Language：English   Publishing type：Research paper (scientific journal)  

Quercetin is a flavonoid widely found in plants and marketed to the public as a supplement. Several studies have reported its effect on glial cells. This study aimed to examine the effect of quercetin on the development of neuropathic pain and the underlying mechanism in a spared nerve injury (SNI) rat model. Male Sprague-Dawley rats randomly assigned to the control or the quercetin group were subjected to SNI of the sciatic nerve. We measured pain behaviors on the hind paw and glial fibrillary acidic protein (GFAP) in the dorsal root ganglion (DRG) and spinal cord. Oral administration of 1% quercetin, begun before surgery, attenuated mechanical allodynia compared to the control group at days 7 and 10 after SNI. On the other hand, established pain was not attenuated in a post-dose group in which quercetin was begun 7 days after SNI. Quercetin inhibited GFAP in the satellite glial cells of the ipsilateral L5 DRG on day 7 compared to the control group. Quercetin suppressed the development of neuropathic pain through a mechanism partly involving the inhibition of satellite glial cells. As its safety is well established, quercetin has great potential for clinical use in pain treatment.

DOI： 10.18926/AMO/56243

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

We conducted this study to determine the short-term treatment outcomes of multidisciplinary approaches to chronic pain management for outpatients in Japan. We evaluated pain reduction and improvement in quality of life (QOL) after treatment. We analyzed 32 patients who had experienced intractable chronic pain for > 3 months. The patients received multidisciplinary therapeutic self-managed exercise instructions and then underwent evaluations 1 and 3 months after the treatment. We used the Pain Disability Short Form-36 (SF-36), Pain Catastrophizing Scale (PCS), and Pain Disability Assessment Scale (PDAS) to evaluate QOL. Although the pain levels were the same before and after the physical exercise program, the patients showed significant improvements in physical function on the SF-36 (48.5 vs. 54.5, 3 months vs. 1 month; p=0.0124), the magnification subscale on the PCS (6.8 vs. 5.9, 1 month vs. before; p=0.0164) and the PDAS (29.2 vs. 23.4, 3 months vs. before; p=0.0055). Chronic pain should be treated with a biopsychosocial approach, but time constraints and costs have limited the implementation of multidisciplinary and behavioral approaches to chronic pain management. Our findings demonstrate that clinical improvements are possible for patients with chronic pain, using multidisciplinary team resources widely available in Japanese clinical practice.

DOI： 10.18926/AMO/56169

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

Aim of investigation: Pulsed radiofrequency (PRF) is a safe and effective approach for treating neuropathic pain. However, the optimal treatment conditions and analgesic mechanisms of PRF remain unclear. The aim of our study was to assess the beneficial and adverse effects of prolonged-duration PRF and the analgesic mechanisms of PRF treatment with neuropathic pain rats. Methods: Male Sprague Dawley rats received L5 spinal nerve ligation (SNL) for developing neuropathic pain. Fourteen days after L5 SNL surgery, they were divided into three groups according to duration of PRF current for 6 minutes, 12 minutes, and none. PRF current was delivered via direct visualization adjacent to the L5 dorsal root ganglion (DRG). Pain behavior was evaluated every week after L5 SNL surgery, until day 28. Seven days after PRF treatment, L5 DRG tissue was harvested to detect levels of activating translation factor 3 (ATF3; a marker of neuronal damage) and hyperpolarization-activated cyclic nucleotide (HCN)-gated cation channels (key factors in neuropathic pain) using quantitative PCR. Results: Before PRF application, withdrawal thresholds were significantly lower than at baseline and did not differ significantly between the three groups. After PRF application, withdrawal thresholds in the PRF6 and PRF12 groups were significantly increased compared to those in the sham group. However, those in the PRF6 and PRF12 groups did not differ significantly. The expression level of ATF3 mRNA in the PRF12 group was significantly higher than that in the sham group (P<0.01), but the expression of HCN1 and HCN2 channels did not differ significantly between the three groups. Conclusion: Prolonged PRF exposure, from 6 to 12 minutes, was not only ineffective but also associated with increased neuronal damage. These findings do not support prolonged PRF exposure as a helpful treatment for neuropathic pain. In this study, the involvement of HCN channels in the antiallodynic effects of PRF was uncertain.

DOI： 10.2147/JPR.S168064

PubMed

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：日本慢性疼痛学会  

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Language：Japanese   Publisher：真興交易(株)医書出版部  

帯状疱疹後神経痛は難治性であり、日常生活に支障をきたすため、発症予防や有効な治療が求められている。内服治療や神経ブロック治療に抵抗性の帯状疱疹後神経痛の治療手段の一つとして脊髄刺激療法があるが、有効性を示すエビデンスは乏しいのが現状である。一方で、近年、帯状疱疹後神経痛への移行を予防する帯状疱疹亜急性期に一時的脊髄刺激療法を行うことの有効性の報告が増えている。今後は、脊髄刺激装置の機器の進歩に伴い、有用性が高まる可能性があり、注視していく必要がある。(著者抄録)

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Language：Japanese   Publisher：真興交易(株)医書出版部  

眼窩下神経ブロックを繰り返し行うことで上顎骨損傷が起こり、治療に難渋した症例を経験した。症例は72歳、男性。右第2枝三叉神経痛に対して眼窩下神経ブロックを行っていたが、回数を重ねるごとに複数回の神経ブロックを要するようになり、効果の持続期間も短縮した。3D-CTを確認したところ、眼窩下孔の拡大が認められた。超音波ガイド下で眼窩下動脈を目印として神経ブロックを行うことで安定した効果が得られるようになった。(著者抄録)

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本運動器疼痛学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(一社)日本ペインクリニック学会  

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Language：Japanese   Publisher：(株)南山堂  

＜Key Points＞敗血症の中でも敗血症性ショックでは、組織低酸素状態による乳酸アシドーシスを生じることが多く、乳酸クリアランスは治療目標の一つである。敗血症では高クロール性代謝性アシドーシスが生じることが多く、特に生理食塩液の大量輸液には注意が必要である。敗血症では弱酸であるアルブミンが低下していることが多く、酸塩基平衡の解釈に注意が必要である。敗血症では高率に急性腎不全を合併しているため、不揮発性酸の蓄積により代謝性アシドーシスが生じていることが多い。(著者抄録)

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Language：Japanese   Publisher：日本臨床麻酔学会  

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Language：Japanese   Publisher：(一社)日本心臓血管麻酔学会  

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Language：Japanese   Publisher：(一社)日本心臓血管麻酔学会  

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Language：Japanese   Publisher：(一社)日本心臓血管麻酔学会  

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Language：Japanese   Publisher：(一社)日本集中治療医学会  

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Language：Japanese   Publisher：(一社)日本集中治療医学会  

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Language：Japanese   Publisher：日本蘇生学会  

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