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  1 / 1806 MEDLINE  
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[PMID]:27738897
[Au] Autor:Blair HA; Frampton JE
[Ad] Endereço:Springer, Private Bag 65901, Mairangi Bay, 0754, Auckland, New Zealand. demail@springer.com.
[Ti] Título:Methoxyflurane: A Review in Trauma Pain.
[So] Source:Clin Drug Investig;36(12):1067-1073, 2016 Dec.
[Is] ISSN:1179-1918
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Methoxyflurane (Penthrox ) is a halogenated ether first used clinically as a volatile inhalational anaesthetic. It has been used as an analgesic in Australia and New Zealand for the past 30 years. In the UK and Europe, methoxyflurane has been approved for the emergency relief of moderate to severe trauma pain in conscious adult patients. Methoxyflurane is self-administered using a hand-held inhaler. This article reviews the pharmacological properties of methoxyflurane and its clinical efficacy and tolerability in these patients. In the phase III STOP! trial, methoxyflurane was effective and generally well tolerated for the management of acute pain due to minor trauma, with a rapid onset of analgesia. In a prospective study, methoxyflurane was more effective than intramuscular tramadol when administered for the treatment of acute musculoskeletal pain in the pre-hospital setting (i.e. by paramedics). Methoxyflurane had a more rapid onset of action than tramadol when administered for the treatment of pain related to ankle injuries in the emergency department. Although methoxyflurane is known to be potentially nephrotoxic at anaesthetic doses, the much lower doses used for pain relief were not associated with nephrotoxicity or an increased risk of renal disease. Inhaled methoxyflurane may offer advantages over other analgesics administered via the intravenous, intramuscular or intranasal routes in terms of its non-invasive self-administration, ease of use and/or rapid onset of action. As such, it is a useful additional treatment option for the management of trauma pain in the pre-hospital or emergency department setting.
[Mh] Termos MeSH primário: Anestésicos Inalatórios/uso terapêutico
Metoxiflurano/uso terapêutico
Dor/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Anestésicos Inalatórios/administração & dosagem
Serviço Hospitalar de Emergência
Seres Humanos
Nebulizadores e Vaporizadores
Medição da Dor
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161015
[St] Status:MEDLINE


  2 / 1806 MEDLINE  
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Registro de Ensaios Clínicos
[PMID]:27567918
[Au] Autor:Coffey F; Dissmann P; Mirza K; Lomax M
[Ad] Endereço:DREEAM: Department of Research and Education in Emergency Medicine, Acute Medicine and Major Trauma, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. frank.coffey@nottingham.ac.uk.
[Ti] Título:Methoxyflurane Analgesia in Adult Patients in the Emergency Department: A Subgroup Analysis of a Randomized, Double-blind, Placebo-controlled Study (STOP!).
[So] Source:Adv Ther;33(11):2012-2031, 2016 Nov.
[Is] ISSN:1865-8652
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Acute pain remains highly prevalent in the Emergency Department (ED) setting. This double-blind, randomized, placebo-controlled UK study investigated the efficacy and safety of low-dose methoxyflurane analgesia for the treatment of acute pain in the ED in the adult population of the STOP! trial. METHODS: Patients presenting to the ED requiring analgesia for acute pain (pain score of 4-7 on the Numerical Rating Scale) due to minor trauma were randomized in a 1:1 ratio to receive methoxyflurane (up to 6 mL) or placebo (normal saline), both via a Penthrox (Medical Developments International Limited, Scoresby, Australia) inhaler. Rescue medication (paracetamol/opioids) was available immediately upon request. Change from baseline in visual analog scale (VAS) pain intensity was the primary endpoint. RESULTS: 300 adult and adolescent patients were randomized; data are presented for the adult subgroup (N = 204). Mean baseline VAS pain score was ~66 mm in both groups. The mean change from baseline to 5, 10, 15 and 20 min was greater for methoxyflurane (-20.7, -27.4, -33.3 and -34.8 mm, respectively) than placebo (-8.0, -11.1, -12.3 and -15.2 mm, respectively). The primary analysis showed a highly significant treatment effect overall across all four time points (-17.4 mm; 95% confidence interval: -22.3 to -12.5 mm; p < 0.0001). Median time to first pain relief was 5 min with methoxyflurane [versus 20 min with placebo; (hazard ratio: 2.32; 95% CI: 1.63, 3.30; p < 0.0001)]; 79.4% of methoxyflurane-treated patients experienced pain relief within 1-10 inhalations. 22.8% of placebo-treated patients requested rescue medication within 20 min compared with 2.0% of methoxyflurane-treated patients (p = 0.0003). Methoxyflurane treatment was rated 'Excellent', 'Very Good' or 'Good' by 77.6% of patients, 74.5% of physicians and 72.5% of nurses. Treatment-related adverse events (mostly dizziness/headache) were reported by 42.2% of patients receiving methoxyflurane and 14.9% of patients receiving placebo; none caused withdrawal and the majority were mild and transient. CONCLUSION: The results of this study support the evidence from previous trials that low-dose methoxyflurane administered via the Penthrox inhaler is a well-tolerated, efficacious and rapid-acting analgesic. FUNDING: Medical Developments International (MDI) Limited and Mundipharma Research GmbH & Co.KG. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01420159, EudraCT number: 2011-000338-12.
[Mh] Termos MeSH primário: Dor Aguda
Metoxiflurano
Ferimentos e Lesões/complicações
[Mh] Termos MeSH secundário: Dor Aguda/diagnóstico
Dor Aguda/tratamento farmacológico
Dor Aguda/etiologia
Adolescente
Adulto
Analgesia/métodos
Anestésicos Inalatórios/administração & dosagem
Anestésicos Inalatórios/efeitos adversos
Relação Dose-Resposta a Droga
Método Duplo-Cego
Monitoramento de Medicamentos/métodos
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Masculino
Metoxiflurano/administração & dosagem
Metoxiflurano/efeitos adversos
Meia-Idade
Manejo da Dor/métodos
Medição da Dor/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:160829
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


  3 / 1806 MEDLINE  
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[PMID]:27181451
[Au] Autor:Frangos J; Mikkonen A; Down C
[Ad] Endereço:Golder Associates, 570 - 588 Swan Street, Richmond, Victoria, 3121, Australia. Electronic address: jfrangos@golder.com.au.
[Ti] Título:Derivation of an occupational exposure limit for an inhalation analgesic methoxyflurane (Penthrox(®)).
[So] Source:Regul Toxicol Pharmacol;80:210-25, 2016 Oct.
[Is] ISSN:1096-0295
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Methoxyflurane (MOF) a haloether, is an inhalation analgesic agent for emergency relief of pain by self administration in conscious patients with trauma and associated pain. It is administered under supervision of personnel trained in its use. As a consequence of supervised use, intermittent occupational exposure can occur. An occupational exposure limit has not been established for methoxyflurane. Human clinical and toxicity data have been reviewed and used to derive an occupational exposure limit (referred to as a maximum exposure level, MEL) according to modern principles. The data set for methoxyflurane is complex given its historical use as anaesthetic. Distinguishing clinical investigations of adverse health effects following high and prolonged exposure during anaesthesia to assess relatively low and intermittent exposure during occupational exposure requires an evidence based approach to the toxicity assessment and determination of a critical effect and point of departure. The principal target organs are the kidney and the central nervous system and there have been rare reports of hepatotoxicity, too. Methoxyflurane is not genotoxic based on in vitro bacterial mutation and in vivo micronucleus tests and it is not classifiable (IARC) as a carcinogenic hazard to humans. The critical effect chosen for development of a MEL is kidney toxicity. The point of departure (POD) was derived from the concentration response relationship for kidney toxicity using the benchmark dose method. A MEL of 15 ppm (expressed as an 8 h time weighted average (TWA)) was derived. The derived MEL is at least 50 times higher than the mean observed TWA (0.23 ppm) for ambulance workers and medical staff involved in supervising use of Penthrox. In typical treatment environments (ambulances and treatment rooms) that meet ventilation requirements the derived MEL is at least 10 times higher than the modelled TWA (1.5 ppm or less) and the estimated short term peak concentrations are within the MEL. The odour threshold for MOF of 0.13-0.19 ppm indicates that the odour is detectable well below the MEL. Given the above considerations the proposed MEL is health protective.
[Mh] Termos MeSH primário: Analgésicos/efeitos adversos
Anestésicos Inalatórios/efeitos adversos
Pessoal de Saúde
Exposição por Inalação/efeitos adversos
Metoxiflurano/efeitos adversos
Exposição Ocupacional/efeitos adversos
Saúde do Trabalhador
[Mh] Termos MeSH secundário: Administração por Inalação
Analgésicos/administração & dosagem
Analgésicos/farmacocinética
Anestésicos Inalatórios/administração & dosagem
Anestésicos Inalatórios/farmacocinética
Animais
Benchmarking
Relação Dose-Resposta a Droga
Ambiente Controlado
Monitoramento Ambiental/métodos
Seres Humanos
Metoxiflurano/administração & dosagem
Metoxiflurano/farmacocinética
Modelos Estatísticos
Medição de Risco
Testes de Toxicidade
Toxicocinética
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics); 0 (Anesthetics, Inhalation); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160517
[St] Status:MEDLINE


  4 / 1806 MEDLINE  
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[PMID]:26877169
[Au] Autor:Gaskell AL; Jephcott CG; Smithells JR; Sleigh JW
[Ad] Endereço:Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand.
[Ti] Título:Self-administered methoxyflurane for procedural analgesia: experience in a tertiary Australasian centre.
[So] Source:Anaesthesia;71(4):417-23, 2016 Apr.
[Is] ISSN:1365-2044
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Methoxyflurane, an agent formerly used as a volatile anaesthetic but that has strong analgesic properties, will soon become available again in the UK and Europe in the form of a small hand-held inhaler. We describe our experience in the use of inhaled methoxyflurane for procedural analgesia within a large tertiary hospital. In a small pilot crossover study of patients undergoing burns-dressing procedures, self-administered methoxyflurane inhalation was preferred to ketamine-midazolam patient-controlled analgesia by five of eight patients. Patient and proceduralist outcomes and satisfaction were recorded from a subsequent case series of 173 minor surgical and radiological procedures in 123 patients performed using inhaled methoxyflurane. The procedures included change of dressing, minor debridement, colonoscopy and incision-and-drainage of abscess. There was a 97% success rate of methoxyflurane analgesia to facilitate these procedures. Limitations of methoxyflurane include maximal daily and weekly doses, and uncertainty regarding its safety in patients with pre-existing renal disease.
[Mh] Termos MeSH primário: Analgesia Controlada pelo Paciente/métodos
Anestésicos Inalatórios/administração & dosagem
Metoxiflurano/administração & dosagem
Dor/tratamento farmacológico
Centros de Atenção Terciária
[Mh] Termos MeSH secundário: Administração por Inalação
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Australásia
Queimaduras/complicações
Estudos Cross-Over
Desbridamento
Feminino
Seres Humanos
Masculino
Meia-Idade
Projetos Piloto
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160321
[Lr] Data última revisão:
160321
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160216
[St] Status:MEDLINE
[do] DOI:10.1111/anae.13377


  5 / 1806 MEDLINE  
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[PMID]:26101794
[Au] Autor:Kingon A; Yap T; Bonanno C; Sambrook P; McCullough M
[Ad] Endereço:Private Practice, Pymble, New South Wales, Australia.
[Ti] Título:Methoxyflurane: a review with emphasis on its role in dental practice.
[So] Source:Aust Dent J;61(2):157-62, 2016 Jun.
[Is] ISSN:1834-7819
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Methoxyflurane was developed as an anaesthetic agent and introduced into clinical practice in 1960. It soon became evident that it possessed analgesic properties that other drugs did not. Due to toxicity concerns, it lost favour in general anaesthesia and had been largely abandoned by the late 1970s. The manufacturer withdrew it in 1999, and the Food and Drug Administration in the United States did not renew its licence in 2005. It has also been withdrawn by the European Union. However, it continues to be used in Australasia, primarily as an inhaled self-administered analgesic by emergency services immediately following trauma. It has become attractive for use in dental practice, likely due to its effectiveness as an analgesic and its additional sedative qualities. Its acceptance is controversial as its use in dentistry is largely elective. Despite its good safety record in analgesic doses, adverse reactions have been recorded. Practitioners should be well aware of risks associated with its use before considering administration, and carefully assess whether or not there are equally good alternative options that do not the carry the same risks. Methoxyflurane is reviewed below with an emphasis on its use in dental practice.
[Mh] Termos MeSH primário: Anestesia/métodos
Anestésicos Inalatórios/uso terapêutico
Odontologia/métodos
Metoxiflurano/uso terapêutico
Dor/prevenção & controle
[Mh] Termos MeSH secundário: Anestésicos Inalatórios/administração & dosagem
Anestésicos Inalatórios/efeitos adversos
Seres Humanos
Hipnóticos e Sedativos/uso terapêutico
Metoxiflurano/administração & dosagem
Metoxiflurano/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 0 (Hypnotics and Sedatives); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:150624
[St] Status:MEDLINE
[do] DOI:10.1111/adj.12346


  6 / 1806 MEDLINE  
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[PMID]:25926525
[Au] Autor:Dayan AD
[Ad] Endereço:London, UK a.dayan@toxic.u-net.com.
[Ti] Título:Analgesic use of inhaled methoxyflurane: Evaluation of its potential nephrotoxicity.
[So] Source:Hum Exp Toxicol;35(1):91-100, 2016 Jan.
[Is] ISSN:1477-0903
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Methoxyflurane is a volatile, halogenated analgesic, self-administered in a controlled low dose from the Penthrox(®) inhaler for short-term pain relief. It was formerly used in significantly higher doses to produce anaesthesia, when it caused a specific type of dose-related renal tubular damage. The pathogenesis of the renal damage and clinical use of methoxyflurane are discussed here with evidence that a low but effective analgesic dose is not associated with the risk of renal adverse effects. The maximum dose employed to produce analgesia is limited to methoxyflurane 6 mL/day and 15 mL/week, producing a minimum alveolar concentration (MAC) of 0.59 MAC-hours. Renal damage is due to the metabolism of methoxyflurane and release of fluoride ions. Exposure of humans to methoxyflurane ≤2.0 MAC-hours, resulting in serum fluoride ≤40 µmol/L, has not been associated with renal tubular toxicity. The safety margin of analgesic use of methoxyflurane in the Penthrox ((®)) inhaler is at least 2.7- to 8-fold, based on methoxyflurane MAC-hours or serum fluoride level, with clinical experience suggesting it is higher. It is concluded from clinical experience in emergency medicine, surgical procedures and various experimental and laboratory investigations that the analgesic use of methoxyflurane in subanaesthetic doses in the Penthrox inhaler does not carry a risk of nephrotoxicity.
[Mh] Termos MeSH primário: Anestésicos Inalatórios/efeitos adversos
Anestésicos Inalatórios/farmacologia
Nefropatias/induzido quimicamente
Metoxiflurano/efeitos adversos
Metoxiflurano/farmacologia
[Mh] Termos MeSH secundário: Anestésicos Inalatórios/química
Animais
Seres Humanos
Metoxiflurano/química
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1609
[Cu] Atualização por classe:151224
[Lr] Data última revisão:
151224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150501
[St] Status:MEDLINE
[do] DOI:10.1177/0960327115578743


  7 / 1806 MEDLINE  
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[PMID]:25655403
[Au] Autor:Huang S; Pepdjonovic L; Konstantatos A; Frydenberg M; Grummet J
[Ad] Endereço:Department of Urology, Bairnsdale Regional Health Service, Bairnsdale, Victoria, Australia.
[Ti] Título:Penthrox alone versus Penthrox plus periprostatic infiltration of local analgesia for analgesia in transrectal ultrasound-guided prostate biopsy.
[So] Source:ANZ J Surg;86(3):139-42, 2016 Mar.
[Is] ISSN:1445-2197
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The objective of this study was to compare pain intensity in patients undergoing transrectal ultrasound (TRUS)-guided biopsy of the prostate with Penthrox alone compared with Penthrox plus periprostatic infiltration of local analgesia (PILA). METHOD: Seventy-two subjects participated in this study after receiving appropriate education. Forty-two patients self-administered inhaled Penthrox (3 mL methoxyflurane) alone for analgesia (Group A), followed by 30 patients who self-administered Penthrox and received PILA with 5 mL of 2% lignocaine. All subjects had TRUS biopsy performed. Immediately after the procedure, patients were asked to rate their pain intensity using a numerical verbal rating scale from 0 to 10. RESULTS: Baseline characteristics of the two groups were similar. Patients in Group B reported significantly lower post TRUS biopsy median pain intensity of 2 (1-3) compared with Group A subjects who reported a median post TRUS biopsy pain intensity of 3 (2-5) (P = 0.014). A total of 72 men underwent TRUS-guided biopsy. All patients indicated they would be happy to have another TRUS-guided prostate biopsy in the future. CONCLUSION: Our study shows that Penthrox plus PILA shows promise as an efficacious and easily tolerated analgesic technique for outpatient TRUS biopsy, keeping resource use to a minimum. Planning for a multi-centre, double-blind randomized control trial comparing Penthrox plus PILA with PILA alone is presently underway.
[Mh] Termos MeSH primário: Lidocaína/administração & dosagem
Metoxiflurano/administração & dosagem
Manejo da Dor/métodos
Neoplasias da Próstata/diagnóstico por imagem
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Idoso
Anestésicos Inalatórios/administração & dosagem
Anestésicos Locais/administração & dosagem
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Autoadministração
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 0 (Anesthetics, Local); 30905R8O7B (Methoxyflurane); 98PI200987 (Lidocaine)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170123
[Lr] Data última revisão:
170123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150207
[St] Status:MEDLINE
[do] DOI:10.1111/ans.12974


  8 / 1806 MEDLINE  
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[PMID]:25446348
[Au] Autor:Shabbir A; Bianchetti E; Nistri A
[Ad] Endereço:Neuroscience Department, Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste, Italy. Electronic address: ashabbir@sissa.it.
[Ti] Título:The volatile anesthetic methoxyflurane protects motoneurons against excitotoxicity in an in vitro model of rat spinal cord injury.
[So] Source:Neuroscience;285:269-80, 2015 Jan 29.
[Is] ISSN:1873-7544
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Neuroprotection of the spinal cord during the early phase of injury is an important goal to determine a favorable outcome by prevention of delayed pathological events, including excitotoxicity, which otherwise extend the primary damage and amplify the often irreversible loss of motor function. While intensive care and neurosurgical intervention are important treatments, effective neuroprotection requires further experimental studies focused to target vulnerable neurons, particularly motoneurons. The present investigation examined whether the volatile general anesthetic methoxyflurane might protect spinal locomotor networks from kainate-evoked excitotoxicity using an in vitro rat spinal cord preparation as a model. The protocols involved 1h excitotoxic stimulation on day 1 followed by electrophysiological and immunohistochemical testing on day 2. A single administration of methoxyflurane applied together with kainate (1h), or 30 or even 60 min later prevented any depression of spinal reflexes, loss of motoneuron excitability, and histological damage. Methoxyflurane per se temporarily decreased synaptic transmission and motoneuron excitability, effects readily reversible on washout. Spinal locomotor activity recorded as alternating electrical discharges from lumbar motor pools was fully preserved on the second day after application of methoxyflurane together with (or after) kainate. These data suggest that a volatile general anesthetic could provide strong electrophysiological and histological neuroprotection that enabled expression of locomotor network activity 1 day after the excitotoxic challenge. It is hypothesized that the benefits of early neurosurgery for acute spinal cord injury (SCI) might be enhanced if, in addition to injury decompression and stabilization, the protective role of general anesthesia is exploited.
[Mh] Termos MeSH primário: Agonistas de Aminoácidos Excitatórios/toxicidade
Locomoção/efeitos dos fármacos
Metoxiflurano/farmacologia
Neurônios Motores/efeitos dos fármacos
Fármacos Neuroprotetores/farmacologia
Traumatismos da Medula Espinal/tratamento farmacológico
[Mh] Termos MeSH secundário: Potenciais de Ação/efeitos dos fármacos
Doença Aguda
Anestésicos Inalatórios/farmacologia
Animais
Morte Celular/efeitos dos fármacos
Morte Celular/fisiologia
Ácido Caínico/toxicidade
Locomoção/fisiologia
Neurônios Motores/patologia
Neurônios Motores/fisiologia
Ratos Wistar
Reflexo/efeitos dos fármacos
Reflexo/fisiologia
Medula Espinal/efeitos dos fármacos
Medula Espinal/patologia
Medula Espinal/fisiopatologia
Traumatismos da Medula Espinal/patologia
Traumatismos da Medula Espinal/fisiopatologia
Transmissão Sináptica/efeitos dos fármacos
Transmissão Sináptica/fisiologia
Fatores de Tempo
Técnicas de Cultura de Tecidos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 0 (Excitatory Amino Acid Agonists); 0 (Neuroprotective Agents); 30905R8O7B (Methoxyflurane); SIV03811UC (Kainic Acid)
[Em] Mês de entrada:1512
[Cu] Atualização por classe:150105
[Lr] Data última revisão:
150105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141203
[St] Status:MEDLINE


  9 / 1806 MEDLINE  
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[PMID]:24888759
[Au] Autor:Lee C; Woo HH
[Ad] Endereço:Summer Research Scholarship, The University of Sydney, Sydney, New South Wales, Australia.
[Ti] Título:Penthrox inhaler analgesia in transrectal ultrasound-guided prostate biopsy.
[So] Source:ANZ J Surg;85(6):433-7, 2015 Jun.
[Is] ISSN:1445-2197
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Periprostatic injection of local anaesthetic (PILA) has been shown to significantly reduce pain in patients undergoing transrectal ultrasound-guided prostate biopsy (TRUSPB). However, this method does not address pain that is associated with ultrasound probe insertion, and the injection of local anaesthetic itself causes pain. The aim of this study was to explore the efficacy of methoxyflurane delivered by a Penthrox inhaler as a novel method of pain relief during TRUSPB. METHOD: From July 2012 to July 2013, 64 patients were scheduled at a single centre to undergo TRUSPB while receiving analgesia via Penthrox inhaler. Fifteen minutes after the biopsy procedure, these patients were asked to complete a pain score survey using a 10-cm visual analogue scale (VAS) to separately report the degree of pain experienced during digital rectal examination (DRE), ultrasound probe insertion and core biopsy. RESULTS: The median pain scores on a 10-cm VAS were 2.0, 2.4 and 3.0 during DRE, probe insertion and needle biopsy, respectively, while using the Penthrox inhaler. Of the 64 patients, 11 had undergone TRUSPB previously receiving PILA. In these patients, PILA was significantly better than the Penthrox inhaler for pain relief during needle biopsy (median pain score 2.0 versus 4.0; P = 0.012). CONCLUSION: The Penthrox inhaler appears to be a safe and effective method of analgesia for TRUSPB. Patients who had experienced both PILA and Penthrox reported pain scores that significantly favoured PILA over the Penthrox inhaler.
[Mh] Termos MeSH primário: Anestésicos Inalatórios/administração & dosagem
Metoxiflurano/administração & dosagem
Nebulizadores e Vaporizadores
Próstata/patologia
Neoplasias da Próstata/patologia
Ultrassonografia de Intervenção
[Mh] Termos MeSH secundário: Adulto
Idoso
Biópsia/métodos
Esquema de Medicação
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Próstata/diagnóstico por imagem
Neoplasias da Próstata/diagnóstico por imagem
Estudos Retrospectivos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Inhalation); 30905R8O7B (Methoxyflurane)
[Em] Mês de entrada:1602
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140604
[St] Status:MEDLINE
[do] DOI:10.1111/ans.12694


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[PMID]:25229197
[Au] Autor:Ho CY; Berridge KC
[Ad] Endereço:Department of Psychology, University of Michigan, 525E University Street, Ann Arbor, MI, 48109-1109, USA.
[Ti] Título:Excessive disgust caused by brain lesions or temporary inactivations: mapping hotspots of the nucleus accumbens and ventral pallidum.
[So] Source:Eur J Neurosci;40(10):3556-72, 2014 Nov.
[Is] ISSN:1460-9568
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Disgust is a prototypical type of negative affect. In animal models of excessive disgust, only a few brain sites are known in which localized dysfunction (lesions or neural inactivations) can induce intense 'disgust reactions' (e.g. gapes) to a normally pleasant sensation such as sweetness. Here, we aimed to map forebrain candidates more precisely, to identify where either local neuronal damage (excitotoxin lesions) or local pharmacological inactivation (muscimol/baclofen microinjections) caused rats to show excessive sensory disgust reactions to sucrose. Our study compared subregions of the nucleus accumbens shell, ventral pallidum, lateral hypothalamus, and adjacent extended amygdala. The results indicated that the posterior half of the ventral pallidum was the only forebrain site where intense sensory disgust gapes in response to sucrose were induced by both lesions and temporary inactivations (this site was previously identified as a hedonic hotspot for enhancements of sweetness 'liking'). By comparison, for the nucleus accumbens, temporary GABA inactivations in the caudal half of the medial shell also generated sensory disgust, but lesions never did at any site. Furthermore, even inactivations failed to induce disgust in the rostral half of the accumbens shell (which also contains a hedonic hotspot). In other structures, neither lesions nor inactivations induced disgust as long as the posterior ventral pallidum remained spared. We conclude that the posterior ventral pallidum is an especially crucial hotspot for producing excessive sensory disgust by local pharmacological/lesion dysfunction. By comparison, the nucleus accumbens appears to segregate sites for pharmacological disgust induction and hedonic enhancement into separate posterior and rostral halves of the medial shell.
[Mh] Termos MeSH primário: Prosencéfalo Basal/fisiopatologia
Núcleo Accumbens/fisiopatologia
Percepção Gustatória/fisiologia
[Mh] Termos MeSH secundário: Tonsila do Cerebelo/efeitos dos fármacos
Tonsila do Cerebelo/fisiopatologia
Baclofeno/farmacologia
Prosencéfalo Basal/efeitos dos fármacos
Cateteres de Demora
Sacarose na Dieta/administração & dosagem
Fármacos atuantes sobre Aminoácidos Excitatórios/toxicidade
Comportamento Alimentar/fisiologia
Agonistas de Receptores de GABA-A/farmacologia
Agonistas dos Receptores de GABA-B/farmacologia
Região Hipotalâmica Lateral/efeitos dos fármacos
Região Hipotalâmica Lateral/fisiopatologia
Metoxiflurano/toxicidade
Muscimol/farmacologia
Núcleo Accumbens/efeitos dos fármacos
Estimulação Física
Proteínas Proto-Oncogênicas c-fos/metabolismo
Distribuição Aleatória
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Dietary Sucrose); 0 (Excitatory Amino Acid Agents); 0 (GABA-A Receptor Agonists); 0 (GABA-B Receptor Agonists); 0 (Proto-Oncogene Proteins c-fos); 2763-96-4 (Muscimol); 30905R8O7B (Methoxyflurane); H789N3FKE8 (Baclofen)
[Em] Mês de entrada:1507
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140918
[St] Status:MEDLINE
[do] DOI:10.1111/ejn.12720



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