Analgesia with epidural nimodipine

Filos, KritonS.; Goudas, Leonidas C.; Patroni, Ourania; Tassoudis, Vassilios

doi:10.1016/0140-6736(93)92899-5

Cited by 15 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These antinociceptive effects caused by PhTx3.5 occurred without altering the normal mechanical or thermal sensitivity of the animals or causing immunogenicity [ 195 ]. Our study is in accordance with others which show the involvement of the L-type VGCCs in different models of pain, such as inflammatory [ 96 , 196 , 197 ], neuropathic [ 192 , 198 ], and cancer [ 199 , 200 ] pain models, in addition to being able to block the development of tolerance caused by opioids in experimental animals [ 77 , 201 - 204 ].…”

Section: L- R- and P/q-type Vgccs Blockers Derived From Animal Venomssupporting

confidence: 92%

Animal Venom Peptides Cause Antinociceptive Effects by Voltage-gated Calcium Channels Activity Blockage

Trevisan

Oliveira

2022

View full text Add to dashboard Cite

: Pain is a complex phenomenon that is usually unpleasant and aversive. It can range widely in intensity, quality, and duration and has diverse pathophysiologic mechanisms and meanings. Voltage-gated sodium and calcium channels are essential to transmitting painful stimuli from the periphery until the dorsal horn of the spinal cord. Thus, blocking voltage-gated calcium channels (VGCCs) can effectively control pain refractory to treatments currently used in the clinic, such as cancer and neuropathic pain. VGCCs blockers isolated of cobra Naja naja kaouthia (α-cobratoxin), spider Agelenopsis aperta (ω-Agatoxin IVA), spider Phoneutria nigriventer (PhTx3.3, PhTx3.4, PhTx3.5, PhTx3.6), spider Hysterocrates gigas (SNX-482), cone snails Conus geographus (GVIA), Conus magnus (MVIIA or ziconotide), Conus catus (CVID, CVIE and CVIF), Conus striatus (SO-3), Conus fulmen (FVIA), Conus moncuri (MoVIA and MoVIB), Conus regularis (RsXXIVA), Conus eburneus (Eu1.6), Conus victoriae (Vc1.1.), Conus regius (RgIA), and spider Ornithoctonus huwena (huwentoxin-I and huwentoxin-XVI) venoms caused antinociceptive effects in different acute and chronic pain models. Currently, ziconotide is the only clinical used N-type VGCCs blocker peptide for chronic intractable pain. However, ziconotide causes different adverse effects. The intrathecal route of administration also impairs its use in a more significant number of patients. In this sense, peptides isolated from animal venoms or their synthetic forms that modulate or block VGCCs channels seem to be a relevant prototype for developing new analgesics efficacious and well tolerated by patients.

show abstract

Section: L- R- and P/q-type Vgccs Blockers Derived From Animal Venomssupporting

confidence: 92%

Animal Venom Peptides Cause Antinociceptive Effects by Voltage-gated Calcium Channels Activity Blockage

Trevisan

Oliveira

2022

View full text Add to dashboard Cite

show abstract

“…Thus, in order to produce clinically significant results, it has been hypothesized that antinociceptive treatment should be initiated before start of surgery and it should be extended well into the postoperative period [5][6][7]. Filos et al [39] recently demonstrated that nimodipine, a calcium channel antagonist with a high affinity for the CNS and a proven potency in enhancing morphine analgesia [40], when administered perioperatively intravenously shows significant pre-emptive effects. The authors observed that when nimodipine was administered continuously intravenously, starting 1 h before operation and lasting up to 24 h postoperation, it significantly reduced not only intraoperative and postoperative opioid requirements, but also visual analogue pain scores and opioid-related side effects, while patient satisfaction was improved [39].…”

Section: Perioperative Rather Than Single-dose Preoperative Analgesicmentioning

confidence: 99%

Pre-Emptive Analgesia: How Important Is It in Clinical Reality?

Filos¹,

Vagianos

1999

Eur Surg Res

View full text Add to dashboard Cite

Surgical trauma induces nociceptive sensitization leading to amplification and prolongation of postoperative pain. In experimental studies, preinjury (e.g. pre-emptive) neural blockade using local anaesthetics or opioids has been shown to prevent or to reduce postinjury sensitization of the central nervous system, while similar techniques applied after the injury had less or no effect. Several clinical studies have evaluated possible pre-emptive analgesic effects by administering prior to surgery a variety of analgesic drugs both systemically or epidurally. These treatment modalities were compared to the same treatment following surgery or to control groups not given such treatment. In general, the results from these studies have been disappointing, although some clinical studies have confirmed the impressive results from animal studies. The present paper discusses deficiencies in study design of clinical trials, since the question regarding the effectiveness of pre-emptive analgesic regimens lies not so much in the timing of analgesic administration (e.g. preinjury vs. postinjury treatment), but in the effective prevention of altered central sensitization. Recent evidence suggests that administration of analgesics in order to effectively pre-empt postoperative pain should start before surgery and furthermore, this treatment should be extended into the early postoperative period.

show abstract

“…L-type CCB are more effective anesthetics when used via the intrathecal or epidural route than intravenously. Intravenously administered nimodipine enhanced the analgesic effect of epidural morphine and epidural nimodipine alone produced brief but intense analgesia [19]. …”

Section: Discussionmentioning

confidence: 99%

Does a single dose of intravenous nicardipine or nimodipine affect the bispectral index following rapid sequence intubation?

Lee

Kim

Ahn

et al. 2010

Korean J Anesthesiol

View full text Add to dashboard Cite

BackgroundTheoretically, L-type calcium channel blockers could modulate anesthetic effects. Nicardipine does not affect the bispectral index (BIS), but nimodipine, which can penetrate the blood-brain barrier, has not been studied. The aim of this study was to evaluate whether a single dose of intravenous nicardipine or nimodipine could affect BIS following rapid sequence intubation.MethodsThis study was done in a double-blind, randomized fashion. Anesthesia was induced with fentanyl 2 µg/kg, thiopental sodium 5 mg/kg, and 100% oxygen. After loss of consciousness, patients received rocuronium 1.0 mg/kg and either a bolus of 20 µg/kg nicardipine, nimodipine, or a comparable volume of normal saline (n = 20). Intubation was performed 1 min after study drug administration. BIS, mean blood pressure (MBP), and heart rate (HR) were measured before anesthetic induction, after loss of consciousness, before intubation, during intubation, and 1, 2 and 5 min after intubation.ResultsBIS dropped rapidly after induction but increased to 60 before intubation in all groups irrespective of study drug. In nimodipine, the increase in BIS during intubation was not significant compared to pre-intubation, in contrast to the other two groups, but there was no difference in BIS during intubation. HR significantly increased, but MBP just rose to pre-induction values after intubation in nicardipine and nimodipine groups. BIS, MBP, and HR following intubation increased in control group.ConclusionsA single dose of intravenous nicardipine or nimodipine could attenuate blood pressure increases but not affect BIS increases in rapid sequence intubation.

show abstract

Analgesia with epidural nimodipine

Cited by 15 publications

References 3 publications

Animal Venom Peptides Cause Antinociceptive Effects by Voltage-gated Calcium Channels Activity Blockage

Animal Venom Peptides Cause Antinociceptive Effects by Voltage-gated Calcium Channels Activity Blockage

Pre-Emptive Analgesia: How Important Is It in Clinical Reality?

Does a single dose of intravenous nicardipine or nimodipine affect the bispectral index following rapid sequence intubation?

Contact Info

Product

Resources

About