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Li Y, Zhang W, Wang H, Zhang W. Case report: A new treatment for restless leg syndrome: three cases. Front Neurosci 2024; 18:1333188. [PMID: 38312929 PMCID: PMC10834780 DOI: 10.3389/fnins.2024.1333188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
Restless legs syndrome is a movement disorder that seriously affects the quality of life of patients. It is characterized by marked discomfort mainly occurring in the deep tissues of the lower extremities, including deep muscle or bone chafing, as well as crawling sensations or pulling sensations. These sensations often cause patients to awaken after falling asleep and to feel the urge to walk around, which seriously affects their sleep quality. Patients with restless leg syndrome exhibit significantly enhanced sympathetic nerve activity and immune disorders, while stellate ganglion blockage can block sympathetic nerves and regulate immune cells and cytokines to maintain immune system homeostasis. We report three patients with restless legs syndrome complicated with severe nephrotic syndrome. After treatment with stellate ganglion block, the symptoms in the restless legs were relieved within 1 month, and the quality of sleep was significantly improved. Our findings suggest that stellate ganglion block has broad promise in the management of restless legs syndrome patients with severe comorbidities.
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Affiliation(s)
| | | | | | - Weiwei Zhang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
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2
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Peterson AM, Miller BJ, Kallogjeri D, Piccirillo JF, Kukuljan S, Roland LT, Schneider JS, Crock LW, Farrell NF. Stellate Ganglion Block for the Treatment of COVID-19-Induced Olfactory Dysfunction: A Prospective Pilot Study. Otolaryngol Head Neck Surg 2024; 170:272-276. [PMID: 37750244 PMCID: PMC10842956 DOI: 10.1002/ohn.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE The objective of this study was to explore the safety and feasibility of stellate ganglion blocks (SGBs) to treat persistent COVID-19-induced olfactory dysfunction (OD). Secondarily, the goal was to determine effect sizes to plan a future randomized clinical trial. STUDY DESIGN Prospective case series. SETTING Quaternary Care Academic Medical Center. METHODS In this single-arm pilot trial, adult participants with a COVID-19 diagnosis ≥ 12 months prior to enrollment with OD underwent bilateral SGBs. Subjects were followed for 1 month after completion of SGB. The primary outcome measure was the change in the Clinical Global Impression-Improvement Scale for smell loss. Secondary outcome measures included changes in the University of Pennsylvania Smell Identification Test (UPSIT) and Olfactory Dysfunction Outcomes Rating (ODOR). RESULTS Twenty participants were enrolled with a mean (SD) age of 46 (11) years and a mean (SD) duration of OD of 21 (5) months. At 1 month, 10 (50%) participants experienced at least slight subjective improvement in their OD, 11 (55%) attained a clinically meaningful improvement in smell identification using the UPSIT, and 7 (35%) achieved a clinically meaningful improvement in olfactory-specific quality of life (QoL) measured by the ODOR. The median difference between UPSIT scores at baseline and 1 month was 6 (95% confidence interval: 3-11), exceeding the minimal clinically important difference of 4. There were no serious adverse events. CONCLUSION Sequential SGBs for COVID-19-associated OD were safe and associated with modest improvements in subjective olfaction, odor identification, and olfactory-specific QoL. A placebo-controlled trial is warranted to determine the efficacy of SGBs for COVID-19-associated OD.
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Affiliation(s)
- Andrew M Peterson
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Brevin J Miller
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Sara Kukuljan
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Lauren T Roland
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - John S Schneider
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Lara W Crock
- Department of Anesthesiology, Division of Pain Management, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Nyssa F Farrell
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
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3
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Ranker A, Behr-Eggers E. [Electrotherapeutical stellate ganglion block on a patient with complex regional pain syndrome of the upper limb]. Schmerz 2023; 37:468-472. [PMID: 36459205 PMCID: PMC10663199 DOI: 10.1007/s00482-022-00682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 12/03/2022]
Abstract
The case of a 51-year-old patient with complex regional pain syndrome (CRPS) of the left hand after radius distortion is reported. Anticonvulsant therapy was difficult in this case due to persisting epilepsy with already dual therapy (lamotrigine and brivaracetam) at high dosage. With existing neuropathic pain, pronounced allodynia and hyperhidrosis, repetitive transcutaneous monophasic electrotherapy was applied above the stellate ganglion. A ganglion blockage could not be clinically confirmed in the absence of Horner syndrome, but neuropathic pain and hyperhidrosis could be positively influenced. This case report summarizes the electrode positions used, current parameters, pitfalls and therapy limitations and discusses them in relation to the literature.
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Affiliation(s)
- Alexander Ranker
- Klinik für Rehabilitationsmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
- Praxis für Allgemeinmedizin, Amelinghausen, Deutschland.
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4
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Ashikawa Y, Kusunoki Nakamoto F, Sato T, Katsumata J, Bannai T, Seki T, Takeda M, Shiio Y. Successful Treatment of Herpes Zoster Ophthalmicus Complicated by Intense Orbital Inflammation Using Laser Irradiation over the Stellate Ganglion. Intern Med 2023; 62:623-627. [PMID: 35831112 PMCID: PMC10017239 DOI: 10.2169/internalmedicine.9503-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 56-year-old man presented with right-sided headache and ptosis accompanied by a facial skin rash. He was diagnosed with herpes zoster ophthalmicus (HZO). Despite acyclovir and steroid therapy, the ocular symptoms worsened. Magnetic resonance imaging (MRI) revealed severe orbital inflammation and abnormal lesions in the right trigeminal nucleus and tract. The effects of re-administration of intravenous acyclovir and steroid pulse therapy were limited. Laser irradiation of the stellate ganglion (SGL) and high-dose oral prednisolone therapy were effective. Our experience suggests the efficacy of early multimodal treatment, including SGL, in treating ocular symptoms associated with HZO.
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Affiliation(s)
| | | | - Tatsuya Sato
- Department of Neurology, Tokyo Teishin Hospital, Japan
| | | | - Taro Bannai
- Department of Neurology, Tokyo Teishin Hospital, Japan
| | - Tomonari Seki
- Department of Neurology, Tokyo Teishin Hospital, Japan
| | - Masako Takeda
- Department of Anesthesiology, Tokyo Teishin Hospital, Japan
| | - Yasushi Shiio
- Department of Neurology, Tokyo Teishin Hospital, Japan
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5
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Near-Infrared Photobiomodulation of the Peripheral Nerve Inhibits the Neuronal Firing in a Rat Spinal Dorsal Horn Evoked by Mechanical Stimulation. Int J Mol Sci 2023; 24:ijms24032352. [PMID: 36768673 PMCID: PMC9917292 DOI: 10.3390/ijms24032352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023] Open
Abstract
Photobiomodulation has analgesic effects via inhibition of nerve activity, but few reports have examined the effects on the spinal dorsal horn, the entry point for nociceptive information in the central nervous system. In this study, we evaluated the effects of laser irradiation of peripheral nerve axons, which are conduction pathways for nociceptive stimuli, on the neuronal firing in lamina II of the spinal dorsal horn of a rat evoked by mechanical stimulation with von Frey filaments (vFF). In order to record neuronal firing, electrodes were inserted into lamina II of the exposed rat spinal dorsal horn. The exposed sciatic nerve axons were irradiated with an 808 nm laser. The 26.0 g vFF-evoked firing frequency was inhibited from 5 min after laser irradiation and persisted for 3 h. Sham irradiation did not alter the firing frequency. Laser irradiation selectively inhibited 15.0 and 26.0 g vFF-evoked firing, which corresponded to nociceptive stimuli. Histopathological evaluation revealed no damage to the sciatic nerve due to laser irradiation. These results indicate that neuronal firing is inhibited in lamina II of the spinal dorsal horn, suggesting that laser irradiation inhibits Aδ and/or C fibers that conduct nociceptive stimuli.
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Luo Q, Wen S, Tan X, Yi X, Cao S. Stellate ganglion intervention for chronic pain: A review. IBRAIN 2022; 8:210-218. [PMID: 37786891 PMCID: PMC10529017 DOI: 10.1002/ibra.12047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 10/04/2023]
Abstract
Stellate ganglion (SG) intervention is currently widely being studied in many kinds of chronic pain. As one of the convenient ways to treat the sympathetic nervous system, the indications for stellate ganglion intervention (SGI) include complex regional pain syndrome, postherpetic neuralgia, cancer pain of different origins, orofacial pain, and so forth. SGI refers to the reversible or irreversible blocking of the cervical sympathetic trunk, cervical sympathetic ganglion, and their innervation range through noninvasive or minimally invasive treatment. Current treatment options include stellate ganglion block (SGB), SG pulsed radiofrequency, continuous radiofrequency treatment, and noninvasive SGB. In particular, SGB continues to be one of the most studied methods in chronic pain management. However, a single SGB usually provides only short-term effects; repeated SGB may result in complications such as hoarseness, light-headedness, and vessel or nerve injury. Meanwhile, the mechanism of SGI is still unclear. This review discusses the research progress of SGI methods, effectiveness, complications, and possible mechanisms in the management of chronic pain.
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Affiliation(s)
- Qingyang Luo
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Department of Pain MedicineAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Song Wen
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Department of Pain MedicineAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Xinran Tan
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Department of Pain MedicineAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Xi Yi
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Department of Pain MedicineAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Song Cao
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Department of Pain MedicineAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Guizhou Key Laboratory of Anesthesia and Organ ProtectionZunyi Medical UniversityZunyiGuizhouChina
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Paley CA, Wittkopf PG, Jones G, Johnson MI. Does TENS Reduce the Intensity of Acute and Chronic Pain? A Comprehensive Appraisal of the Characteristics and Outcomes of 169 Reviews and 49 Meta-Analyses. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1060. [PMID: 34684097 PMCID: PMC8539683 DOI: 10.3390/medicina57101060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022]
Abstract
Background and Objectives: Uncertainty about the clinical efficacy of transcutaneous electric nerve stimulation (TENS) to alleviate pain spans half a century. There has been no attempt to synthesise the entire body of systematic review evidence. The aim of this comprehensive review was to critically appraise the characteristics and outcomes of systematic reviews evaluating the clinical efficacy of TENS for any type of acute and chronic pain in adults. Materials and Methods: We searched electronic databases for full reports of systematic reviews of studies, overviews of systematic reviews, and hybrid reviews that evaluated the efficacy of TENS for any type of clinical pain in adults. We screened reports against eligibility criteria and extracted data related to the characteristics and outcomes of the review, including effect size estimates. We conducted a descriptive analysis of extracted data. Results: We included 169 reviews consisting of eight overviews, seven hybrid reviews and 154 systematic reviews with 49 meta-analyses. A tally of authors' conclusions found a tendency toward benefits from TENS in 69/169 reviews, no benefits in 13/169 reviews, and inconclusive evidence in 87/169 reviews. Only three meta-analyses pooled sufficient data to have confidence in the effect size estimate (i.e., pooled analysis of >500 events). Lower pain intensity was found during TENS compared with control for chronic musculoskeletal pain and labour pain, and lower analgesic consumption was found post-surgery during TENS. The appraisal revealed repeated shortcomings in RCTs that have hindered confident judgements about efficacy, resulting in stagnation of evidence. Conclusions: Our appraisal reveals examples of meta-analyses with 'sufficient data' demonstrating benefit. There were no examples of meta-analyses with 'sufficient data' demonstrating no benefit. Therefore, we recommend that TENS should be considered as a treatment option. The considerable quantity of reviews with 'insufficient data' and meaningless findings have clouded the issue of efficacy. We offer solutions to these issues going forward.
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Affiliation(s)
- Carole A. Paley
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
- Research and Development Department, Airedale National Health Service (NHS) Foundation Trust, Skipton Road, Steeton, Keighley BD20 6TD, UK
| | - Priscilla G. Wittkopf
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Gareth Jones
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
| | - Mark I. Johnson
- Centre for Pain Research, Leeds Beckett University, Leeds LS1 3HE, UK; (C.A.P.); (P.G.W.); (G.J.)
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8
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Osman MM, Iravani A, Hofman MS, Hicks RJ. Intra-patient comparison of physiologic 68Ga-PSMA-11 and 18F-DCFPyL PET/CT uptake in ganglia in prostate cancer patients: a pictorial essay. Cancer Imaging 2021; 21:35. [PMID: 33863390 PMCID: PMC8052677 DOI: 10.1186/s40644-021-00404-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background Recent studies reported metabolic uptake in at least one of the evaluated ganglia in 98.5% of patients undergoing 68Ga -PSMA-11 and in 96.9% of patients undergoing 18F-DCFPyL PET/CT examination. We have observed different patterns of ganglion visualization with 18F-DCFPyL compared to 68Ga-PSMA-11. This includes more frequent visualization of cervical and sacral ganglia, which may be attributable to better imaging characteristics with 18F PET imaging. Case presentation This pictorial essay is to illustrate and compare, in the same patient, various representative cases of 68Ga-PSMA-11 and 18F-DCFPyL PET/CT uptake in ganglia at different anatomic locations, with different patterns and distribution of metabolic activity. Conclusion Reading physicians should be aware of the frequently encountered and occasionally different physiologic uptake of 68Ga-PSMA-11 and 18F DCFPyL in different ganglia.
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Affiliation(s)
- Medhat M Osman
- Division of Nuclear Medicine, Department of Radiology, Saint Louis University Hospital, St. Louis, MO, USA.
| | - Amir Iravani
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.,Centre for Molecular Imaging, Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael S Hofman
- Centre for Molecular Imaging, Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Rodney J Hicks
- Centre for Molecular Imaging, Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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Park JH, Kim R, Na SH, Kwon SY. Effect of botulinum toxin in stellate ganglion for craniofacial hyperhidrosis: a case report. J Int Med Res 2021; 49:3000605211004213. [PMID: 33788638 PMCID: PMC8020114 DOI: 10.1177/03000605211004213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Craniofacial hyperhidrosis causes sweating of the face and scalp due to excessive action of the sweat glands and manifests when patients become tense/nervous or develop an elevated body temperature. If noninvasive treatments are ineffective, invasive treatments such as a sympathetic block and resection are considered. A 32-year-old woman with no specific medical history was referred for uncontrolled craniofacial hyperhidrosis that included excessive sweating and hot flushing. Physical examination showed profuse sweating, and infrared thermography showed higher temperature in the neck and face than in the trunk. The patient underwent several stellate ganglion blocks, and her symptoms improved; however, the treatment effect was temporary. Botulinum toxin was then injected into the stellate ganglion. At the time of this writing, her sweating had been reduced for about 6 months and she was continuing to undergo follow-up. Craniofacial hyperhidrosis is a clinical condition in which patients experience excessive sweating of their faces and heads. It is less common than palmar and plantar hyperhidrosis. Botulinum toxin injection into the stellate ganglion is simple and safe and produces longer-lasting effects than other treatments, such as endoscopic sympathectomy and a single nerve block.
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Affiliation(s)
- Jung Hyun Park
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Rip Kim
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - Sang Hoon Na
- Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea
| | - So Young Kwon
- Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea
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Ichinohe T, Akiike Y, Saito N, Koike M, Koshika K, Matsuura N. Effects of Stellate Ganglion Blockade on Muscle Blood Flow During Hypercapnia. Anesth Prog 2020; 67:135-139. [PMID: 32992330 DOI: 10.2344/anpr-67-01-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/27/2019] [Indexed: 11/11/2022] Open
Abstract
This study investigated the effects of a unilateral stellate ganglion block (SGB) on ipsilateral and contralateral masseter muscle blood flow during permissive hypercapnia. Eight male Japanese white rabbits were anesthetized with isoflurane. Observed variables included heart rate (HR), blood pressure (BP), left common carotid artery blood flow (LCBF), left and right masseter muscle tissue blood flow (LMBF and RMBF), and left femoral quadriceps muscle tissue blood flow (LQBF). Variable measurements were taken at a baseline end-tidal carbon dioxide tension (EtCO2) of 40 mm Hg and repeated at an elevated EtCO2 of 60 mm Hg prior to and after administration of a left SGB. HR decreased, while systolic BP was elevated during hypercapnia and after the SGB. LCBF increased during hypercapnia and after the SGB. LMBF and RMBF decreased to 75% and LQBF decreased to 60% of their respective baseline values during hypercapnia. After the SGB, LMBF was restored, reapproximating its baseline, but RMBF and LQBF further decreased to 55 and 45% of their respective baseline values. In conclusion, unilateral SGB restored the ipsilateral masseter muscle blood flow that had been reduced during hypercapnia. In contrast, the SGB exacerbated the hypercapnia-induced reduction in blood flows in the contralateral masseter muscle and the femoral quadriceps muscle.
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Affiliation(s)
- Tatsuya Ichinohe
- Professor and Chairman, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Yui Akiike
- Senior Assistant Professor, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Natsuki Saito
- Postgraduate Student, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Masato Koike
- Assistant Professor, Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kyotaro Koshika
- Senior Assistant Professor, Department of Anesthesiology, Ichikawa General Hospital, Tokyo Dental College, Tokyo, Japan
| | - Nobuyuki Matsuura
- Associate Professor, Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
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Anitasari S, Wahab DE, Barlianta B, Budi HS. Determining the Effectivity of Infrared Distance to Eliminate Dental Pain Due to Pulpitis and Periodontitis. Eur J Dent 2020; 14:360-365. [PMID: 32707590 PMCID: PMC7462716 DOI: 10.1055/s-0040-1714454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The infrared rays is one of the treatments to relief of dental pain due to pulpitis or periodontitis. The ability of infrared to increase the pain threshold which make eliminating P substance on the inflammation area and inducing Aβ and Aδ fibers to activate γ-aminobutyrate (GABA) and neuropeptides to decrease the pain. Hence, reducing or eliminating dental pain. This study to get information about effectively distance between patients and infrared rays which can reduce or eliminate dental pain. MATERIALS AND METHODS The explorative experimental research to determine the effectivity of the infrared rays' distance: 45, 55, and 55 cm in reducing or eliminating dental pain. The material of infrared was tungsten with luminous light and the time for the lighting was 15 minutes. STATISTICAL ANALYSIS The data were obtained and analyzed using Wilcoxon's signed rank test and Kruskal-Wallis test (α= 0.05). RESULTS There were influenced of the infrared rays to reduce the dental pain as follow, distance 45 cm (p = 0.007), distance 55 cm (p = 0.026), and distance 65 cm (p = 0.007). The average scale reduction for distance 45 cm was 2.23 ± 0.83, the distance 55 cm was 3.33 ± 0.87, and the distance 65 cm was (1.78 ± 0.83). Therefore, according to Kruskal-Wallis test with p = 0.004 (p < 0.05) showed the significant difference between the scale to decrease of dental pain was the distance of 55. CONCLUSION Infrared rays located at a distance of 55 cm from patients might be more effective in relieving dental pain, compared with other distances tested.
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Affiliation(s)
- Silvia Anitasari
- Department of Dental Material and Devices, Dentistry Program, Faculty of Medicine, Universitas Mulawarman, Samarinda, Indonesia.,Department of Microbiology, Faculty of Medicine, Universitas Mulawarman Samarinda, Indonesia
| | - Deasy E Wahab
- Department of Health, Samarinda City Government, Samarinda, Indonesia
| | | | - Hendrik S Budi
- Department of Oral Biology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia.,Research Center, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
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Zayan K, Aggarwal S, Felix E, Levitt R, Sarantopoulos K, Galor A. Transcutaneous Electrical Nerve Stimulation for the Long-Term Treatment of Ocular Pain. Neuromodulation 2020; 23:871-877. [PMID: 32196838 DOI: 10.1111/ner.13146] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/13/2020] [Accepted: 02/24/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Ocular pain is a debilitating condition that is challenging to treat as therapies that target the ocular surface are often ineffective. We previously reported a short-term reduction in ocular pain after one periocular transcutaneous electrical nerve stimulation (TENS) session. The current study aims to elucidate the long-term effect of TENS on ocular pain. MATERIALS AND METHODS Fourteen individuals with eye pain were identified as candidates for a TENS device (RS Medical, Vancouver) for home use after a successful trial in clinic between February 2018 and July 2019 at the Miami Veterans Administration Hospital or University of Miami. Ten of the 14 patients were included in this retrospective review, based on the inclusion of receiving and using the device for a minimum of three months. The median age of the ten patients was 47.5 years, range 32-73 years, and eight were male. The main outcome measures were 1) frequency of long-term integration of TENS into ocular pain management and 2) patient reported ocular pain intensity (0-10) pre- vs. post-treatment. RESULTS Patients reported an initial median use of the device 14.0 times per week and over time reducing the frequency to 3.0 times per week. All reported that the TENS unit was successfully incorporated into their ocular pain management routine for at least three months (median duration of use 6.5 months, range 3-14 months). Nine of ten patients reported subjective pain reduction with use of the TENS device at home. Overall, pain intensity decreased by approximately 27.4% (mean rank = 5.6, Z = -2.1, p = 0.02) post- vs. pre-treatment. No adverse events associated with TENS were reported in any patient. CONCLUSION Our preliminary data suggest that TENS can be integrated into the long-term management of ocular pain with improvements in overall pain intensity.
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Affiliation(s)
- Kristen Zayan
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Shruti Aggarwal
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Elizabeth Felix
- Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Roy Levitt
- Department of Anesthesia, University of Miami, Miller School of Medicine, Miami, FL, USA
| | | | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL, USA
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Shionoya Y, Sunada K, Shigeno K, Nakada A, Honda M, Nakamura T. Can nerve regeneration on an artificial nerve conduit be enhanced by ethanol-induced cervical sympathetic ganglion block? PLoS One 2017; 12:e0189297. [PMID: 29220373 PMCID: PMC5722367 DOI: 10.1371/journal.pone.0189297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 11/22/2017] [Indexed: 11/27/2022] Open
Abstract
This study aimed to determine whether nerve regeneration by means of an artificial nerve conduit is promoted by ethanol-induced cervical sympathetic ganglion block (CSGB) in a canine model. This study involved two experiments—in part I, the authors examined the effect of CSGB by ethanol injection on long-term blood flow to the orofacial region; part II involved evaluation of the effect of CSGB by ethanol injection on inferior alveolar nerve (IAN) repair using polyglycolic acid-collagen tubes. In part I, seven Beagles were administered left CSGB by injection of 99.5% ethanol under direct visualization by means of thoracotomy, and changes in oral mucosal blood flow in the mental region and nasal skin temperature were evaluated. The increase in blood flow on the left side lasted for 7 weeks, while the increase in average skin temperature lasted 10 weeks on the left side and 3 weeks on the right. In part II, fourteen Beagles were each implanted with a polyglycolic acid-collagen tube across a 10-mm gap in the left IAN. A week after surgery, seven of these dogs were administered CSGB by injection of ethanol. Electrophysiological findings at 3 months after surgery revealed significantly higher sensory nerve conduction velocity and recovery index (ratio of left and right IAN peak amplitudes) after nerve regeneration in the reconstruction+CSGB group than in the reconstruction-only group. Myelinated axons in the reconstruction+CSGB group were greater in diameter than those in the reconstruction-only group. Administration of CSGB with ethanol resulted in improved nerve regeneration in some IAN defects. However, CSGB has several physiological effects, one of which could possibly be the long-term increase in adjacent blood flow.
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Affiliation(s)
- Yoshiki Shionoya
- Department of Dental Anesthesia, Nippon Dental University Hospital at Tokyo, Japan
- * E-mail:
| | - Katsuhisa Sunada
- Department of Dental Anesthesiology, Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Keiji Shigeno
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | - Akira Nakada
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | - Michitaka Honda
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | - Tatsuo Nakamura
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
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