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Biomedical subjects

V Bonicalzi

Publications and source records attributed to V Bonicalzi.

36 records · Page 2Linked to original sources
PubMed1998

The neurochemistry of central pain: evidence from clinical studies, hypothesis and therapeutic implications.

Recent evidence suggests that central pain, i.e., pain due to central nervous system damage, may be due to a deranged neurotransmission between the sensory thalamus and sensory cortical areas. Central pain can be controlled either by opposing glutamate neurotransmission or potentiating GABAergic transmission. It is speculated that a relative hypofunction of the GABAergic inhibition both at thalamic and cortical levels leads to a sectorial excitatory hypertonus in those same areas. A blend of the two should mark each patient. A pharmacological dissection approach is provided that should optimize the treatment, up to now globally poor, of central pain.

Anesthetics, Intravenous↗
PubMed1997

Lamotrigine reduces total postoperative analgesic requirement: a randomized double-blind, placebo-controlled pilot study.

BACKGROUND: Postoperative pain is undertreated. Lamotrigine, a new antiepileptic drug, has analgesic properties in its antisodium and antiglutamatergic effects. It may prevent postoperative pain. This pilot study assessed lamotrigine effects on postoperative pain. METHODS: This was a double-blind, randomized, placebo-controlled pilot study of 30 patients submitted to transurethral prostatectomy under spinal anesthesia and receiving 200 mg of lamotrigine 1 hour before spinal anesthesia. RESULTS: We observed a statistically significant reduction in total analgesic assumption (p < 0.01) and in visual analog scale scores at 2 (p = 0.04), 4 (p < 0.01), and 6 (p = 0.04) hours after operation. CONCLUSIONS: Lamotrigine may be an effective means of reducing postoperative pain.

Adenoma↗
PubMed1997

Central neurogenic pruritus: a literature review.

Central neurogenic pruritus is a rare symptom of central nervous system lesions, such as brain strokes, spinal tumors and multiple sclerosis. Only 26 cases appear in the literature. A further case is added. On the basis of similar features, it is speculated that central pruritus and central pain share a common origin.

Adult↗
PubMed1995

Propofol analgesia in central pain: preliminary clinical observations.

Propofol, an intravenous general anaesthetic, has been reported to relieve some forms of pruritus at subhypnotic doses. We assessed its effectiveness in 32 patients with several kinds of non-malignant chronic pain, in a placebo-controlled, double-blind study. We found that central pain, but not neuropathic pain, is at least partially controlled by propofol at subhypnotic doses, without major side-effects. In particular, allodynia associated with central, but no neuropathic, pain has been completely controlled. Propofol analgesia leads to renormalization of brain metabolism as seen on single photon emission computed tomography. We conclude that propofol may help in the diagnosis of central pain, particularly in unclear cases, and also in treatment. Possible mechanisms of action are discussed.

Adult↗
PubMed1995

Comparison of two regional anesthetic techniques for knee arthroscopy.

This study compares the efficacy of "3-in-1 block" versus femoral nerve block for knee arthroscopy. One-hundred patients had a 3-in-1 block; 180 patients had a femoral nerve block. The 3-in-1 block provided anesthesia in 75 patients; 20 patients needed supplementary local anesthesia. Five patients required a general anesthesia to complete the operation. The femoral nerve block was effective in 88 patients; 90 patients needed intravenous flunitrazepam and/or fentanyl; 2 patients needed general anesthesia. The 3-in-1 block provided more satisfactory muscle relaxation and a longer postoperative analgesia than femoral nerve block. No side effects were recorded in either group. Our results suggest that the 3-in-1 block is the most effective technique of regional anesthesia for knee arthroscopy.

Adult↗
PubMed1993

The role of cortex in central pain syndromes: preliminary results of a long-term technetium-99 hexamethylpropyleneamineoxime single photon emission computed tomography study.

The role of the somatosensory cortex in central pain syndromes is widely questioned. Two recent position emission tomography studies detected a strong activation of the parietal and cingular cortices after brief nociceptive stimuli. On the other hand, a recent single photon emission computed tomography study found no cortical activation in five patients affected by central poststroke pain and algodystrophia. In this study, we present the single photon emission computed tomography findings in five patients suffering from central pain syndromes. Two of these, one with facial postrhizotomy anesthesia dolorosa and the other with central poststroke pain, showed a decrease of blood flow in the parietal lobe, further decreasing after stimulation by nonpainful maneuvers. Our results suggest that somatosensory cortical areas might be involved in the generation of anomalous pain states in some cases of central pain syndromes.

Adult↗
PubMed1992

[Metabolic and water-electrolyte changes as postoperative complications in aneurysms of the anterior communicating artery].

A study was performed on hydroelectrolytic changes in neurosurgical patients operated for clipping anterior communicating artery aneurysm. The patients were observed during a seven day period in ICU, between the preoperative day and the sixth post-operative day. No statistically significant changes were observed, except for hyponatriemia on the day of surgery. The etiology of this phenomenon is not clear: it could be a change of ADH or "cerebral salt wasting syndrome". A wider number of patients and repeated haematological tests are necessary.

Adult↗
PubMedDate not supplied

Intravenous subhypnotic propofol in central pain: a double-blind, placebo-controlled, crossover study.

OBJECTIVE: To validate IV subhypnotic propofol, a gamma-aminobutyric acid A (GABA-A) agonist, as a diagnostic test for central pain. METHODS: The efficacy of systemic propofol (0.2 mg/kg IV bolus) was evaluated in a double-blind, placebo-controlled and crossover fashion on both spontaneous ongoing pain and allodynia in 44 patients with chronic central pain of both brain and cord origin. RESULTS: Propofol was significantly superior to the placebo (Intralipid, Kabi Pharmacia) in reducing the intensity of spontaneous ongoing pain for up to 1 hour after the injection: 24 of 44 patients (55%) receiving propofol showed a significant reduction in spontaneous pain, whereas only 6 patients showed this after the placebo. Propofol also significantly reduced the intensity of both mechanical and cold allodynia. In a few cases, only the evoked components were abolished but not the spontaneous pain. In general, the side effects were minimal and consisted mainly of transitory burning upon injection of both propofol and placebo and slight lightheadedness in a few cases. CONCLUSIONS: Systemic propofol induces analgesic effects on all studied components of central pain and highlights the key role of GABA modulation in central pain.

Adult↗