Hidemichi Ogawa

Sevoflurane suppresses behavioral response in the rat formalin test : Combination with intrathecal lidocaine produced profound suppression of the response

We investigated the effects of intrathecal (i.t.) lidocaine, inhalation sevoflurane, and a combination of i.t. lidocaine and sevoflurane on the formalin test in rats. Group 1 (control) received i.t. saline 10 microl. Groups 2 and 3 received i.t. lidocaine 200 microg and 400 microg, respectively. Groups 4-6 received 1.2%, 2.4% and 3.6% sevoflurane, respectively. Interaction of drugs was analyzed using a dose addition model. Group 7 received i.t. lidocaine 200 microg and 1.2% sevoflurane. The biphasic behavioral activity of the hindpaw of rats was observed. This study showed that i.t. lidocaine or inhalation sevoflurane before formalin injection, significantly suppressed the behavioral activity of the hindpaw of rats, and that this suppression was significantly potentiated by the co-administration of i.t. lidocaine and inhalation sevoflurane.

NALTREXONE, BUT NOT ATROPINE OR YOHIMBINE, ANTAGONIZES SUPPRESSION OF FORMALIN-INDUCED SPINAL SENSITIZATION BY INTRATHECAL NOCICEPTIN

We investigated the effects of spinal nociceptin on formalin-induced spinal sensitization and examined the role of the opioidergic, alpha 2-adrenergic and muscarinic cholinergic receptors in the nociceptin-produced suppression of spinal sensitization. The results demonstrated that spinal nociceptin suppressed the formalin-induced spinal sensitization in a dose-dependent manner (1, 5 and 10 nmol). The inhibitory effect of 10 nmol of nociceptin on spinal sensitization, was readily antagonized by naltrexone, but not by atropine or yohimbine. Each of the antagonists, naltrexone, atropine or yohimbine, alone had no effect on the formalin-induced spinal sensitization. Our results show that spinal nociceptin elicits dose-dependent, naltrexone-reversible suppression of spinal sensitization evoked by injection of formalin.

High-dose intrathecal morphine to control cancer pain--a case report.

A 52-year-old woman with recurrent parotid gland cancer was referred to our hospital for uncontrollable severe pain in her right leg. We implanted a port in the chest wall and started a morphine infusion into the intrathecal space. The pain increased daily, and the patient finally needed 140 mg/day of morphine to control the pain. Cerebrospinal fluid was noted at the site of puncture and spinal catheter implantation. We removed the port and intrathecal catheter, then implanted the port again on the other side of the chest wall.

Stellate ganglion block therapy for a patient with Tietze's syndrome

A 45-year-old woman came to our clinic because of chest wall pain. It was 6 years earlier when she first felt slight chest pain. The pain was in the infraclavicular region and ran to the left arm when pressure was applied. When the pain increased, she felt not only left upper chest pain but also paresthesia and weakness of the left arm. Physicians noted costal cartilage tenderness, but did not note swelling or flush over the skin. Laboratory studies revealed a white blood cell count to be 7000mm -3 and the concentration of C-reactive protein to be under 0.5mg.d1-1. Computed tomography (CT) showed swelling of the first left costal cartilage. Radionuclide imaging with 67Ga showed inflammation of the left first costochondral junction. A non steroid