Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Afferent projections from the periaqueductal gray matter (PAG) to the B3 region (nucleus raphe magnus, NRM; and nucleus reticularis paragigantocellularis, NPG) were examined by means of the horseradish peroxidase (HRP) method revealed by using the tetramethylbenzidine (TMB) procedure. Following iontophoretic injection of HRP into the B3 cellular area, numerous labeled neurons were found between the third oculomotor complex and the rostral part of the tegmental nucleus dorsalis of Gudden. The most densely labeled regions were the lateral parts of the dorsal raphe nucleus (wings of the DRN) and Hamilton's nucleus dorsalis of the PAG. Very few neurons were found within the medial part of the DRN. In contrast, results with control injections performed outside the B3 area gave a different distribution of labeled neurons. The functional significance of these connections, particularly those emanating from the wings of the DRN which represent new information, is briefly discussed with regard to mechanisms operative in the control of pain. Although the major PAG-B3 direct projections could underlie a role for the B3 area in PAG-induced analgesia, the comparison of our anatomical and behavioral results points out some problems. Indeed, there is no strict correlation between the location of stimulation sites which induce analgesia in the freely moving rats and the distribution within the PAG of B3 projections. These observations lead us to question the role of direct PAG-B3 connections in the antinociception induced by PAG stimulation and alternative hypotheses are proposed.
 ...
PMID:Projections from the periaqueductal gray matter to the B3 cellular area (nucleus raphe magnus and nucleus reticularis paragigantocellularis) as revealed by the retrograde transport of horseradish peroxidase in the rat. 632 8

Clinicians often use a technique combining intrathecal sufentanil and epidural bupivacaine to provide labor analgesia. This study determines the effect of 27- or 24-gauge dural puncture and intrathecal sufentanil 10 micrograms on the dermatomal spread of epidural bupivacaine. Healthy laboring women received no dural puncture (n = 77) (no puncture group [NPG]) or dural puncture with a 27-gauge Whitacre needle (n = 33) or a 24-gauge Sprotte needle (n = 37) and intrathecal sufentanil 10 micrograms (dural puncture group [DPG]) before epidural injection of 13 mL bupivacaine 0.25%. More dermatomes were anesthetized in the DPG, 16.6 +/- 7.5 vs 13.6 +/- 6.6 in the NPG (P < 0.02). More patients in the DPG had sensory blockade T-4 or higher (17 of 70 DPG patients vs 8 of 77 NPG patients; P < 0.05). No patient in either group showed clinical evidence of respiratory compromise. In conclusion, epidural bupivacaine anesthetized more dermatomes when administered 104 +/- 42 min after dural puncture and intrathecal sufentanil 10 micrograms than when given without prior dural puncture and intrathecal injection.
 ...
PMID:The dermatomal spread of epidural bupivacaine with and without prior intrathecal sufentanil. 878 Feb 75

Pheochromocytoma is a rare neuroendocrine tumor of childhood. We present a 14-year-old boy with bilateral pheochromocytoma, post nephrectomy in view of a non-functioning kidney presenting with severe hypertension and end organ damage. Diagnosis was confirmed with 24-hour urinary VMA, catechol amines, and CT scan. Preoperative blood pressure (BP) was controlled with prazosin, propranolol, nicardipine, and HCT-spironolactone. Anesthesia was given with general endotracheal anesthesia with epidural analgesia. Intraoperative BP rise was managed with infusion of NTG, MgSO4, esmolol, and dexmedetomidine which was especially challenging on account of bilateral tumor.
...
PMID:Child with bilateral pheochromocytoma and a surgically solitary kidney: Anesthetic challenges. 2395 24