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Intravenous Hydrogen Peroxide for Chronic Pain: An Alternative Etiology and Treatment Plan for the Long-Standing Painful States

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Pain Studies and Treatment 2014年第2期2卷 73-78页

作者： Stuart L. Weg former address: department of anesthesiology Bergen Region Medical Center Paramus USA Current Address: Patients Medical New York USA

Background: Anecdotal reports of improvement in chronic pain patients given oxidative therapy (OXT) in the form of Intravenous Hydrogen Peroxide (IVHP) led the author to try this therapy on intractable pain cases. Method: 54 intractable non-malignant pain cases selected at random (16 had spinal problems, 14 had Interstitial Cystitis, 8 had headaches and 16 with miscellaneous problems) each received an average of 9 weekly IVHP infusions of 250 ml 0.03% Hydrogen Peroxide. After 4 months of this therapy all patients were given a questionnaire to evaluate and study any improvements in their condition. The questions covered three areas: 1) Subjective improvements: pain, function, mental and emotional status, general health, and sexual health, 2) Analgesic medication usage: dosage and efficacy changes, 3) Satisfaction with the therapy and desire to continue. Results: 52%-70% mean 66% of the patients responded positively (more than slightly improved) to questions in the subjective areas, 85% of the patients were using less medication and/ or getting more effect from the analgesics they were taking, 96% of the patients wished to continue the therapy. These improvements were constant over the range of the four diagnostic groups. The improved patients all demonstrated some signs and lab results including fever, chills, abscess formation, purulent discharges, elevated WBCs and ESRs consistent with resolving systemic and/ or regional infections. Conclusions: IVPH can significantly improve patients in a majority of chronic painful conditions. Chronic Infection is associated with or absolutely the cause of Chronic Pain in the patients studied.

关键词： Intravenous Hydrogen Peroxide (IVHP) Chronic Pain Oxidative Therapy (OXT) Infectious Disease

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Spinal Cord Stimulation Enhances Microglial Activation in the Spinal Cord of Nerve-Injured Rats

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Neuroscience Bulletin 2020年第12期36卷 1441-1453页

作者： Bin Shu Shao-Qiu He Yun Guan department of anesthesiology and Critical Care Medicine School of MedicineJohns Hopkins UniversityBaltimoreMD 21205USA Present address:department of anesthesiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China department of Neurological Surgery School of MedicineJohns Hopkins UniversityBaltimoreMD 21205USA

Microglia can modulate spinal nociceptive ***,their role in spinal cord stimulation(SCS)-induced pain inhibition is ***,we examined how SCS affects microglial activation in the lumbar cord of rats with chronic constriction injury(CCI)of the sciatic *** rats received conventional SCS(50 Hz,80%motor threshold,180 min,2 sessions/day)or sham stimulation on days 18-20 *** transiently attenuated the mechanical hypersensitivity in the ipsilateral hind paw and increased OX-42 immunoreactivity in the bilateral dorsal *** also upregulated the mRNAs of Ml-like markers,but not M2-like *** NOS protein expression was increased,but brain-derived neurotrophic factor was decreased after *** minocycline(1μg-100μg),which inhibits microglial activation,dosedependently attenuated the mechanical *** with low-dose minocycline(1μg,30 min)prolonged the SCS-induced pain *** findings suggest that conventional SCS may paradoxically increase spinal M1-like microglial activity and thereby compromise its own ability to inhibit pain.

关键词： Spinal cord stimulation Microglia Neuropathic pain Spinal cord Rat

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Sevoflurane exposure in 7-day-old rats affects neurogenesis, neurodegeneration and neurocognitive function

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Neuroscience Bulletin 2012年第5期28卷 499-508页

作者： Fang Fang Zhanggang Xue Jing Cang department of anesthesiology Zhongshan Hospital Fudan University Shanghai 200032 China

Objective Sevoflurane is widely used in pediatric anesthesia and former studies showed that it causes neurodegeneration in the developing brain. The present study was carried out to investigate the effects of sevoflurane on neurogenesis, neurodegeneration and behavior. Methods We administered 5-bromodeoxyuridine, an S-phase marker, before, during, and after 4 h of sevoflurane given to rats on postnatal day 7 to assess dentate gyrus progenitor proliferation and Fluoro-Jade staining for degeneration. Spatial reference memory was tested 2 and 6 weeks after anesthesia. Results Sevoflurane decreased progenitor proliferation and increased cell death until at least 4 days after anesthesia. Spatial reference memory was not affected at 2 weeks but was affected at 6 weeks after sevoflurane administration. Conclusion Sevoflurane reduces neurogenesis and increases the death of progenitor cells in developing brain. This might mediate the lateonset neurocognitive outcome after sevoflurane application.

关键词： sevoflurane neurogenesis progenitor proliferation degeneration

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Analgesic effect of AG490, a Janus kinase inhibitor, on oxaliplatin-induced acute neuropathic pain

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Neural Regeneration Research 2018年第8期13卷 1471-1476页

作者： Shuang-Feng Li Bi-Shan Ouyang Xin Zhao Ya-Ping Wang department of anesthesiology The Second Xiangya Hospital Xiangya School of Medicine Central South University department of anesthesiology Hainan General Hospital department of Neurology Xiangya Hospital Xiangya School of Medicine Central South University

Neuropathic pain often occurs during chemotherapy with oxaliplatin. AG490 has been shown to exert an antagonistic effect on inflammatory pain, but its effect on oxaliplatin-induced neuropathic pain remains poorly understood. This study sought to observe the analgesic effect of AG490 on acute neuropathic pain induced by a single oxaliplatin treatment and to address the possible mechanism. In this study, we estab- lished a model of oxaliplatin-induced acute neuropathic pain by intraperitoneal injection of 6 mg/kg oxaliplatin. On day 2 after injection, models were intraperitoneally injected with i, 5, or 10 mg/kg AG490. Paw withdrawal threshold to mechanical stimuli and tail withdrawal latency to cold stimuli were determined. Western blot assay was performed to detect the expression of spinal phosphorylated signal transducer and activator of transcription 3 （p-STAT3）. Immunohistochemistry was used to determine the immunoreactivity of p-STAT3 and inter- leukin-6. Results demonstrated that paw withdrawal threshold and tail withdrawal latency were significantly increased by the treatment of AG490 in rats. There was no significant difference in the effect among the different doses of AG490. AG490 10 mg/kg decreased the expression of p-STAT3, the immunoreactivity of p-STAT3 and interleukin-6 in spinal cord of acute neuropathic pain rats. These findings confirm that AG490 can attenuate oxaliplatin-induced acute neuropathic pain and is associated with the inhibition in the JAK/STAT3 signaling pathway.

关键词： nerve regeneration A G490 analgesia oxaliplatin cancer chemotherapy neuropathic pain phosphorylated STA T3 JAK/STA Tsignaling pathway interleukin-6 neural regeneration

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Efficacy and safety of perioperative parecoxib for acute postoperative pain treatment in children： a meta-analysis

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Frontiers of Medicine 2015年第4期9卷 496-507页

作者： Xueshan Bu Lei Yang Yunxia Zuo department of anesthesiology West China Hospital Sichuan University Chengdu 610041 China

Perioperative parecoxib administration reduces postoperative pain, opioid consumption, and adverse events in adult patients. However, the efficacy and safety of parecoxib in children remain unclear. This meta-analysis included related published studies to address this concern. Eight databases in the literature until February 2015 were systematically explored to identify randomized controlled trials （RCTs） comparing perioperative parecoxib administration and placebo/standard treatments for acute postoperative pain in children. Primary outcomes were postoperative pain scores and adverse events. The Face, Legs, Activity, Crying, Consolability scale was used to score pain in children younger than 6 years, whereas the Visual Analog Scale was used in children older than 6 years. Secondary outcomes were sedation scores （measured using the Ramsay scale）, agitation scores （measured using the Sedation-Agitation Scale）, and opioid consumption. The methodological quality of RCTs was independently assessed in accordance with the ＂Risk of bias＂ of Cochrane Collaboration. Data were analyzed using Review Manager 5.2. Twelve RCTs involving 994 patients met the inclusion criteria. Compared with children who received placebo treatment, those who received parecoxib demonstrated lower early （2 h） and later （12 h） postoperative pain scores; lower incidence rates of postoperative nausea, vomiting, and agitation; higher early （1 h） postoperative sedation scores; and lower agitation scores. Similarly, children who received parecoxib had lower early （2 h） and later （12 h） postoperative pain scores, lower incidence rates of postoperative nausea and vomiting, and lower early （1 h） postoperative sedation scores compared with those who received standard treatments; however, these children showed no significant difference in agitation scores. Unfortunately, data on the effect of parecoxib on opioid consumption were insufficient. Overall, these results suggested that perioperative parecoxib admini

关键词： NSAID cyclooxygenase 2 inhibitor child pain, postoperative opioid placebo

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Effect of sevoflurane inhalation and general anesthesia on serum IL-6 and S100β levels and coagulation function in elderly patients undergoing total hip replacement

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Journal of Hainan Medical University 2020年第18期26卷 35-39页

作者： Min Wu Rong Liu Jin-Hui Xiao Shu-Hong Xia Min-Hua Wang Ming Peng United Logistics Service 908 Hospital(former People's Liberation Army 184 Hospital)department of anesthesiology 335000

Objective:To investigate the effects of sevoflurane inhalation general anesthesia on serum IL-6,brain injury protein S100βand coagulation function in elderly patients undergoing total hip ***:From May 2017 to May 2019,84 patients,age 60-75 underwent total hip arthroplasty in our *** randomly divided into two groups:group A(n=42)and group B(n=42).Group A was maintained with sevoflurane inhalation by general anesthesia and group B with propofol by intravenous *** surgical related indexes and postoperative complications in the two groups were *** level of serum IL-6,S100β,Coagulation function index[platelet count(PLT),Fibrinogen(FIB),plasma D-dimer(D-D),activated partial enzyme activity time(APTT),prothrombin time(PT)],MMSE score and MoCA score were compared between two groups before and after ***:There was no significant difference in anesthesia time,operation time,intraoperative bleeding and postoperative drainage(P>0.05).1h,1d and 7d after operation,the level of PLT,D-D and FIB in group A were significantly lower than that in group B(P<0.05),PT and APTT were significantly higher than that in group B(P<0.05).1h,1d and 7d after operation,the level of IL-6,S100βin group A were significantly lower than that in group B(P<0.05).1d after operation,the MMSE and MoCA scores in group B were significantly lower than those in group A(P<0.05).The incidence of lower extremity deep venous thrombosis(2.38%)and cognitive impairment(2.38%)in group A was lower than that in group B(14.29%,16.67%)(t1=3.896,P1=0.048;t2=4.974,P2=0.026).Conclusion:sevoflurane anesthesia can reduce the incidence of deep venous thrombosis and cognitive impairment of the lower extremity after operation in elderly patients with thr,stabilize the coagulation index of patients,and downregulate the expression of il-6 and S100β.

关键词： Sevoflurane Total Hip replacement Interleukin6 brain injury protein S100β Coagulation function

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Effect of Preemptive Ketamine Administration on Postoperative Visceral Pain after Gynecological Laparoscopic Surgery

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第4期36卷 584-587页

作者：林洪启贾东林 department of anesthesiology the People's Hospital of Henan Province department of Pain Treatment Peking University Third Hospital

The pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience visceral pain after the former surgery. The aim of this study was to determine the effects of preemptive ketamine on visceral pain in patients undergoing gynecological laparoscopic surgery. Ninety patients undergoing gynecological laparoscopic surgery were randomly assigned to one of three groups. Group 1 received placebo. Group 2 was intravenously injected with preincisional saline and local infiltration with 20 m L ropivacaine（4 mg/m L） at the end of surgery. Group 3 was intravenously injected with preincisional ketamine（0.3 mg/kg） and local infiltration with 20 m L ropivacaine（4 mg/m L） at the end of surgery. A standard anesthetic was used for all patients, and meperidine was used for postoperative analgesia. The visual analogue scale（VAS） scores for incisional and visceral pain at 2, 6, 12, and 24 h, cumulative analgesic consumption and time until first analgesic medication request, and adverse effects were recorded postoperatively. The VAS scores of visceral pain in group 3 were significantly lower than those in group 2 and group 1 at 2 h and 6 h postoperatively（P〈0.05 and P〈0.01, respectively）. At 2 h and 6 h, the VAS scores of incisional pain did not differ significantly between groups 2 and 3, but they were significantly lower than those in group 1（P〈0.01）. Groups 1 and 2 did not show any differences in visceral pain scores at 2 h and 6 h postoperatively. Moreover, the three groups showed no statistically significant differences in visceral and incisional pain scores at 12 h and 24 h postoperatively. The consumption of analgesics was significantly greater in group 1 than in groups 2 and 3, and the time to first request for analgesics was significantly longer in groups 2 and 3 than in group 1, with no statistically significant difference between groups 2 and 3. However, the three groups showed no significant difference in

关键词： preemptive analgesia ketamine gynecological laparoscopic surgery visceral pain

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CHANGE OF CARBON MONOXIDE IN PLASMA AND TISSUE DURING ACUTE HYPOXIA

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Chinese Medical Sciences Journal 2003年第1期18卷 50-53页

作者：丁学琴刘贵明王俊科盛卓人 department of anesthesiology and ICU the First Affiliated HospitalChina Medical University

*** investigate the role of endogenous carbon monoxide(CO)in hypoxia. Methods. After rats were inhaled with hypoxic gases and the heme oxygenase inhibitor ZnPPIX was administered,we measured the CO levels in plasma,liver,lung and kidney. Meanwhile plasma cGMP levels were observed. Furthermore,we recorded the changes of hemodynamic and blood gases. Results. Acute mild hypoxia(10%O2)significantly increased CO levels in plasma as well as liver,kidney and lung,while acute severe hypoxia(5%O2)significantly decreased CO levels in plasma as well as liver,kidney and lung. In addition,the former significantly elevated cGMP levels in plasma while the latter markedly reduced cGMP levels in plasma. The hemodynamic changes occurred in accordance with the changes of carbon monoxide. Conclusions. Our results indicate,for the first time ,that the endogenous carbon monoxide plays an important role in regulating the vessel tone during hypoxia.

关键词： carbon monoxide hypoxia cGMP

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Current status of nitrous oxide use in pediatric patients

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World Journal of Clinical Pediatrics 2022年第2期11卷 93-104页

作者： Nishkarsh Gupta Anju Gupta R M Vishnu Narayanan department of Onco-anesthesiology and Palliative Medicine AIIMSNew Delhi 110029DelhiIndia department of anesthesiology Pain Medicine and Critical CareAIIMSNew Delhi 110029DelhiIndia

Nitrous oxide is one of the most commonly used inhalational anesthetic agents used in *** is a cost-effective,pleasant,safe,and versatile anesthetic agent with many desirable properties like good quality analgesia,decreased awareness,accelerated induction and recovery from anesthesia,and reduced utilization of other expensive inhalational agents with potential cost *** use of nitrous oxide has been questioned by a lot of studies and case reports perceiving its adverse systemic,hematological,immune,and neurologic adverse ***,the literature in the recent past has tried to resolve the controversies related to its *** concerns over an increase in cardiovascular complications and mortality following nitrous oxide use have been negated by recent ***,its use in certain vulnerable populations like children with cobalamin and folate deficiency or defects in their metabolic pathways remains a cause of concern for its toxic *** this narrative review,we aim to discuss the pharmacological properties of nitrous oxide,the potential advantages and drawbacks of the use of nitrous oxide in children,address the neurodevelopmental and other systemic effects,and throw light on the evidence regarding the safety of nitrous oxide use and its current role in pediatric procedural sedation and anesthesia *** literature related to its use in the pediatric population for painful procedures and surgeries has been summarized.

关键词： Child Nitrous oxide Vitamin B12 Vulnerable populations anesthesiology Anesthetics Folic acid Metabolic networks and pathways

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A SURVEY OF ELECTIVE SURGICAL PATIENTS' ATTITUDES TOWARD ANESTHESIA IN PUMC HOSPITAL

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Chinese Medical Sciences Journal 2002年第2期17卷 77-80页

作者：黄宇光杨克勤任洪智罗爱伦 department of anesthesiology Peking Union Medical College Hospital CAMS & PUMC Beijing 100730.

*** assess patients’ knowledge,attitudes,and concerns regarding anesthetic ***.A survey of 55items was developed and administered preoperatively to 500patients including 190men and 310women in our *** were interviewed on their know ledge of the role of anesthesiolo-gists,their preferences regarding anesthetic management,and also their concernaboutpotential anesthetic ***’ perceptions ofanesthesiologists’ training androle have reacheda ***-cant preoperative concerns regardi ng the anesthesiologists focused on experience,qualifications,and pr esence or absence during the ***’ concerns also included the possibility of not being waken up following anesthesia,experiencing postoperative pain,and becoming *** variations of concerns depended partial-ly on patients’ sex,type of anesthesia,and propose d surgical procedure,partially on t heir education and living *** is suggested that anesthesiologists address significant patient con cerns during the preopera-tive visit to enhance their effectiv eness in patient *** to educate the public on the anesthesiologists’ role in preoperative care would improve p atients’ confidence.

关键词： surgical operation patients anesthesia

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