Ultimo Aggiornamento: 31 Dicembre 2002

Anesthesiology 2001 Dec;95(6):1467-1472

Inhalation Anesthetics Induce Apoptosis in Normal Peripheral Lymphocytes In Vitro.

Matsuoka H, Kurosawa S, Horinouchi T, Kato M, Hashimoto Y

Submitted for publication February 22, 2001.

[Record supplied by publisher]

BACKGROUND: The authors hypothesized that perioperative lymphocytopenia is partially caused by apoptosis of lymphocytes induced by inhalation anesthetics. Therefore, they evaluated whether sevoflurane and isoflurane induce apoptosis of normal peripheral lymphocytes. METHODS: Normal peripheral blood mononuclear cells were exposed to sevoflurane and isoflurane, and the percentages of apoptotic lymphocytes was measured by Annexin V-fluorescein isothiocyanate-7-amino actinomycin D flow cytometry after 24 h of exposure (0.5, 1.0, and 1.5 mm) and after 6, 12, and 24 h of exposure (1.5 mm). The percentages of lymphocytes with caspase 3-like activity were also measured after 24 h of exposure (1.5 mm). RESULTS: The percentages of apoptotic lymhocytes were increased in a dose-dependent manner (controls: 5.1 +/- 1.4%; sevo-flurane: 7.3 +/- 1.3% [0.5 mm], 9.1 +/- 1.5% [1.0 mm], 12.6 +/- 2.1% [1.5 mm]; isoflurane: 7.5 +/- 1.6% [0.5 mm], 10.5 +/- 1.5% [1.0 mm], 16.3 +/- 2.7% [1.5 mm]) after 24 h of exposure and in a time-dependent manner (controls: 1.2 +/- 0.4% [6 h], 3.4 +/- 0.7% [12 h], 5.6 +/- 1.2% [24 h]; sevoflurane: 1.8 +/- 0.4% [6 h], 6.4 +/- 1.2% [12 h], 11.3 +/- 2.2% [24 h]; isoflurane: 2.6 +/- 0.5% [6 h], 8.8 +/- 1.5% [12 h],16.0 +/- 1.9% [24 h]) at the concentration of 1.5 mm. The percentages of lymphocytes with caspase 3-like activity were increased (controls: 10.0 +/- 1.1%; sevoflurane: 13.8 +/- 1.2%; isoflurane: 17.0 +/- 1.3%). CONCLUSIONS: Both sevoflurane and isoflurane induced apoptosis in peripheral lymphocytes in dose-dependent and time-dependent manner s in vitro.

PMID: 11748407

Anesthesiology 2001 Dec;95(6):1435-1340

Anesthetic Effects on Mitochondrial ATP-sensitive K Channel.

Kohro S, Hogan QH, Nakae Y, Yamakage M, Bosnjak ZJ

Submitted for publication January 16, 2001.

[Record supplied by publisher]

BACKGROUND: Volatile anesthetics show an ischemic preconditioning-like cardioprotective effect, whereas intravenous anesthetics have cardioprotective effects for ischemic-reperfusion injury. Although recent evidence suggests that mitochondrial adenosine triphosphate-regulated potassium (mitoKATP) channels are important in cardiac preconditioning, the effect of anesthetics on mitoKATP is unexplored. Therefore, the authors tested the hypothesis that anesthetics act on the mitoKATP channel and mitochondrial flavoprotein oxidation. METHODS: Myocardial cells were isolated from adult guinea pigs. Endogenous mitochondrial flavoprotein fluorescence, an indicator of mitochondrial flavoprotein oxidation, was monitored with fluorescence microscopy while myocytes were exposed individually for 15 min to isoflurane, sevoflurane, propofol, and pentobarbital. The authors further investigated the effect of 5-hydroxydeanoate, a specific mitoKATP channel antagonist, on isoflurane- and sevoflurane-induced flavoprotein oxidation. Additionally, the effects of propofol and pentobarbital on isoflurane-induced flavoprotein oxidation were measured. RESULTS: Isoflurane and sevoflurane induced dose-dependent increases in flavoprotein oxidation (isoflurane: R2 = 0.71, n = 50; sevoflurane: R2 = 0.86, n = 20). The fluorescence increase produced by both isoflurane and sevoflurane was eliminated by 5-hydroxydeanoate. Although propofol and pentobarbital showed no significant effects on flavoprotein oxidation, they both dose-dependently inhibited isoflurane-induced flavoprot ein oxidation. CONCLUSIONS: Inhalational anesthetics induce flavoprotein oxidation through opening of the mitoKATP channel. This may be an important mechanism contributing to anesthetic-induced preconditioning. Cardioprotective effects of intravenous anesthetics may not be dependent on flavoprotein oxidation, but the administration of propofol or pentobarbital may potentially inhibit the cardioprotective effect of inhalational anesthetics.

PMID: 11748403

Anesthesiology 2001 Dec;95(6):1422-1426

Isoflurane and Sevoflurane Anesthesia in Pigs with a Preexistent Gas Exchange Defect.

Kleinsasser A, Lindner KH, Hoermann C, Schaefer A, Keller C, Loeckinger A

Submitted for publication November 2, 2000.

[Record supplied by publisher]

BACKGROUND: Decreased arterial partial pressure of oxygen (Pao2) during volatile anesthesia is well-known. Halothane has been examined with the multiple inert gas elimination technique and has been shown to alter the distribution of pulmonary blood flow and thus Pao2. The effects of isoflurane and sevoflurane on pulmonary gas exchange remain unknown. The authors hypothesized that sevoflurane with a relatively high minimum alveolar concentration (MAC) would result in significantly more gas exchange disturbances in comparison with isoflurane or control. METHODS: This study was performed in a porcine model with an air pneumoperitoneum that generates a reproducible gas exchange defect. After a baseline measurement of pulmonary gas exchange (multiple inert gas elimination technique) during propofol anesthesia, 21 pigs were randomly assigned to three groups of seven animals each. One group received isoflurane anesthesia, one group received sevoflurane anesthesia, and one group was continued on propofol anesthesia (control). After 30 min of volatile anesthesia at 1 MAC or propofol anesthesia, a second measurement (multiple inert gas elimination technique) was performed. RESULTS: At the second measurement, inert gas shunt was 15 +/- 3% (mean +/- SD) during sevoflurane anesthesia versus 9 +/- 1% during propofol anesthesia (P = 0.02). Blood flow to normal ventilation/perfusion (VA/Q) lung areas was 83 +/- 5% during sevoflurane anesthesia versus 89 +/- 1% during propofol anesthesia (P = 0.04). This resulted in a Pao2 of 88 +/- 11 mmHg during sevoflurane anesthesia versus 102 +/- 15 mmHg during propofol anesthesia (P = 0.04). Inert gas and blood gas variables during isoflurane anesthesia did not differ significantly from those obtained during propofol anesthesia. CONCLUSIONS: In pigs with an already existent gas exchange defect, sevoflurane anesthesia but not isoflurane anesthesia causes significantly more gas exchange disturbances than propofol anesthesia does.

PMID: 11748401

Anesthesiology 2001 Dec;95(6):1406-1413

Ketamine Blockade of Voltage-gated Sodium Channels: Evidence for a Shared Receptor Site with Local Anesthetics.

Wagner LE 2nd, LE, Gingrich KJ, Kulli JC, Yang J

Submitted for publication March 26, 2001.

[Record supplied by publisher]

BACKGROUND: The general anesthetic ketamine is known to be an N-methyl-d-aspartate receptor blocker. Although ketamine also blocks voltage-gated sodium channels in a local anesthetic-like fashion, little information exists on the molecular pharmacology of this interaction. We measured the effects of ketamine on sodium channels. METHODS: Wild-type and mutant (F1579A) recombinant rat skeletal muscle sodium channels were expressed in Xenopus oocytes. The F1579A amino acid substitution site is part of the intrapore local anesthetic receptor. The effect of ketamine was measured in oocytes expressing wild-type or mutant sodium channels using two-electrode voltage clamp. RESULTS: Ketamine blocked sodium channels in a local anesthetic-like fashion, exhibiting tonic blockade (concentration for half-maximal inhibition [IC50] = 0.8 mm), phasic blockade (IC50 = 2.3 mm), and leftward shift of the steady-state inactivation; the parameters of these actions were strongly modified by alteration of the intrapore local anesthetic binding site (IC50 = 2.1 mm and IC50 = 10.3 mm for tonic and phasic blockade, respectively). Compared with lidocaine, ketamine showed greater tonic inhibition but less phasic blockade. CONCLUSIONS: Ketamine interacts with sodium channels in a local anesthetic-like fashion, including sharing a binding site with commonly used clinical local anesthetics.

PMID: 11748399

Anesthesiology 2001 Dec;95(6):1351-1355

The Effect of Prone Positioning on Intraocular Pressure in Anesthetized Patients.

Cheng MA, Todorov A, Tempelhoff R, McHugh T, Crowder CM, Lauryssen C

Submitted for publication March 12, 2001.

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BACKGROUND: Ocular perfusion pressure is commonly defined as mean arterial pressure minus intraocular pressure (IOP). Changes in mean arterial pressure or IOP can affect ocular perfusion pressure. IOP has not been studied in this context in the prone anesthetized patient. METHODS: After institutional human studies committee approval and informed consent, 20 patients (American Society of Anesthesiologists physical status I-III) without eye disease who were scheduled for spine surgery in the prone position were enrolled. IOP was measured with a Tono-pen(R) XL handheld tonometer at five time points: awake supine (baseline), anesthetized (supine 1), anesthetized prone (prone 1), anesthetized prone at conclusion of case (prone 2), and anesthetized supine before w ake-up (supine 2). Anesthetic protocol was standardized. The head was positioned with a pinned head-holder. Data were analyzed with repeated-measures analysis of variance and paired t test. RESULTS: Supine 1 IOP (13 +/- 1 mmHg) decreased from baseline (19 +/- 1 mmHg) (P < 0.05). Prone 1 IOP (27 +/- 2 mmHg) increased in comparison with baseline (P < 0.05) and supine 1 (P < 0.05). Prone 2 IOP (40 +/- 2 mmHg) was measured after 320 +/- 107 min in the prone position and was significantly increased in comparison with all previous measurements (P < 0.05). Supine 2 IOP (31 +/- 2 mmHg) decreased in comparison with prone 2 IOP (P < 0.05) but was relatively elevated in comparison with supine 1 and baseline (P < 0.05). Hemodynamic and ventilatory parameters remained unchanged during the prone period. CONCLUSIONS: Prone positioning increases IOP during anesthesia. Ocular perfusion pressure could therefore decrease, despite maintenance of normotension.

PMID: 11748391

Anesthesiology 2001 Dec;95(6):1315-1322

Assessing Pediatric Anesthesia Practices for Volunteer Medical Services Abroad.

Fisher QA, Nichols D, Stewart FC, Finley GA, Magee WP Jr, WP, Nelson K

Submitted for publication August 14, 2000.

[Record supplied by publisher]

BACKGROUND: Anesthetic techniques and problems in volunteer medical services abroad are different from those of either the developed countries from which volunteers originate or the host country in which they serve because of differences in patient population, facilities, and goals for elective surgery. Assessing outcomes is hampered by the transience of medical teams and the global dispersion of providers. We studied general anesthesia techniques and outcomes in a large international voluntary surgical program. METHODS: Anesthesia providers and nurs es participating in care of patients undergoing reconstructive plastic and orthopedic surgery by Operation Smile over an 18-month period were asked to complete a quality assurance data record for each case. Incomplete data were supplemented by reviewing the original patient records. RESULTS: General anesthesia was used in 87.1% of the 6,037 cases reviewed. The median age was 5 yr (25th-75th percentiles: 2-9 yr). Orofacial clefts accounted for more than 80% of procedures. Halothane mask induction was performed in 85.6% of patients; 96.3% of patients had tracheal intubation, which was facilitated with a muscle relaxant in 19.3%. Respiratory complications occurred during anesthesia in 5.0% of patients and during recovery (postanesthesia care unit) in 3.3%. Arrhythmias requiring therapy occurred in 1.5%, including three patients to whom cardiopulmonary resuscitation was administered. Prolonged ventilatory support was required in seven patients. There was one death. Inadvertent extubation during surgery occurred in 38 patients. Cancellation of surgery after induction of anesthesia occurred in 25 patients. Overall, complications were more common in younger children. CONCLUSIONS: Our study showed that in this setting it is feasible to track anesthesia practice patterns and adverse perioperative events. We identified issues for further examination.

PMID: 11748386

Anesthesiology 2001 Dec;95(6):1313-1314

Echocardiography and Anesthesiology Successes and Challenges.

Thys DM

[Record supplied by publisher]

PMID: 11748385

Can J Anaesth 2001 Dec;48(11):1168-1169

The prediction of effect of lumbar epidural anesthesia.

Arakawa M, Aoyama Y, Ohe Y

Tokyo, Japan.

[Record supplied by publisher]

PMID: 11744598

Can J Anaesth 2001 Dec;48(11):1167

[2] Web-Based Systems in Anesthesia: A New Series in CJA New Media.

Doyle DJ

Toronto, Ontario.

[Record supplied by publisher]

PMID: 11744597

Can J Anaesth 2001 Dec;48(11):1165-1167

[1] Clinical Workgroups on the Web: A Future Tool in Anesthesia Practice?

Doyle DJ

Toronto, Ontario.

[Record supplied by publisher]

PMID: 11744596

Can J Anaesth 2001 Dec;48(11):1127-1142

Patients' perceptions of cardiac anesthesia services: a pilot study : [Les perceptions de patients sur l'anesthesie cardiaque : une etude pilote].

Le May S, Hardy JF, Harel F, Taillefer MC, Dupuis G

Faculty of Nursing and the Department Of Anesthesiology University of Montreal, the Department Of Biostatistics, Montreal Heart Institute, and the Department Of Psychology Universite du Quebec a Montreal, Montreal, Quebec, Canada.

[Record supplied by publisher]

PURPOSE: To develop an instrument to measure patients' perceptions of the services provided by anesthesiologists, an important indicator of quality for which little information is available. METHODS: The scale of patients' perceptions of cardiac anesthesia services (SOPPCAS) is composed of 17 Likert-type and sociodemographic questions. Data collection was conducted on T-1 (fourth postoperative day) and T-2 (15 days postoperatively). In addition, we employed the Marlow-Crowne scale and a short form of the Psychological Symptoms Index to verify the influence of social desirability and psychological distress respectively. Data analysis included a principal component analysis (PCA). RESULTS: One hundred seventy patients answered the questionnaires at T-1 and 133 patients at T-2. Cronbach alpha of the SOPPCAS was 0.58. PCA revealed four perioperative factors: patient/anesthesiologist interactions, preoccupations related to anesthesia, experience with anesthesia and pain management. Global mean satisfaction was 4.45 +/- 0.64 (maximum score 6.0). Main items related to satisfaction were: satisfaction with premedication, empathy from anesthesiologists, pain management. Main items related to dissatisfaction were: lack of information on blood transfusion and recall of endotracheal intubation. A score of 14/20 was obtained for social desirability. Social desirability did not influence the construct of the SOPPCAS. CONCLUSION: We developed, using rigorous methods, an instrument to measure patients' perceptions of the quality of cardiac anesthesia services. Global mean satisfaction with anesthesia services was moderately high contrary to previous studies where it was high. Finally, the SOPPCAS should allow anesthesiologists to improve the quality of the care they provide.

PMID: 11744591

Can J Anaesth 2001 Dec;48(11):1122-1126

Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour : [La chorio-amnionite est associee a la fievre puerperale pendant le travail, mais non l'analgesie epidurale].

Vallejo MC, Kaul B, Adler LJ, Phelps AL, Craven CM, Macpherson TA, Sweet RL, Ramanathan S

Departments of Anesthesiology, Pathology, Obstetrics and Gynecology, Magee-Womens Hospital, University of Pittsburgh School of Medicine, and Quantitative Sciences (School of Business), Duquense University, Pittsburgh, Pennsylvania, USA.

[Record supplied by publisher]

PURPOSE: Maternal fever is associated with chorioamnionitis and has been linked to labour epidural analgesia (LEA). The purpose of this study was to determine possible associations between LEA and chorioamnionitis, m aternal fever, operative delivery rate, and neonatal outcome. METHODS: Data from 14,073 patients were entered into a database over a two-year period. From this database, 62 nulliparous parturients with clinical chorioamnionitis (amnionitis), but without LEA were identified (Group I). Two other groups who received LEA were matched for parity and gestation: Group II - LEA with concomitant amnionitis (n=50) and, Group III - LEA without concomitant amnionitis (n=201). The diagnosis of chorioamnionitis was confirmed by histologic examination. Results are expressed as mean +/- SD and analyzed at P <0.05 using ANOVA or Chi-square. RESULTS: No differences were noted among the groups in the operative delivery rate or Apgar scores at five minutes. The percentage of patients with maternal fever during labour (38.0 degrees C) with amnionitis was significantly less in Group III compared to the other groups (100% in both Groups I and II vs 1.0% in Group III; P=0.000). Likewise, Group III had a lower percentage of neonates with Apgar scores <7 at one minute (35.5% in Group I, 20.0% in Group II, 17.4% in Group III; P=0.010). The percentage of histologic chorioamnionitis was significantly higher in both amnionitis groups compared to Group III (67.7% in Group I, 56.0% in Group II, 4.0% in Group III; P=0.000). CONCLUSION: LEA without chorioamnionitis is not associated with maternal fever (38.0 degrees C), increased operative delivery rates or low Apgar scores.

PMID: 11744590

Can J Anaesth 2001 Dec;48(11):1114-1116

Best evidence in anesthetic practice: Prevention: planned Cesarean delivery reduces early perinatal and neonatal complications for term breech presentations.

McNiven P, Kaufman K, McDonald H, Campbell DC

Hamilton, Ontario Saskatoon, Saskatchewan.

[Record supplied by publisher]

PMID: 117 44588

Can J Anaesth 2001 Dec;48(11):1070-1074

Perioperative management of a patient with purpura fulminans syndrome due to protein C deficiency : [La demarche anesthesique perioperatoire adoptee chez une patiente atteinte du syndrome de purpura fulminans cause par un deficit en proteine C].

Kumagai K, Nishiwaki K, Sato K, Kitamura H, Yano K, Komatsu T, Shimada Y

Department of Anesthesiology, Aichi Medical University School of Medicine, Aichi. the Department Of Anesthesiology, Nagoya University School of Medicine and the Department Of Anesthesiology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.

[Record supplied by publisher]

PURPOSE: Protein C is a vitamin K-dependent anticoagulant and homozygous protein C deficiency is a rare fatal thrombotic disease. This report describes the perioperative management of homozygous protein C deficiency in a patient who underwent a total of three surgical procedures under general anesthesia and the successful use of activated protein C concentrate. Clinical features: A female baby, who developed disseminated intravascular coagulation and purpura fulminans shortly after birth, was diagnosed as purpura fulminans syndrome due to homozygous protein C deficiency. At one month of age, she suffered bilateral retinal detachment and glaucoma due to retinal hemorrhage. After marked improvement of her condition after administration of activated protein C concentrate, she underwent a left iridectomy and implantation of a Broviak catheter under general anesthesia. Her intraoperative course was uncomplicated but, on postoperative day four, she presented another episode of massive cutaneous necrosis and gangrene. Activated protein C concentrate was administered again, with good results. She underwent replacement of a Broviak catheter at four months of age , and right iridectomy for glaucoma at eight months. Both were uneventful. CONCLUSION: The perioperative management of homozygous protein C deficiency and purpura fulminans requires appropriate measures for thromboembolic prophylaxis. Sufficient iv fluid administration is necessary. Attention should be paid to decrease the risk of tissue compression such as that associated with positioning, blood pressure cuff, and endotracheal intubation, which may cause necrosis over pressure points. Replacement therapy with activated protein C concentrate appears safe and effective. The anesthetic management is reviewed and discussed.

PMID: 11744581

Can J Anaesth 2001 Dec;48(11):1055-1060

Souffrance cerebrale sous anesthesie generale: que peut-on attendre de la surveillance de l'EEG?/Brain injury under general anesthesia: is monitoring of the EEG helpful?

Billard V

Service d'anesthesie, Institut Gustave Roussy, Villejuif, France.

[Record supplied by publisher]

PMID: 11744578

J Cardiothorac Vasc Anesth 2001 Dec;15(6):758-760

High thoracic epidural anesthesia for coronary artery bypass graft surgery in a patient with severe obstructive lung disease.

Visser WA, Liem TH, Brouwer RM

Departments of Anesthesiology and Cardiothoracic Surgery, University Hospital Nijmegen, Nijmegen, The Netherlands.

[Record supplied by publisher]

PMID: 11748529

J Cardiothorac Vasc Anesth 2001 Dec;15(6):750-752

Anesthesia for outpatient repair of patent ductus arteriosus.

Uezono S, Hammer GB, Wellis V, Boltz MG, Pike NA, Black MD

Departments of Anesthesia, Pediatrics, and Cardiovascular Surgery, Stanford University Medical Center, Stanford, CA.

[Record supplied by publisher]

PMID: 11748526

J Cardiothorac Vasc Anesth 2001 Dec;15(6):680-683

Chest radiograph interpretation skills of anesthesiologists.

Kaufman B, Dhar P, O'neill DK, Leitman B, Fermon CM, Wahlander SB, Sutin KM

Departments of Anesthesiology and Radiology, New York University Medical Center, New York, NY.

[Record supplied by publisher]

OBJECTIVE: To assess the skills of anesthesiologists in the interpretation of chest radiographs. DESIGN: Randomized evaluation conducted among anesthesiologists and radiologists. SETTING: Postgraduate Assembly of the New York State Society of Anesthesiologists in 1999, and the Department of Radiology, New York University Medical Center. PARTICIPANTS: A total of 61 anesthesiologists (48 attending physicians; 13 residents); control group of 8 radiology residents (all participants volunteered). INTERVENTIONS: After completing a demographic survey, participants were asked to review a series of 10 chest radiographs. A brief clinical scenario accompanied each radiograph. No time limit was set for these interpretations. Measurements and Main Results: The demographic characteristics of the anesthesiology participants included university faculty (46%), private group practitioners (41%), independent practitioners (11%), and 1 participant with an unspecified type of practice. Additional training among the participants included internal medicine (31%), surgery (19%), and pediatrics (3%); 34% did not specify any additional training. Of the participants, 92% were involved in cases requiring general anesthesia; 96% managed patients in the recovery room; and 34% managed patients in the intensive care unit. Of participants, 80% usually order chest radiographs, but only 42% interpret the films themselves. Misdiagnosed radiographs included pneumothorax by 11% of part icipants, free air under the diaphragm by 41%, bronchial perforation from a nasogastric tube by 28%, right mainstem intubation by 20%, superior vena cava perforation from a central venous catheter by 31%, normal film by 75%, negative pressure pulmonary edema by 16%, left lower lobe collapse by 80%, pulmonary infarction from a pulmonary artery catheter by 29%, and tension pneumothorax by 41%. Overall scores of the attending physicians were not significantly different from that of residents (p > 0.05). The control group of radiology residents scored significantly better (mean, 83.7; p = 0.009) than the anesthesia residents (mean, 62.8) and anesthesia attending physicians (mean, 62.5). CONCLUSION: Anesthesiologists are deficient in skills for the interpretation of chest radiographs. The skill level of university-based physicians is not greater than physicians in private practice, and skill level does not improve with level of training or experience. Most anesthesiologists rely on radiologists for interpretative results. Further training during the residency years may help improve diagnostic skills. Copyright 2001 by W.B. Saunders Company

PMID: 11748512

J Cardiovasc Pharmacol 2002 Jan;39(1):142-149

Cyclic Adenosine Monophosphate-Dependent Vascular Responses to Purinergic Agonists Adenosine Triphosphate and Uridine Triphosphate in the Anesthetized Mouse.

Shah MK, Kadowitz PJ

Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.

[Record supplied by publisher]

SUMMARY: The mechanism by which purinergic agonist adenosine triphosphate (ATP) and uridine triphosphate (UTP) decrease systemic arterial pressure in the anesthetized mouse was investigated. Intravenous injections of adenosine triphosphate (ATP) and uridine triphosphate (UTP) produce d dose-dependent decreases in systemic blood pressure in the mouse. The order of potency was ATP > UTP. Vasodilator responses to ATP and UTP were altered by the cyclic adenosine monophosphate (cAMP) phosphodiesterase inhibitor rolipram. The vascular responses to ATP and UTP were not altered by a nitric oxide synthase inhibitor, a cyclooxygenase inhibitor, a cGMP phosphodiesterase inhibitor, or a particular P2 receptor antagonist. These data suggest that ATP and UTP cause a decrease in systemic arterial pressure in the mouse via a cAMP-dependent pathway via a novel P2 receptor linked to adenylate cyclase and that nitric oxide release, prostaglandin synthesis, cGMP, and P2X 1, P2Y 1, and P2Y 4 receptors play little or no role in the vascular effects of these purinergic agonists in the mouse.

PMID: 11743236

Neurosci Lett 2001 Dec 28;316(3):149-152

A human oral capsaicin pain model to assess topical anesthetic-analgesic drugs.

Ngom PI, Dubray C, Woda A, Dallel R

Laboratoire de Physiologie Oro-Faciale, Faculte de Chirurgie Dentaire, 11 Boulevard Charles de Gaulle, 63000, Clermont-Ferrand, France

[Record supplied by publisher]

Repeated application of capsaicin on the tongue has been used as a human oral pain model to assess topical anesthetic-analgesic drugs. The reliability of the model was evaluated by observing the variability of the response to repeated applications of capsaicin after three successive sessions at 1 day intervals. No session effect was observed for the time course of the visual analogue scale (VAS) scores and the area under the curve, but a significant decrease of VAS peak scores was noted from the first to the third session. The sensitivity of the model was assessed by mouth rinses with three doses of lidocaine (0.25, 0.5 and 1%). Lidocaine significantly reduc ed the burning pain. This effect was rapid, reversible and dose dependent. It is concluded that the oral capsaicin pain model displays good reliability and sensitivity and allows safe evaluation of candidate topical analgesic and anesthetic drugs.

PMID: 11744224