PubMed Health⌕ Search

Biomedical subjects

E P Vandermeulen

Publications and source records attributed to E P Vandermeulen.

5 recordsLinked to original sources
PubMed2000

Alterations in ascending dorsal horn neurons by a surgical incision in the rat foot.

BACKGROUND: Little is known about the mechanisms of pain caused by a surgical incision. The authors have developed a rat model of postoperative pain characterized by decreased withdrawal thresholds to punctate mechanical stimuli after plantar incision. The present studies examined the response characteristics of dorsal horn neurons receiving input from the plantar aspect of the foot before and after a plantar incision placed adjacent to the low threshold area of the receptive field (RF). METHODS: Individual dorsal horn neurons from the lumbar enlargement were antidromically identified and characterized as low threshold, wide dynamic range (WDR), and high threshold (HT) based on their responses to brush and pinch. Thresholds (in millinewtons), the pinch RF, and stimulus-response functions (SRFs) to von Frey filaments characterized the neurons. SRFs were analyzed using area under the curve. Changes in background activity, punctate mechanical thresholds, SRFs, and RF were recorded after an incision was made adjacent to the most sensitive area of the RF. RESULTS: In all cells, an incision increased background activity; this remained elevated in 3 of 9 HT and 16 of 28 WDR neurons 1 h later. The SRFs were enhanced in 10 of 27 WDR neurons and in 2 of 8 HT cells after incision. Only the WDR neurons were responsive to filaments that produced withdrawal responses after incision in behavioral experiments. Increases in the RFs outside of the injured area occurred after incision in 15 of 29 WDR and 2 of 9 HT cells. CONCLUSION: A plantar incision caused dorsal horn cell activation and central sensitization. Because the threshold of HT neurons did not decrease to the range of the withdrawal responses in behavioral experiments, particular WDR dorsal horn neurons likely contribute to the reduced withdrawal threshold observed in behavioral experiments. Both WDR and HT neurons are capable of transmitting enhanced responses to strong punctate mechanical stimuli after incision.

Animals↗
PubMed1997

Intravenous administration of tenoxicam 40 mg for post-operative analgesia: a double-blind, placebo-controlled multicentre study.

The analgesic efficacy of tenoxicam, a newer injectable non-steroidal anti-inflammatory drug, for post-operative analgesia after abdominal or orthopaedic surgery in ASA Grade I/II patients is reported. Two hundred and fifty-six patients received a single dose of tenoxicam 40 mg intravenous (i.v.) at the end of surgery and this was repeated 24 h later. These patients were compared, with respect to pain or adverse events, with 258 patients that received placebo. All patients were monitored for the next 72 h. Overall, tenoxicam provided reliable analgesia with comparable pain scores at rest, moving and coughing. The cumulative rescue PCA-morphine consumption was always lower in the tenoxicam treated patients and was most marked at 4 and 24 h after the second injection of tenoxicam. This effect was more pronounced after abdominal surgery. The intravenous administration of tenoxicam was associated with a low incidence of adverse events and a high tolerability.

Abdomen↗
PubMed1995

Labor pain relief using bupivacaine and sufentanil: patient controlled epidural analgesia versus intermittent injections.

OBJECTIVES: To determine whether the use of patient-controlled epidural analgesia (PCEA) versus intermittent injections (CIT) resulted in local anesthetic dose reduction. STUDY DESIGN: PCEA and CIT using a mixture of 0.125% bupivacaine with sufentanil 1 or 0.75 microgram/ml were compared in 60 and 195 parturients, respectively. Assessments included pain scores, local anesthetic consumption, degree of motor blockade, type of delivery and neonatal outcome. Statistical analysis was done using Student's t test and Chi-squares. RESULTS: PCEA and CIT provided effective analgesia during labor and delivery. A higher dose of opioid significantly reduced the use of local anesthetic solution in PCEA-patients. There was no difference in motor blockade, type of delivery and neonatal outcome. CONCLUSION: Patient-controlled epidural analgesia is an effective, safe and acceptable alternative to conventional intermittent epidural injections for pain relief during labor and delivery.

Adult↗
PubMed1994

[Nociceptive modulation during intravenous anesthesia].

The surgical stress can be defined as a complex array of neuroendocrine, haemodynamic, metabolic and inflammatory changes following surgical injury. These responses, when excessive, may contribute to increased postoperative morbidity and mortality. Thus a major endpoint of general anaesthesia is to protect the patient against the noxious stress response components. The different classes of anaesthetic or associated drugs are reviewed in this respect: sedative/hypnotics (barbiturates, etomidate, propofol, benzodiazepines), opioids, alpha-2 adrenergic agonists (clonidine), non-steroidal antiinflammatory drugs, intravenous local anaesthetics. Central and peripheral sensitization phenomenons--ie the sympathoadrenal response to surgery--might likely be efficiently attenuated by preemptive analgesia, and/or well-designed computer-guided total intravenous anaesthesia. 119 references complete this review.

Adrenergic beta-Antagonists↗