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Gercek O, Keles I, Saritas TB, Koyuncu B, Topal K, Demirbas A. Effect of obturator nerve block during transurethral resection of bladder tumors on the disease recurrence, progression and surgery outcomes. Int Urol Nephrol 2023; 55:2765-2772. [PMID: 37531039 DOI: 10.1007/s11255-023-03727-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE In our study, we aimed to evaluate the effect of the obturator nerve block (ONB) on the operation time, duration of hospital stay, complete resection, presence of muscle tissue in the pathology, second resection, recurrence, and progression, when applied in addition to spinal anesthesia in patients with primary bladder lateral wall tumor and Transurethral Resection of Bladder Tumor (TURBT) was planned. MATERIALS AND METHODS Seventy patients with bladder lateral wall tumors were included in the study. In addition, ONB was applied to 35 of the patients who underwent spinal anesthesia. The two groups were compared in terms of obturator reflex development, perforation, complete resection, presence of muscle tissue in pathology samples, need for second resection, need for second resection due to inadequate muscle tissue, and 1 year recurrence and progression rates. RESULTS When the two groups were compared for obturator reflex and bladder perforation, both were found to be lower in the ONB group (p = 0.002, p = 0.198, respectively). The rate of complete resection and the presence of muscle tissue in the pathology samples were higher in the ONB group (p = 0.045, p = 0.034, respectively). The rates of second resection and second resection due to inadequate muscle tissue were found to be higher in the group without ONB (p = 0.015, p = 0.106, respectively). In the 1-year follow-up, the recurrence rate was significantly lower in the ONB group (p < 0.001), while there was no significant difference between the progression rates (p = 0.106). CONCLUSION In our study, we found out that ONB applied in addition to spinal anesthesia increases the rate of complete and muscle tissue resection by decreasing the obturator reflex, and causes a significant reduction in the need for second resection and tumor recurrence.
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Affiliation(s)
- O Gercek
- Department of Urology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - I Keles
- Department of Urology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - T B Saritas
- Department of Anesthesiology and Reanimation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - B Koyuncu
- Department of Anesthesiology and Reanimation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - K Topal
- Department of Urology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - A Demirbas
- Department of Urology, Bursa Doruk Hospital, Bursa, Turkey
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Chiavari R, Pace V, Lambo MS, Volpe D, Fusco P, Marinangeli F. Performing a Continuous Subarachnoid Anesthesia in ASA 2 or ASA 3 patients undergoing Laparotomic Prostatectomy provides hemodynamic stability and painless postoperative recovery. Minerva Anestesiol 2021; 88:416-417. [PMID: 34709021 DOI: 10.23736/s0375-9393.21.16176-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Roberta Chiavari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy -
| | - Vincenzo Pace
- Department of Anesthesia and Intensive Care, Santissima Annunziata Hospital, Sulmona, L'Aquila, Italy
| | - Massimo S Lambo
- Department of Anesthesia and Intensive Care, Santissima Annunziata Hospital, Sulmona, L'Aquila, Italy
| | - Donatella Volpe
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Pierfrancesco Fusco
- Department of Anesthesia and Intensive Care, San Salvatore Academic Hospital, L'Aquila, Italy
| | - Franco Marinangeli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Khawaja A, Dar Y, Suhail M, Sofi K, Muzaffar P, Parra S, Malik S, Bhat A, Wani M. Feasibility and safety of retrograde radical cystectomy under combined spinal and epidural anesthesia in high-risk and elderly patients. A single surgeon experience. UROLOGICAL SCIENCE 2021. [DOI: 10.4103/uros.uros_156_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Çakici MÇ, Özok HU, Erol D, Çatalca S, Sari S, Özdemir H, Selmi V, Kartal İG, Karakoyunlu N. Comparison of general anesthesia and combined spinal-epidural anesthesia for retrograde intrarenal surgery. MINERVA UROL NEFROL 2019; 71:636-643. [DOI: 10.23736/s0393-2249.19.03481-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Khorrami MH, Izadpanahi MH, Mohammadi M, Alizadeh F, Zargham M, Khorrami F, Isfahani FF. Comparison of Two Treatment Methods "One Shot" and "Sequential" on Reduction the Level of Hemoglobin in Patients with Percutaneous Nephrolithotripsy in Al Zahra Hospital in 2012-2013. Adv Biomed Res 2017; 6:84. [PMID: 28808650 PMCID: PMC5539665 DOI: 10.4103/2277-9175.210661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Access dilation is the most important part of percutaneous nephrolithotripsy (PCNL) that is done by different methods, especially metal telescoping and one shot. In this study, two different methods of access dilation one shot and telescoping were compared. MATERIALS AND METHODS In observational cross-sectional study, 240 patients who were a candidate for PCNL were selected and randomly divided into two groups. The first group was undergone one-shot method and the second group was undergone telescoping method. The decrease in hemoglobin (Hb), duration of hospitalization and the time of radiation exposure during access dilation was compared in two groups by SPSS software version 21, (SPSS Inc., Chicago, IL, USA). RESULTS The decrease of Hb level after intervention in one-shot group was 1.08 ± 1.23 g/dl and in telescoping, group was 1.51 ± 1.08 g/dl with no difference statistically (P = 0.37). The mean duration of hospitalization in one shot and telescoping group were 2.36 ± 0.67 and 2.28 ± 0.61 days, respectively. According to t-test, there was no significant difference between the two groups (P = 0.37). Average radiation exposure in one shot group was 7.13 s and in telescoping, group was 35.75 s, and there was a significant difference between the two groups (P < 0.001). CONCLUSION One-shot method is superior to telescoping method due to less time for radiation exposure and no more blood loss and other complications during PCNL.
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Affiliation(s)
| | | | - Mehrdad Mohammadi
- From the Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farshid Alizadeh
- From the Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahtab Zargham
- From the Department of Urology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farbod Khorrami
- Department of Biology, A. Y. Jackson Secondary School, Toronto, Ontario, Canada
| | - Felora Farahini Isfahani
- Isfahan Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Joshi GP, Jaschinski T, Bonnet F, Kehlet H. Optimal pain management for radical prostatectomy surgery: what is the evidence? BMC Anesthesiol 2015; 15:159. [PMID: 26530113 PMCID: PMC4632348 DOI: 10.1186/s12871-015-0137-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/22/2015] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Increase in the diagnosis of prostate cancer has increased the incidence of radical prostatectomy. However, the literature assessing pain therapy for this procedure has not been systematically evaluated. Thus, optimal pain therapy for patients undergoing radical prostatectomy remains controversial. METHODS Medline, Embase, and Cochrane Central Register of Controlled Trials were searched for studies assessing the effects of analgesic and anesthetic interventions on pain after radical prostatectomy. All searches were conducted in October 2012 and updated in June 2015. RESULTS Most treatments studied improved pain relief and/or reduced opioid requirements. However, there were significant differences in the study designs and the variables evaluated, precluding quantitative analysis and consensus recommendations. CONCLUSIONS This systematic review reveals that there is a lack of evidence to develop an optimal pain management protocol in patients undergoing radical prostatectomy. Most studies assessed unimodal analgesic approaches rather than a multimodal technique. There is a need for more procedure-specific studies comparing pain and analgesic requirements for open and minimally invasive surgical procedures. Finally, while we wait for appropriate procedure specific evidence from publication of adequate studies assessing optimal pain management after radical prostatectomy, we propose a basic analgesic guideline.
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Affiliation(s)
- Grish P Joshi
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX, 75390-9068, USA.
| | - Thomas Jaschinski
- Institute for Research in Operative Medicine, Witten/Herdecke University, Cologne, Germany
| | - Francis Bonnet
- Department d' Anesthesie Reanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris Université Pierre & Marie Curie, Paris, France
| | - Henrik Kehlet
- Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
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Kim SS, Lee JW, Yu JH, Sung LH, Chung JY, Noh CH. Percutaneous nephrolithotomy: comparison of the efficacies and feasibilities of regional and general anesthesia. Korean J Urol 2013; 54:846-50. [PMID: 24363866 PMCID: PMC3866288 DOI: 10.4111/kju.2013.54.12.846] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/29/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose To compare surgical outcomes and complications after percutaneous nephrolithotomy (PCNL) under regional or general anesthesia. Materials and Methods One hundred and one patients who underwent PCNL as a first-line treatment for kidney calculi between June 2004 and June 2013 were enrolled in this retrospective study. Patients were classified into two groups by anesthetic method: 77 were allocated to the regional anesthesia group and 24 to the general anesthesia group. Patient general characteristics, stone features, surgical outcomes, and complications were compared between the two groups. Results The two groups were similar in terms of mean age and stone size, number, and type. Furthermore, they did not differ significantly in terms of general characteristics, treatment outcomes, or complications excluding postoperative fever. However, mean hospital stay was significantly shorter in the regional anesthesia group than in the general anesthesia group (8.9±3.2 days vs. 11.5±6.9 days, respectively, p=0.025). Also, the postoperative fever rate was significantly higher in the general anesthesia group (53.2% vs. 83.3%, respectively, p=0.007). Conclusions Regional anesthesia is as effective as general anesthesia during percutaneous nephrolithotomy and is associated with shorter hospital stays and lower rates of postoperative fever.
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Affiliation(s)
- Sung Soo Kim
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jeong Woo Lee
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ji Hyoung Yu
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Luck Hee Sung
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Yong Chung
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Choong Hee Noh
- Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Transanal endoscopic microsurgery for the resection of submucosal and retrorectal tumors. Surg Laparosc Endosc Percutan Tech 2013; 23:66-8. [PMID: 23386155 DOI: 10.1097/sle.0b013e3182757860] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transanal endoscopic microsurgery (TEM) was originally designed for local endoscopic excision of benign and low-grade mucosal rectal lesions through an endoscopic system. The procedure is particularly challenging for submucosal and retrorectal lesions, as the tumor margins are not well defined. OBJECTIVE To investigate patient and surgical characteristics of TEM as a treatment for submucosal rectal and retrorectal lesions. METHODS All the patients in our department of general surgery who underwent TEM for a submucosal rectal or retrorectal lesion, between the years 2001 and 2011, were identified. Their charts were reviewed and data pertaining to demographic characteristics and medical history, including tumor characteristics, were collected. Operative notes and histopathology reports were also reviewed. The adequacy of the tumor resection, that ism attainment of free margins, endoscopic completion of the procedure, and perioperative complications, were assessed. RESULTS Fifteen patients (5 females, 10 males), mean age 53.9 ± 16.9 years, were identified. The main indications for surgery were gastrointestinal stromal tumor (5 patients) and tailgut or duplication cyst (4 patients). All procedures were completed endoscopically. The median distance from the anal verge was 7.3 cm (range, 5 to 10 cm), and the mean diameter of the tumors was 3 ± 1.1 cm. The one patient in whom the margins presented tumoral involvement underwent repeated TEM. No intraoperative complications were reported. The postoperative complication rate was 13.3%, and the mean length of hospital stay was 1.85 ± 1.77 days. CONCLUSIONS TEM for retrorectal and submucosal rectal lesions is feasible and safe. A remarkably low morbidity rate and limited surgical injury favor TEM in selected patients.
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The feasibility of regional anesthesia in the percutaneous nephrolithotomy with supracostal approach and its comparison with general anesthesia. Urolithiasis 2012; 41:53-7. [PMID: 23532424 DOI: 10.1007/s00240-012-0528-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 12/08/2012] [Indexed: 10/27/2022]
Abstract
There are various approaches for the percutaneous nephrolithotomy (PCNL). Supracostal approach is a well known technique for doing of it. This approach is being done commonly under general anesthesia (GA). In this retrospective study, we evaluated the feasibility of supracostal PCNL under regional anesthesia (RA) and compared it with the same procedure under GA. Since March 2000 to March 2005, a total of 123 renal stone cases underwent PCNL with supracostal access in our center. GA was selected in 69 cases (56 %) (Group 1), spinal anesthesia (SA) in 45 cases (36.5 %), and epidural anesthesia (EA) in 9 cases (7.5 %) (Group 2). The operative time, success rate, hospital stay, and ensuing complications were compared between group 1 and group 2. There were no significant differences between groups 1 and 2 among surgical parameters, including age, stone area, anesthesia time, and hospitalization time (P > 0.05). There was no difference in the rate of complications or success rate between GA and RA cases (P > 0.05). Overall complete stone free rate, regardless of stone size, in relation to type of anesthesia was as follows: 88.4 % for GA, 88.9 % for EA, and 91.1 % for SA (P > 0.05). Conversion to GA was not needed in any patient with RA. The results showed that the supracostal PCNL with regional anesthesia was feasible but without evident advantages versus general anesthesia in this population, and possible advantages of the procedure in patients with pulmonary co-morbidities have still to be evaluated. The anesthesia related complications of RA were negligible and easily controllable.
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Alonso-Iñigo JM, Herranz-Gordo A, Fas MJ, Giner R, Llopis JE. Epidural anesthesia and non-invasive ventilation for radical retropubic prostatectomy in two obese patients with chronic obstructive pulmonary disease. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2012; 59:573-576. [PMID: 22749299 DOI: 10.1016/j.redar.2012.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 05/04/2012] [Indexed: 06/01/2023]
Abstract
We report two cases of anesthesia for radical retropubic prostatectomy (RRP) in obese-chronic obstructive pulmonary disease (COPD) patients using the combination of epidural anesthesia and non-invasive ventilation (NIV). This technique avoided intubation, general anesthesia and perioperative pulmonary complications.
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Affiliation(s)
- J M Alonso-Iñigo
- Department of Anaesthesia, Hospital Universitario de la Ribera, Alzira, Valencia, Spain.
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Tangpaitoon T, Nisoog C, Lojanapiwat B. Efficacy and safety of percutaneous nephrolithotomy (PCNL): a prospective and randomized study comparing regional epidural anesthesia with general anesthesia. Int Braz J Urol 2012; 38:504-11. [DOI: 10.1590/s1677-55382012000400010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2012] [Indexed: 11/22/2022] Open
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Karl A, Schneevoigt B, Weninger E, Grimm T, Stief C. Feasibility of radical cystectomy in exclusive spinal and/or epidural anaesthesia. World J Urol 2012; 31:1279-84. [PMID: 22832588 DOI: 10.1007/s00345-012-0912-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 07/12/2012] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Muscle invasive bladder cancer can be found predominantly in elderly people with a high likelihood of suffering from concomitant diseases; especially in these patients, the risks associated with general anaesthesia during radical cystectomy can be the limiting factor of performing an otherwise indicated radical operation. To overcome this limitation, we analysed the feasibility of performing radical cystectomy in exclusive spinal and/or epidural anaesthesia. METHODS Between March and June 2010, nine patients underwent radical cystectomy in exclusive spinal and/or epidural anaesthesia. These patients were either not willing or unfit to undergo radical cystectomy in general anaesthesia. A continent urinary diversion (ileum neobladder) and an ileum-conduit were performed in five patients and four patients, respectively. The feasibility of radical cystectomy in regional anaesthesia was tested using a variety of parameters. RESULTS All nine procedures could be performed under strict regional anaesthesia. Mean operation time was 206 min (range 146-265 min), mean intraoperative blood loss was 622 ml (range 200-1,500 ml), mean postoperative time at intermediate care was 1 day (range 0-3 days) and mean length of hospital stay was 21.8 days (range 17-26 days). Analgesics of the WHO class I, II and III were applied for 5.7, 1.2 and 2.8 days mean, respectively. CONCLUSION Performance of radical cystectomy in exclusive spinal and/or epidural anaesthesia is feasible and can be considered particularly in those patients who would be otherwise unfit to undergo radical cystectomy in general anaesthesia. This new operative and anaesthesiological concept could also play an important role in new fast track regimens.
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Affiliation(s)
- A Karl
- Department of Urology, Ludwig-Maximilians-University, LMU, Marchionistr. 15, 81377, Munich, Germany,
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Herranz Gordo A, Alonso Iñigo JM, Fas Vicent MJ, Llopis Calatayud JE. [Applications of noninvasive mechanical ventilation in anesthesiology and postanesthesia recovery care]. ACTA ACUST UNITED AC 2010; 57:16-27. [PMID: 20196519 DOI: 10.1016/s0034-9356(10)70158-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Noninvasive ventilation (NIV) can be useful to anesthesiologists working in critical care units, postanesthesia recovery units, operating theaters, or other settings. NIV can help in situations of acute respiratory failure or serve as a preventive measure in patients undergoing interventions under local-regional anesthesia or diagnostic or therapeutic procedures requiring sedation. Successful NIV depends on adequately trained health personnel and the proper choice of material (interfaces, respirators, etc.) for each setting where this modality is used.
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Affiliation(s)
- A Herranz Gordo
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor. Hospital Universitario La Ribera, Alzira, Valencia
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Price TJ, Cervero F, Gold MS, Hammond DL, Prescott SA. Chloride regulation in the pain pathway. BRAIN RESEARCH REVIEWS 2009; 60:149-70. [PMID: 19167425 PMCID: PMC2903433 DOI: 10.1016/j.brainresrev.2008.12.015] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2008] [Indexed: 12/18/2022]
Abstract
Melzack and Wall's Gate Control Theory of Pain laid the theoretical groundwork for a role of spinal inhibition in endogenous pain control. While the Gate Control Theory was based on the notion that spinal inhibition is dynamically regulated, mechanisms underlying the regulation of inhibition have turned out to be far more complex than Melzack and Wall could have ever imagined. Recent evidence indicates that an exquisitely sensitive form of regulation involves changes in anion equilibrium potential (E(anion)), which subsequently impacts fast synaptic inhibition mediated by GABA(A), and to a lesser extent, glycine receptor activation, the prototypic ligand gated anion channels. The cation-chloride co-transporters (in particular NKCC1 and KCC2) have emerged as proteins that play a critical role in the dynamic regulation of E(anion) which in turn appears to play a critical role in hyperalgesia and allodynia following peripheral inflammation or nerve injury. This review summarizes the current state of knowledge in this area with particular attention to how such findings relate to endogenous mechanisms of hyperalgesia and allodynia and potential applications for therapeutics based on modulation of intracellular Cl(-) gradients or pharmacological interventions targeting GABA(A) receptors.
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Affiliation(s)
| | - Fernando Cervero
- McGill University, Department of Anesthesia, McGill Centre for Research on Pain,
| | | | - Donna L Hammond
- University of Iowa, Department of Anesthesia, Department of Pharmacology,
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Suardi N, Scattoni V, Briganti A, Salonia A, Naspro R, Gallina A, Cestari A, Colombo R, Karakiewicz PI, Guazzoni G, Rigatti P, Montorsi F. Nerve-Sparing Radical Retropubic Prostatectomy in Patients Previously Submitted to Holmium Laser Enucleation of the Prostate for Bladder Outlet Obstruction Due to Benign Prostatic Enlargement. Eur Urol 2008; 53:1180-5. [DOI: 10.1016/j.eururo.2007.07.027] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Accepted: 07/12/2007] [Indexed: 11/30/2022]
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