No abstract available.
Animals ; Epidermal Growth Factor* ; Gene Expression* ; Gonadotropin-Releasing Hormone* ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Rats*

Disc fragment migration occurs in 35%-72% of lumbar disc herniations. Most of the herniated disc fragments migrate in the rostal, caudal and lateral directions. Posterior epidural disc fragment migration is a rare finding and posterior migration causing Cauda Equina syndrome is exceptionally rare. We report here on two cases of L4-5 disc fragment posterior epidural migration that caused Cauda Equina syndrome, and this was diagnosed by performing radiological examination, and we also include a review of the related literature.
Intervertebral Disc Displacement ; Polyradiculopathy

BACKGROUND: It is stated frequently that patients with spinal block may be drowsy, although they may not have received any sedative drugs. Intrathecal clonidine increase the duration of sensory and motor blockades, and also has a sedative effect. Thus we conducted this study to investigate the effects of spinal anesthesia and intrathecal clonidine on propofol hypnotic requirements. METHODS: Forty-five adult patients scheduled to undergo local or spinal anesthesia were enrolled in this study. Group 1 included patients on local anesthesia, group 2 were patients on spinal anesthesia with 0.5% hyperbaric bupivacaine, and group 3 were patients on spinal anesthesia with 0.5% hyperbaric bupivacaine and 75microgram clonidine. The target controlled infusion (TCI) of propofol was started at a target concentration of 1microgram/ml. We checked the lowest BIS during 5 min observation after the effect site concentration (Ce) had been reached (1microgram/ml). The TCI of propofol was then restarted at a target concentration of 1.5microgram/ml and we checked the lowest BIS during 5 min observation after the Ce had been reached (1.5microgram/ml). We also checked the Ce when the BIS reached 80 and 70. RESULTS: The minimum BIS's at 1 microgram/ml Ceiiwere 86.9 +/- 11.3 (Group 1), 80.5 +/- 8.5 (Group 2) and 66.9 +/- 15.5 (Group 3), and the minimum BIS's at 1.5microgram/ml Ce were 76.0 +/- 13.4, 62.9 +/- 12.4, 48.5 +/- 13.7, respectively. The Ce's of propofol at BIS 80 were checked initially at 1.4 +/- 0.5microgram/ml (Group 1), 1.1 +/- 0.3microgram/ml (Group 2) and 0.8 +/- 0.3microgram/ml (Group 3). The Ce's of propofol at BIS 70 were 1.8 +/- 0.6microgram/ml, 1.4 +/- 0.3microgram/ml and 1.0 +/- 0.3microgram/ml, respectively. The Ce's of Group 2 and Group 3 at BIS 80 and BIS 70 were statistically lower than those of Group 1 (P < 0.05), and the Ce's of Group 3 at BIS 80 and BIS 70 were statistically lower than those of Group 2 (P < 0.05). CONCLUSIONS: Spinal anesthesia and intrathecal clonidine reduce the requirement of propofol for conscious sedation. The Ce of propofol for conscious sedation is 1.4-1.8microgram/ml for local anesthesia, 1.1-1.4microgram/ml for spinal anesthesia with 0.5% hyperbaric bupivacaine, and 0.6-1.0microgram/ml for spinal anesthesia with 0.5% hyperbaric bupivacaine and 75microgram clonidine.
Adult ; Anesthesia, Local ; Anesthesia, Spinal* ; Bupivacaine ; Clonidine* ; Conscious Sedation* ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Propofol*

BACKGROUND: Mirror-image allodynia is a mysterious phenomenon that occurs in association with many clinical pain syndromes including complex regional pain syndromes (CRPS). Underlying mechanisms for the development of such pain are still a matter of investigation. Several studies suggest that activation of the N-methyl-D-aspartate (NMDA) receptor is essential for central sensitization as a base for persistent pain. The aim is to assess whether alteration of NMDA receptor expression correlates with the contralateral allodynia in the chronic post-ischemia pain (CPIP) model rats representing CRPS-Type I. METHODS: Application of a tight-fitting tourniquet for a period of 3 hours before reperfusion produced CPIP in male Sprague-Dawley rats. The mechanical paw withdrawal thresholds to von Frey stimuli (using a dynamic plantar aesthesiometer) were measured as pain indicators in ipsilateral and contralateral hindpaws. Phosphorylation of the NMDA receptor 1 subunit (pNR1), assessed with Western blot, was measured in the contralateral L4-6 spinal cord. RESULTS: Ipsilateral and contralateral mechanical allodynia is present at 4 hours after reperfusion, peaked at 3 days, and continued for 7 days after reperfusion. The relative density of pNR1 of CPIP rats significantly decreased in the contralateral L4-6 spinal cord compared to baseline value (P < 0.05). There was significant correlation between paw withdrawal threshold and the relative density of pNR1 (ipsilateral; R2 = 0.75, P < 0.01, contralateral; R2 = 0.60, P < 0.01). CONCLUSIONS: These data suggest that pNR1 is correlated to the contralateral mechanical allodynia in CPIP rats.
Animals ; Blotting, Western ; Central Nervous System Sensitization ; Complex Regional Pain Syndromes ; Humans ; Hyperalgesia ; Inositol Phosphates ; Male ; N-Methylaspartate ; Phosphorylation ; Prostaglandins E ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Specific Gravity ; Spinal Cord ; Tourniquets