ObjectivesTo assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs).MethodsNinety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia.ResultsTPVB and IVPCA provided good pain relief. VAS scores were significantly lower in the TPVB group than in the IVPCA group at rest and during coughing (P < 0.05). Patients in the TPVB group had a higher PaO2 and PaO2/FiO2 and lower P(A–a)O2 compared with the IVPCA group (P < 0.05). Moreover, patients in the TPVB group showed higher FVC, FEV1/FVC, and PEFR, and fewer complications than did the IVPCA group (P < 0.05).ConclusionTPVB is superior to IVPCA in pain relief and preservation of pulmonary function in patients with MRFs.

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neuropathic pain is rarely diagnosed. oxyntomodulin is peripherally and centrally distributed; however, the potential mechanisms underlying the effects of oxyntomodulin in attenuating nociception remain unclear; thus, we aimed to explore them in the present study. a neuropathic pain model in male c57Bl/6 mice was induced by intrathecal injection of tumor necrosis factor-α (TnF-α), and the duration of nociceptive behavioral responses was measured with a stop-watch timer within 30 min. Western blotting was used to explore the protein levels of ionized calcium binding adaptor molecule-1 (iBa1), nuclear factor-κB (nF-κB) phosphorylated-p65, interleukin (il)-6 and il-1β. We performed reverse transcription-quantitative polymerase chain reaction and eliSa were performed to determine the mrna and protein expression levels of il-6 and il-1β, respectively. an MTT assay was conducted to detect BV2 cell viability. oxyntomodulin was observed to attenuate TnF-α-induced pain hypersensitivity in mice, as well as the expression of iBa1, nF-κB p-p65, il-6 and il-1β in the spinal cord. oxyntomodulin exhibited no cytotoxicity on BV2 cells, and attenuated TnF-α-induced il-6 and il-1β production and release in BV2 cells and culture medium, respectively. collectively, we proposed oxyntomodulin to attenuate TnF-α induced neuropathic pain associated with the release of glial cytokines il-6 and il-1β via inhibiting the activation of the nF-κB pathway.

Context Veratramine may have a potential therapeutic effect for diabetic peripheral neuropathy (DPN). Objective To evaluate whether veratramine ameliorates neuropathic pain in a rat diabetic model. Materials and methods Sprague–Dawley rats were used for a diabetic model induced by a streptozotocin + high-fat diet. Two months after the induction of the diabetic model, the rats with DPN were screened according to the mechanical pain threshold. The rats with DPN were divided into a model group (n = 12) and a treated group (n = 12). Rats with diabetes, but without peripheral neuropathy, were used in the vehicle group (n = 9). The treatment group received 50 μg/kg veratramine via the tail vein once a day for 4 weeks. During modelling and treatment, rats in all three groups were fed a high-fat diet. Results The mechanical withdrawal threshold increased from 7.5 ± 1.9 N to 17.9 ± 2.6 N in DPN rats treated with veratramine. The tolerance time of the treated group to hot and cold ectopic pain increased from 11.8 ± 4.2 s and 3.4 ± 0.8 s to 20.4 ± 4.1 s and 5.9 ± 1.7 s, respectively. Veratramine effectively alleviated L4-L5 spinal cord and sciatic nerve pathological injury. Veratramine inhibited the expression of SIGMAR1 and the phosphorylation of the N-methyl-d-aspartate receptor (NMDAR) Ser896 site in spinal cord tissue, as well as inhibited the formation of SIGMAR1-NMDAR and NMDAR-CaMKII complexes. Discussion and conclusions Veratramine may alleviate the occurrence of pain symptoms in rats with DPN by inhibiting activation of the SIGMAR1-NMDAR pathway.