 |
|
Long-lasting Nerve Block Could Change Pain Management
April 16, 2009Boston, Mass. -- Researchers at Children's Hospital Boston have developed a slow-release anesthetic drug-delivery system that could potentially revolutionize treatment of pain during and after surgery, and may also have a large impact on chronic pain management.
In NIH-funded work, they used specially designed fat-based particles called liposomes to package saxitoxin, a potent anesthetic, and produced long-lasting local anesthesia in rats without apparent toxicity to nerve or muscle cells. The research will be published online on April 13 by the Proceedings of the National Academy of Sciences.
"The idea was to have a single injection that could produce a nerve block lasting days, weeks, maybe even months," explains Daniel Kohane, MD, PhD, of the Division of Critical Care Medicine in the Department of Anesthesiology at Children's, and the report's senior author. "It would be useful for conditions like chronic pain where, rather than use narcotics, which are systemic and pose a risk of addiction, you could just put that piece of the body to sleep, so to speak."
Previous attempts to develop slow-release anesthetics have not been successful due to the tendency for conventional anesthetics to cause toxicity to surrounding tissue. Indeed, drug packaging materials have themselves been shown to cause tissue damage. Now, Kohane and colleagues report that if saxitoxin is packaged within liposomes, it is able to block nerve transmission of pain without causing significant nerve or muscle damage.
In lab experiments, the researchers evaluated various formulations--various types of liposomes containing saxitoxin with or without dexamethasone, a potent steroid known to augment the action of encapsulated anesthetics. The best liposomes produced nerve blocks lasting two days if they contained saxitoxin alone and seven days if combined with dexamethasone.
Cell culture experiments and tissue analysis confirmed that the formulations were not toxic to muscle or nerve cells. Furthermore, when the team examined expression of four genes known to be associated with nerve injury, they found no up-regulation.
"If these long-acting, low-toxicity formulations of local anesthetics are shown to be effective in humans, they could have a major impact on the treatment of acute and chronic pain," says Alison Cole, PhD, of the NIH's National Institute of General Medical Sciences, which partially funded the work. "This slow-release technology may also have broader applications in drug delivery for the treatment of a variety of diseases."
Kohane is currently optimizing the formulation to make it last even longer, while avoiding local and systemic toxicity. "It is conceivable we could have a formulation that is suitable for clinical trials before too long," he says.
The study was supported by the National Institute of General Medical Sciences. Hila Epstein-Barash, PhD, was first author on the paper.
Children's Hospital Boston
Previous attempts to develop slow-release anesthetics have not been successful due to the tendency for conventional anesthetics to cause toxicity to surrounding tissue. Indeed, drug packaging materials have themselves been shown to cause tissue damage. Now, Kohane and colleagues report that if saxitoxin is packaged within liposomes, it is able to block nerve transmission of pain without causing significant nerve or muscle damage.
In lab experiments, the researchers evaluated various formulations--various types of liposomes containing saxitoxin with or without dexamethasone, a potent steroid known to augment the action of encapsulated anesthetics. The best liposomes produced nerve blocks lasting two days if they contained saxitoxin alone and seven days if combined with dexamethasone.
Cell culture experiments and tissue analysis confirmed that the formulations were not toxic to muscle or nerve cells. Furthermore, when the team examined expression of four genes known to be associated with nerve injury, they found no up-regulation.
"If these long-acting, low-toxicity formulations of local anesthetics are shown to be effective in humans, they could have a major impact on the treatment of acute and chronic pain," says Alison Cole, PhD, of the NIH's National Institute of General Medical Sciences, which partially funded the work. "This slow-release technology may also have broader applications in drug delivery for the treatment of a variety of diseases."
Kohane is currently optimizing the formulation to make it last even longer, while avoiding local and systemic toxicity. "It is conceivable we could have a formulation that is suitable for clinical trials before too long," he says.
The study was supported by the National Institute of General Medical Sciences. Hila Epstein-Barash, PhD, was first author on the paper.
Children's Hospital Boston
Chronic Pain Current Events and Chronic Pain News RSSSeeing is relieving
An f1000 evaluation examines how pain relief improves greatly when the sufferer can actually see the area where the pain is occurring.
Pain thresholds linked to inflammation and sleep problems in arthritis patients
Despite recent advances in anti-inflammatory therapy, many rheumatoid arthritis (RA) patients continue to suffer from pain.
Nanowire biocompatibility in the brain: So far so good
The biological safety of nanotechnology, in other words, how the body reacts to nanoparticles, is a hot topic. Researchers at Lund University in Sweden have managed for the first time to carry out successful experiments involving the injection of so-called 'nanowires.'
Extra care for outwardly healthy workers costs companies millions annually
Someone healthy enough to work could still cost an employer more than $4,000 annually in unnecessary health care costs.
Study pinpoints key mechanism in brain development, raising question about use of antiseizure drug
Researchers at the Stanford University School of Medicine have identified a key molecular player in guiding the formation of synapses - the all-important connections between nerve cells - in the brain.
Shingles raises risk of stroke by 30 percent or more in adults
Adults with shingles were about 30 percent more likely to have a stroke during a one-year follow-up than adults without shingles, in a study reported in Stroke: Journal of the American Heart Association.
Chronic pain treatments work better together, says Queen's anesthesiologist
People who suffer from debilitating neuropathic pain may get more relief and sleep better by combining two commonly-prescribed drugs.
Researchers develop an integrated treatment for veterans with chronic pain and posttraumatic stress
The wars in Iraq and Afghanistan have resulted in a growing number of soldiers evacuated to the United States for comprehensive care for physical and psychological trauma.
Using magnetism to turn drugs on and off
Many medical conditions, such as chronic pain, cancer and diabetes, require medications that cannot be taken orally, but must be dosed intermittently, on an as-needed basis, over a long period of time.
Relieving pain affecting millions
An unprecedented gathering of some of Australia's leading authorities in pain medicine, together with consumer groups representing chronic pain sufferers, will meet in Melbourne today to work towards a national, coordinated approach to managing chronic pain.
More Chronic Pain Current Events and Chronic Pain News Articles
 |
The Pain Survival Guide: How to Reclaim Your Life (APA Lifetools) by Dennis C. Turk (Author), Frits, Ph.D. Winter (Author) If you suffer from chronic pain, this proven 10-step program brings hope and relief, showing you how gradual changes in specific behaviors can lead to great improvements in your ability to cope. Psychologists Turk and Winters’ recommendations are based on solid research that shows what works and on their success with thousands of patients. Unlike the authors of other pain books, they promise no miracle cures, but they do help you learn "not to let your body push you around" so life becomes enjoyable again. The key lessons in this book include • Uncovering some of the myths about pain and the deceptive ways it fools your body into unconstructive behavior • Pacing your activity, so you build strength without overdoing or underdoing it • Learning how to induce deep relaxation... |
 |
Understanding Chronic Pain: A Doctor Talks to His Patients by Robert T. Jr.; M.d. Cochran (Author) "This is a personal narrative, a record of my passage among victims of chronic pain and the discoveries that have come from those encounters. I write for physicians, nurses, therapists, and caregivers, but mostly, I write for you who suffer the disease. I know you very well, perhaps as well as anybody in the world. I have listened to your stories with patience and attention, and I have been greatly rewarded. You have trusted me with the deep recesses of your thoughts and fears, and the memories of the dreadful experiences that are so often the origin of chronic pain. I have treated thousands of you and I believe I have some understanding of your illness. I offer a series of essays about people like you who suffer chronic pain. From their case histories, I derive certain conclusions.... |
 |
Pain Free: A Revolutionary Method for Stopping Chronic Pain by Pete Egoscue (Author), Roger Gittines (Contributor) Starting today, you don't have to live in pain. That is the revolutionary message of this breakthrough system for eliminating chronic pain without drugs, surgery, or expensive physical therapy. Developed by Pete Egoscue, a nationally renowned physiologist and sports injury consultant to some of today's top athletes, the Egoscue Method has an astounding 95 percent success rate. The key is a series of gentle exercises and carefully constructed stretches called E-cises. Inside you'll find detailed photographs and step-by-step instructions for dozens of motioncizes specifically designed to provide quick and lasting relief of: Lower back pain, hip problems, sciatica, and bad knees Carpal tunnel syndrome and even some forms of arthritis Migraines and other headaches,... |
 |
Reversing Chronic Pain: A 10-Point All-Natural Plan for Lasting Relief by Maggie Phillips (Author) Reversing Chronic Pain offers a dynamic framework for joining body and mind to speed the healing of traumatic pain from the body level up. Each chapter presents a body-centered skill set that can be mastered through a broad menu of practice exercises. The resulting interlinked somatic building blocks help readers shift from physical pain to body awareness, and from unstoppable suffering to heartfelt connection and peace. Building on the AIDS cocktail approach that reflects the fact that chronic pain is complex and no one tactic is likely to solve the problem, renowned expert Maggie Phillips presents a 10-1 pain plan comprised of easy strategies based on somatic experience. Even if the reader’s pain is perceived as a “10” at the onset of the program, with 10 being... |
 |
Curing Chronic Pain: Stories of Hope and Healing by Robert T. Cochran Jr. (Author) In 2004, Dr. Robert T. Cochran published Understanding Chronic Pain, a ground-breaking work exploring the links between pain, depression, childhood trauma, substance abuse, and bipolar disease. A companion to that work, Curing Chronic Pain demonstrates the advancements Cochran has made in successfully treating patients suffering from pain. He has found that chronic pain, a single core illness, can be alleviated with the careful application of certain drugs, even those in the controversial opiate class. In many cases, Cochran says, miraculous cures have been achieved. Presented in a conversational, anecdotal format, this book examines the specific experiences of chronic pain patients under Cochran's supervision. As a reader you will be struck by Cochran's warmth, compassion, intellect,... |
 |
Managing Chronic Pain: A Cognitive-Behavioral Therapy Approach Workbook (Treatments That Work) by John Otis (Author) Chronic pain has a multitude of causes, many of which are not well understood or effectively treated by medical therapies. Individuals with chronic pain often report that pain interferes with their ability to engage in occupational, social, or recreational activities. Sufferers' inability to engage in these everyday activities may contribute to increased isolation, negative mood and physical deconditioning, which in turn can contribute to their experience of pain. Cognitive-behavioral therapy (CBT) has been proven effective at managing various chronic pain conditions, including rheumatoid arthritis, osteoarthritis, chronic back pain, and tension/migraine headache. The CBT treatment engages patients in an active coping process aimed at changing maladaptive thoughts and behaviors that... |
 |
Cognitive Therapy for Chronic Pain: A Step-by-Step Guide by Beverly E. Thorn Phd (Author) Grounded in state-of-the-art theory and research, this hands-on volume provides a complete cognitive-behavioral treatment program for clients suffering from chronic pain. Ten clearly organized modules for use with groups or individuals offer well-tested strategies for engaging clients, challenging distorted thoughts and beliefs about pain, and helping to build needed skills for coping and adaptation. Also featured are a detailed theoretical and empirical rationale, along with guidelines for setting up treatment groups and conducting effective assessments. Presented in a large-size format for ease of photocopying and use, the book contains everything needed to implement the program, including numerous case examples and troubleshooting tips and over 40 reproducible session outlines, client... |
 |
Chronic Pain For Dummies (For Dummies (Health & Fitness)) by For Dummies (Publisher) Proven exercises and techniques for dealing with pain Your compassionate guide to conquering pain and living a full life Do you suffer from chronic pain? This reassuring, practical guide helps you understand what causes pain and how to manage it with the newest pain-relieving techniques. You'll see how to track your pain triggers, weigh the benefits and risks of pain-reducing medications, improve your pain levels with diet and exercise, and determine whether surgery is right for you. Discover how to: Diagnose your pain Build an anti-pain medical team Prevent or minimize pain attacks Explore alternative therapies Make helpful lifestyle changes |
 |
10 Simple Solutions to Chronic Pain: How to Stop Pain from Controlling Your Life by Blake H. Tearnan (Author) Get Chronic Pain Under Control Have you tried a number of approaches to manage chronic pain without much relief? The discouraging cycle of hope followed by frustration and continued pain can be as damaging to your quality of life as pain itself. To address this problem, the most current approaches to pain management advocate living well despite pain. They encourage pain sufferers to set aside their struggle with pain and learn the skills they need to stay engaged with life. Distilled from the very best of these techniques, this little book offers you ten simple, effective solutions for thriving with chronic pain. First, you'll get a quick introduction to the physiology of pain. Then it's down to the business of improving your quality of life: You'll learn ... |
 |
Living Beyond Your Pain: Using Acceptance & Commitment Therapy to Ease Chronic Pain by Joanne Dahl (Author), Tobias Lundgren (Author) A rich and rewarding life is possible for those of us who live with chronic pain. Based on acceptance and commitment therapy (ACT), one of the most promising and fastest growing psychotherapies being practiced today, this book breaks with conventional notions of pain management. These "feel good" approaches—including the use of pain-killing medication—all work to prevent painful sensations. The ACT approach, however, begins with the assumption that pain is a normal part of living that teaches us a lot about the state of our bodies and minds. Attempts to avoid it often cause more harm than good. By accepting and learning to live with pain, you limit the control it exerts over you. Mindfulness exercises, in particular, help you transform pain from a life-defining preoccupation to a... |
| © 2009 BrightSurf.com |