined. This study was designed to evaluate the duration of relief obtained and therapeutic value following controlled medial branch blocks with or without adjuvant agents Sarapin (High Chemical Company, Levittown, PA) and Depo-medrol (Pharmacia and Upjohn Company, Kalamazoo, MI). The study population consisted of 180 consecutive patients seen in a single pain management practice, divided into three groups with 60 patients in each group. Group I was treated with local anesthetic only, Group II with the addition of Sarapin, and Group III with the addition of Depo-medrol along with Sarapin. The prevalence of facet joint pain in chronic low back pain was determined as 36%, with a false-positive rate of 25%. Comparison of duration of relief in days with each block in the three groups showed that the relief was significantly superior in Group III compared with Group I and Group II, whereas Group II was superior to Group I.

关键词：神经传导阻滞/方法病人满意度植物提取物患病率可重复性结果敏感性与特异性治疗结果中年人

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Ultrasound

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CLINICAL RADIOLOGY 2000年第6期55卷 433-434页

作者： Baxter, GM Western Infirm NHS Trust Dept Radiol Glasgow G11 6NT Lanark Scotland

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Extrapleural intercostal nerve block

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ANNALS OF THORACIC SURGERY 2000年第3期69卷 975-976页

作者： Richardson, JA Mearns, AJ Bradford Royal Infirm Dept Anaesthesia Bradford BD9 6RJ W Yorkshire England

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