Evaluation of the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) on patients with centrally mediated abdominal pain syndrome: a randomized controlled trial

Comparison of pre-treatment with different diluted sufentanil in reducing propofol injection pain in gastrointestinal endoscopy: A randomized controlled study

BACKGROUND

This study aimed to investigate the efficacy of pre-treatment with different concentrations of sufentanil in mitigating propofol injection-induced pain.

METHODS

This study included 421 patients who were scheduled for gastrointestinal endoscopy between June 2023 and December 2024. Participants were randomly assigned to one of the four groups with different concentrations sufentanil: 0 µg/mL group(0.9% normal saline), 0.5 µg/mL group, 1 µg/mL group and 5 µg/mL group.

RESULTS

Among the four groups, the rates of pain relief were 82 (77.4%), 93 (89.4%), 96 (89.7%), and 91 (87.5%), respectively. Compared to the 0 µg/mL group, the other groups demonstrated significantly reduced pain following propofol injection (p < 0.05). The recovery times were 14.59 ± 3.92 min, 15.13 ± 3.20 min, 14.27 ± 3.06 min, and 15.57 ± 3.24 min, respectively. Notably, the 1 µg/mL group did not exhibit a prolonged recovery time compared to the 0 µg/mL group. The total propofol consumption was recorded as 218.5 ± 36.8 mg, 196.7 ± 31.0 mg, 183.8 ± 25.0 mg, and 189.6 ± 31.4 mg, respectively, with the 1 µg/mL group showing the lowest total propofol consumption among the groups. The incidences of adverse events (AEs) were 61.3%, 70.2%, 58.9%, and 76.9%, respectively. In comparison to the 1 µg/mL group, the 5 µg/mL group exhibited a higher incidence of AEs. Furthermore, multivariate analysis indicated that a 5 µg/mL dilution of sufentanil increases the risk of AEs (p < 0.05).

CONCLUSIONS

The 1 µg/mL group demonstrated greater safety and efficacy when combined with propofol.

TRIAL REGISTRATION

The study has been registered in the Chinese Clinical Trial Registry (ChiCTR). Link of the registry: http://www.chictr.org.cn. Date of registration: 2023/06/12. Trial registration number: ChiCTR2300072402.

Trastornos de la interacción cerebro-intestino (trastornos funcionales digestivos): neuromoduladores en la práctica clínica (parte II)

Introducción: este artículo continúa la revisión de los neuromoduladores utilizados en la práctica clínica y su papel en el tratamiento de los diferentes trastornos de la interacción cerebro-intestino (TICI), en particular los gástricos, intestinales y anales. Materiales y métodos: el grupo de trabajo revisó las patologías más frecuentes y los medicamentos según la bibliografía más reciente, y de acuerdo con la mejor evidencia clínica en cada caso. Resultados: debido a la diversidad de trastornos, tipos de estudios y opciones terapéuticas, se decidió presentar aquellas evidencias con los mejores resultados para cada caso, en los que se determinaron las dosis utilizadas, sus resultados y efectos colaterales. Conclusiones: se presenta la mejor evidencia disponible de los medicamentos utilizados en cada TICI; al finalizar se presenta una tabla en la que se resaltan para cada condición clínica los medicamentos más utilizados, sus dosis y sus efectos gastrointestinales, y en otra tabla, los efectos secundarios más importantes. Dado que la evidencia disponible no resulta definitiva, se requiere para cada condición más ensayos clínicos controlados que puedan confirmar la efectividad y seguridad de estos.

Endogenous opiates and behavior: 2021

This paper is the forty-fourth consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2021 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonizts and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).

Analysis of clinical characteristics of centrally mediated abdominal pain syndrome, exploration of diagnostic markers and its relationship with the efficacy of duloxetine treatment

INTRODUCTION

Centrally mediated abdominal pain syndrome (CAPS) is characterized by severe abdominal pain. Diagnosis of CAPS is still an exclusionary diagnosis, there remain no effective diagnostic biomarkers so far. Duloxetine is the major pharmacotherapy of CAPS, while some CAPS patients do not respond to duloxetine treatment. However, there is a lack of molecular markers to predict the efficacy of duloxetine. In our pilot study, we have found differential expression profiles of serum miRNAs between CAPS patients and healthy controls. Our study aims to explore the clinical characteristics, specific miRNAs in serum as diagnostic biomarkers of CAPS and predictive biomarkers of the efficacy of duloxetine.

METHODS/DESIGN

In this prospective cohort study, we plan to enroll 430 participants including 215 CAPS patients and 215 healthy controls. The CAPS group takes duloxetine 30 mg per day as an initial dose. Patients will have 24-week medication period and follow up at week 0, 4, 12, 24 and 36. Blood samples will be obtained from patients at every visits and health controls at the initial visit and a series of questionnaires will be completed by the participants. The primary end points are: The differential expression of miRNAs between CAPS groups and healthy control groups at baseline. The changes in abdominal pain scores before and after duloxetine treatment in patients with CAPS and their relationship with the changes in miRNAs. The secondary end point is the changes in scores of depression, anxiety, sleep quality and quality of life before and after duloxetine treatment in patients with CAPS and their relationship with changes in miRNAs.

DISCUSSION

Findings of study will provide the reliable basis for diagnosis and the predictor of duloxetine efficacy of CAPS. Importantly, findings grant patients a chance to benefit from treatment.