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1.
Eur J Anaesthesiol ; 38(12): 1230-1241, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34735395

RESUMEN

BACKGROUND: Remifentanil is an effective drug in peri-operative pain therapy, but it can also induce and aggravate hyperalgesia. Supplemental administration of N2O may help to reduce remifentanil-induced hyperalgesia. OBJECTIVE: To evaluate the effect of 35 and 50% N2O on hyperalgesia and pain after remifentanil infusion. DESIGN: Single site, phase 1, double-blind, placebo-controlled, randomised crossover study. SETTING: University Hospital, Germany from January 2012 to April 2012. PARTICIPANTS: Twenty-one healthy male volunteers. INTERVENTIONS: Transcutaneous electrical stimulation induced spontaneous acute pain and stable areas of hyperalgesia. Each volunteer underwent the following four sessions in a randomised order: 50 to 50% N2-O2 and intravenous (i.v.) 0.9% saline infusion (placebo); 50 to 50% N2-O2 and i.v. remifentanil infusion at 0.1 µg kg-1 min-1 (remifentanil); 35 to 15 to 50% N2O-N2-O2 and i.v. remifentanil infusion at 0.1 µg kg-1 min-1 (tested drug) and 50 to 50% N2O-O2 and i.v. remifentanil infusion at 0.1 µg kg-1 min-1 (gas active control). Gas mixtures were inhaled for 60 min; i.v. drugs were administered for 30 min. MAIN OUTCOME MEASURES: Areas of pin-prick hyperalgesia, areas of touch-evoked allodynia and pain intensity on a visual analogue scale were assessed repeatedly for 160 min. RESULTS: Data from 20 volunteers were analysed. There were significant treatment and treatment-by-time effects regarding areas of hyperalgesia (P < 0.001). After the treatment period, the area of hyperalgesia was significantly reduced (P < 0.001) in the tested drug and in the gas active control (30.6 ±â€Š9.25 and 24.4 ±â€Š7.3 cm2, respectively) compared with remifentanil (51.0 ±â€Š17.0 cm2). There was also a significant difference between the gas active control and the tested drug sessions (P < 0.001). For the area of allodynia and pain rating, results were consistent with the results for hyperalgesia. CONCLUSIONS: Administration of 35% N2O significantly reduced hyperalgesia, allodynia and pain intensity induced after remifentanil. It might therefore be suitable in peri-operative pain relief characterised by hyperalgesia and allodynia, such as postoperative pain, and may help to reduce opioid demand. TRIAL REGISTRATION: EudraCT-No.: 2011-000966-37.


Asunto(s)
Óxido Nitroso , Piperidinas , Analgésicos Opioides , Método Doble Ciego , Voluntarios Sanos , Humanos , Hiperalgesia/inducido químicamente , Hiperalgesia/diagnóstico , Hiperalgesia/tratamiento farmacológico , Masculino , Dolor Postoperatorio , Piperidinas/efectos adversos , Remifentanilo
2.
Eur Phys J E Soft Matter ; 44(7): 98, 2021 Jul 20.
Artículo en Inglés | MEDLINE | ID: mdl-34286363

RESUMEN

Under terrestrial conditions, solidification processes are influenced to a large degree by the gravity effects such as natural convection or buoyancy force, which can dramatically modify the final characteristics of the grown solid. In the last decades, the coupling of in situ observation of growth from the melt, that enables the study of microstructure formation dynamics, and microgravity experimentation, that allows to approach diffusive conditions, has been implemented for both transparent and metallic materials. The results of these investigations enable to test the validity of advanced solidification theories, to validate or develop numerical models and sometimes to reveal unexpected phenomena. The aim of this paper is to present a selection of conclusive experiments obtained with this combined approach in our group to highlight the gravity effects by a comparative study of experiments carried out on earth and in microgravity conditions.

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