Recent Advances in Peripheral Opioid Receptor Therapeutics

Seth, Raghav; Kuppalli, Sumanth; Nadav, Danielle; Chen, Grant; Gulati, Amitabh

doi:10.1007/s11916-021-00951-6

Cited by 6 publications

(2 citation statements)

References 65 publications

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“…Some studies have proved that dexmedetomidine and dexamethasone can significantly enhance the analgesic effect as local anesthetic adjuvants [16,17], but the former is not the most desirable local anesthetic adjuvant because of its side effects such as bradycardia and the latter because of a slight increase in blood glucose [9,18]. Opioid receptors are widely expressed in the central and peripheral nervous system as well as in non-neural tissues [19]. Local application of exogenous opioid agonists can activate peripheral opioid receptors in inflamed tissues, resulting in an effective analgesic effect.…”

Section: Discussionmentioning

confidence: 99%

Butorphanol as an Adjuvant to Ropivacaine for Adductor Canal Blocks in Total Knee Arthroplasty Patients: A Randomized, Double, Blind Study

Liu

Gao

2022

Journal of Healthcare Engineering

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Background. The objective of this study was to observe the effects of butorphanol as an adjuvant to ropivacaine for the adductor canal block (ACB) on postoperative analgesia in patients undergoing total knee arthroplasty (TKA). Methods. Seventy-four patients undergoing TKA were included and randomly divided into two groups: Group BR received 20 ml of 0.33% ropivacaine plus 1 mg butorphanol and Group R received 20 ml of 0.33% ropivacaine plus 1 ml normal saline for ultrasound-guided adductor canal blocks. The primary outcomes were the duration of the sensory block and the pain visual analogue scale (VAS), and secondary outcomes included the number of PCIA attempts (patient-controlled intravenous analgesia) and the time to first pressing and rescue analgesia. Other outcomes included knee active range of motion (ROM), quadriceps strength, the time to first mobilization, the duration of postoperative hospital stay, Knee Society Score (KSS), and postoperative complications. Results. Since two patients in each group rejected postoperative assessments, 35 patients were included in each group. Compared with Group R, Group BR had longer duration of sensory blocks (18.42 ± 3.46 vs. 15.36 ± 2.29 h, p < 0.01 ) and lower postoperative pain scores within 24 hours at rest and within 12 hours with activity ( p < 0.01 ). The number of PCIA attempts decreased within 48 hours after surgery (4.5 ± 1.2 vs. 7.8 ± 1.5 times, p < 0.01 ), and the time to first pressing was later (20.31 ± 2.59 vs. 16.25 ± 2.31 h, p < 0.01 ). In addition, Group BR had bigger knee ROM at within 24 hours after the operation than Group R (68.37 ± 4.70°vs. 59.21 ± 6.41,85.67 ± 5.17 vs. 74.37 ± 4.68°, 97.62 ± 5.43 vs. 84.18 ± 4.49°, p < 0.01 ). There was no significant difference between the two groups ( p > 0.05 ) in terms of rescue analgesia, quadriceps strength, the time to first mobilization, the duration of postoperative hospital stay, the KSS function scores, and postoperative complications. Conclusions. Butorphanol plus ropivacaine ultrasound-guided adductor canal block can prolong the duration of sensory block, relieve early postoperative pain, and improve the range of motion of the knee joint, without affecting the occurrence of postoperative complications. Name of the Registry. Chinese Clinical Trial Registry. Trial Registration Number. ChiCTR2100041859. URL of Trial Registry Record. http://www.chictr.org.cn/edit.aspx?pid=119731&htm=4. Date of Registration. 08/01/2021 0:00:00.

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Section: Discussionmentioning

confidence: 99%

Butorphanol as an Adjuvant to Ropivacaine for Adductor Canal Blocks in Total Knee Arthroplasty Patients: A Randomized, Double, Blind Study

Liu

Gao

2022

Journal of Healthcare Engineering

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“…Commonly used analgesics are classified as opioids (cocaine, morphine) and nonsteroidal anti-inflammatory drugs (NSAIDs), which have a good clinical therapeutic effect. However, opioids carry a significant risk of severe side effects including nausea, itching, sedation, respiratory depression, addiction, tolerance and dependence, and even the unacceptably high death rate for repeated dosing of opioids ( Lutfy, 2020 ; Uniyal et al, 2020 ; Seth et al, 2021 ). According to the survey, in 2016, around 2.1 million Americans were addicted to opioids, and more than 42,000 patients died due to opioid overdose ( Seth et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Progress on the Elucidation of the Antinociceptive Effect of Ginseng and Ginsenosides in Chronic Pain

Wei

2022

Front. Pharmacol.

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Ginseng (Panax ginseng C.A. Meyer) is a traditional Oriental herbal drug widely used in East Asia. Its main active ingredients are ginsenosides whose constituents are known to have various pharmacological activities such as anticancer, antinociception, and neuroprotection. The analgesic effects of ginsenosides, such as Rg1, Rg2, and Rb1, as well as compound K, are well known and the analgesic mechanism of action in inflammatory pain models is thought to be the down regulation of pro-inflammatory cytokine expression (TNF-α IL-1β, and IL-6). Several studies have also demonstrated that ginsenosides regulate neuropathic pain through the modulation of estrogen receptors. Recently, an increasing number of pathways have emerged in relation to the antinociceptive effect of ginseng and ginsenosides. Therefore, this review presents our current understanding of the effectiveness of ginseng in chronic pain and how its active constituents regulate nociceptive responses and their mechanisms of action.

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