Background: Central sensitization is modulated by the endogenous opioid system and plays a major role in the development and maintenance of pain. Recent animal studies performed following resolution of inflammatory pain showed reinstatement of tactile hypersensitivity induced by administration of a mu-opioid-antagonist, suggesting latent sensitization is mediated by endogenous opioids. In a recent crossover study in healthy volunteers, following resolution of a first-degree burn, 4 out of 12 volunteers developed large secondary areas of hyperalgesia areas after a naloxone infusion, while no volunteer developed significant secondary hyperalgesia after the placebo infusion. In order to consistently demonstrate latent sensitization in humans, a pain model inducing deep tissue inflammation, as used in animal studies, might be necessary. The aim of the present study is to examine whether a high-dose target-controlled naloxone infusion can reinstate pain and hyperalgesia following recovery from open groin hernia repair and thus consistently demonstrate opioid-mediated latent sensitization in humans.Methods/DesignPatients submitted to unilateral, primary, open groin hernia repair will be included in this randomized, placebo-controlled, double-blind, crossover study. The experimental days take place 6–8 weeks after surgery, time-points at which patients are expected to be almost pain- free. Prior to administration of naloxone or placebo, the primary outcome (a summated measure of pain: at rest, during transition from supine to standing position, and evoked by pressure algometry) and the secondary outcomes (secondary hyperalgesia/allodynia, pressure pain thresholds, assessed at the surgical site and at the mirror-site in the contralateral groin, and, opioid withdrawal symptoms) will be assessed. These assessments will be repeated at each step of the target-controlled infusion of placebo or naloxone at estimated median (95 % CI) plasma concentrations of 344 ng/ml (130;567), 1059 ng/ml (400;1752) and 3196 ng/ml (1205;5276).DiscussionWe aim to demonstrate opioid-mediated latent sensitization in a post-surgical setting, using pain as a clinical relevant variable. Impairment of the protective endogenous opioid system may play an important role in the transition from acute to chronic pain. In order to sufficiently block the endogenous opioid system, a high-dose target-controlled naloxone-infusion is used, in accordance with recent findings in animal studies.Trial registration numberEUDRACT: 2015-000793-36 (Registration date: 16 February 2015)Clinicaltrials.gov: NCT01992146 (Registration date: 12 December 2014)
from #Medicine via ola Kala on Inoreader http://ift.tt/1li8AZP
via IFTTT
Αρχειοθήκη ιστολογίου
-
►
2023
(138)
- ► Φεβρουαρίου (74)
- ► Ιανουαρίου (64)
-
►
2022
(849)
- ► Δεκεμβρίου (61)
- ► Σεπτεμβρίου (74)
- ► Φεβρουαρίου (65)
-
►
2021
(2936)
- ► Δεκεμβρίου (59)
- ► Σεπτεμβρίου (180)
- ► Φεβρουαρίου (325)
-
►
2020
(1624)
- ► Δεκεμβρίου (293)
- ► Σεπτεμβρίου (234)
- ► Φεβρουαρίου (28)
-
►
2019
(13362)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (5586)
- ► Ιανουαρίου (5696)
-
►
2018
(66471)
- ► Δεκεμβρίου (5242)
- ► Σεπτεμβρίου (5478)
- ► Φεβρουαρίου (4835)
- ► Ιανουαρίου (5592)
-
►
2017
(44259)
- ► Δεκεμβρίου (5110)
- ► Σεπτεμβρίου (5105)
-
►
2016
(7467)
- ► Δεκεμβρίου (514)
- ► Σεπτεμβρίου (1038)
- ► Φεβρουαρίου (793)
-
▼
2015
(2119)
- ► Δεκεμβρίου (940)
-
▼
Νοεμβρίου
(765)
-
▼
Νοε 10
(50)
- Sensors, Vol. 15, Pages 28271-28286: Real-Valued C...
- Remote Sensing, Vol. 7, Pages 14988-15013: A Compa...
- A qualitative evidence synthesis on the management...
- Adherence to competing strategies for colorectal c...
- Lateral approach liver hanging maneuver in laparos...
- Meta-analysis of laparoscopic surgery for recurren...
- Identification of novel anti-hepatitis C virus age...
- Angiogenesis and vascular endothelial growth facto...
- Dexmedetomidine versus morphine infusion following...
- Tripterygium wilfordii hook F as maintenance treat...
- Variation in treatment priorities for chronic hepa...
- Randomized comparison of surveillance intervals in...
- Positive regulation of β-catenin–PROX1 signaling a...
- Prognostic factors for progression-free and overal...
- Prospective cohort study comparing transient EUS g...
- Palliative chemotherapy for patients 70 years of a...
- Influence of the intervention of exercise on obese...
- Characteristics of colonoscopic findings in the ve...
- Changes in insulin sensitivity and secretion after...
- Prevalence of pathogenic mutations in cancer predi...
- Current status of immunomodulatory therapy in chro...
- Blunting of colon contractions in diabetics with g...
- Family physicians’ intention to support women in m...
- Sharp-Hook Acupuncture (Feng Gou Zhen) for Patient...
- Cross-Sectional Study of Respiratory Symptoms, Spi...
- JFMK, Vol. 1, Pages 16-29: Clinical Kinesiology an...
- Insects, Vol. 6, Pages 943-960: Mating Success, Lo...
- Genes, Vol. 6, Pages 1201-1214: Identification of ...
- Graded Resistance Exercise And Type 2 Diabetes in ...
- Effect of a high-dose target-controlled naloxone i...
- Automated analysis of single cells using Laser Twe...
- Information, Vol. 6, Pages 733-749: Digital Inform...
- IJMS, Vol. 16, Pages 26880-26913: Therapeutic Impl...
- IJMS, Vol. 16, Pages 26871-26879: Identification o...
- IJMS, Vol. 16, Pages 26850-26870: Augmenting the A...
- Inorganics, Vol. 3, Pages 500-510: Holmium(III) Su...
- IJMS, Vol. 16, Pages 26880-26913: Therapeutic Impl...
- IJMS, Vol. 16, Pages 26871-26879: Identification o...
- IJMS, Vol. 16, Pages 26850-26870: Augmenting the A...
- IJMS, Vol. 16, Pages 26832-26849: Single-Cell Isol...
- IJERPH, Vol. 12, Pages 14312-14326: Kinetics and M...
- IJERPH, Vol. 12, Pages 14301-14311: Exposure to Ai...
- IJERPH, Vol. 12, Pages 14285-14300: Arsenic and Ot...
- IJMS, Vol. 16, Pages 26832-26849: Single-Cell Isol...
- Drug Delivery Using Novel Biological and Synthetic...
- Exploring Clinical and Epidemiological Characteris...
- Changes of Plantar Pressure and Gait Parameters in...
- Senescence-Associated Changes in Proteome and O-Gl...
- Selection of the Strain Lactobacillus acidophilus ...
- Cancers, Vol. 7, Pages 2262-2276: Differences in R...
-
▼
Νοε 10
(50)
Αναζήτηση αυτού του ιστολογίου
Τρίτη 10 Νοεμβρίου 2015
Effect of a high-dose target-controlled naloxone infusion on pain and hyperalgesia in patients following groin hernia repair: study protocol for a randomized controlled trial
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
-
Αλέξανδρος Γ. Σφακιανάκης Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,0030693260717...
-
heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
-
Alimentary Pharmacology &Therapeutics, EarlyView. https://ift.tt/2qECBIJ
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου
Σημείωση: Μόνο ένα μέλος αυτού του ιστολογίου μπορεί να αναρτήσει σχόλιο.