| 1. |
- Gordh, Torsten, et al.
(author)
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Lidocaine : The Origin of a Modern Local Anesthetic
- 2010
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In: Anesthesiology. - 0003-3022 .- 1528-1175. ; 113:6, s. 1433-1437
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Journal article (peer-reviewed)abstract
- Before the introduction of lidocaine, the choice of local anesthetics was limited Procaine was most commonly used and offered less toxicity than cocaine, but it had a short duration faction Tetracaine had substantial systemic toxicity, limiting its use largely to spinal anesthesia An agent with low toxicity, a quick onset, and a longer duration of action was needed This article reports the initial clinical trials with the newly synthesized lidocaine The first trials were wheal tests on the forearms of human volunteers Lidocaine anesthesia duration was markedly longer than that produced by procaine Lidocaine was first tested for infiltration anesthesia in many short procedures performed in the emergency department, followed by major procedures, including those for goiter and hernia in the operating room Consistent success was observed in both environments Lidocaine was then tested for conduction anesthesia using brachial plexus and mandibular, sacral, and paravertebral blocks Its onset as again substantially faster and longer lasting than that of procaine Lidocaine also provided good spinal and surface anesthesia of the cornea
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| 2. |
- Basnet, A., et al.
(author)
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Donepezil provides positive effects to patients treated with gabapentin for neuropathic pain : an exploratory study
- 2014
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In: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 58:1, s. 61-73
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Journal article (peer-reviewed)abstract
- BackgroundThe first-line medication gabapentin and the acetylcholinesterase inhibitor donepezil represent a new promising combination to improve treatment outcomes for patients with severe neuropathic pain. The drugs have previously shown synergism following co-administration in nerve-injured rats. MethodsThe clinical relevance of adding donepezil to existing gabapentin treatment in patients with post-traumatic neuropathic pain was explored in this open-label study. The study comprised two consecutive periods of minimum 6 weeks: (1) titration of gabapentin to the highest tolerable dose or maximum 2400mg daily, and (2) addition of donepezil 5mg once daily to the fixed gabapentin dose. Efficacy and tolerability were assessed by ratings of pain intensity, questionnaires for pain and health-related quality of life, and reporting of adverse events. Pain scores were also analysed using mixed-effects analysis with the software NONMEM to account for intersubject variability. ResultsEight patients commenced treatment with donepezil, of which two withdrew because of adverse events. Addition of donepezil resulted in clinically relevant reductions of pain (>11 units on a 0-100 scale) and improved mental wellness in three of six patients. The remaining three patients had no obvious supplemental effect. Mixed-effects analysis revealed that pain scores were significantly lower during co-administration (P<0.0001 combination vs. monotherapy). ConclusionDonepezil may provide additional analgesia to neuropathic pain patients with insufficient pain relief from gabapentin as monotherapy. The promising results support controlled clinical trials of the drug combination. The usefulness of mixed-effects analysis in small-scale trials and/or for data with high intersubject variability was also demonstrated.
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| 3. |
- Gordh, Torsten E, et al.
(author)
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Gabapentin in traumatic nerve injury pain : a randomized, double-blind, placebo-controlled, cross-over, multi-center study
- 2008
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In: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 138:2, s. 255-266
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Journal article (peer-reviewed)abstract
- A double-blind, randomized, placebo-controlled cross-over multi-center study was conducted to evaluate the efficacy and safety of gabapentin in the treatment of neuropathic pain caused by traumatic or postsurgical peripheral nerve injury, using doses up to 2400 mg/day. The study comprised a run-in period of two weeks, two treatment periods of five weeks separated by a three weeks' washout period. The primary efficacy variable was the change in the mean pain intensity score from baseline to the last week of treatment. Other variables included pain relief, health related quality of life (SF-36), interference of sleep by pain, Clinician and Patient Global Impression of Change, and adverse effects. Nine centers randomized a total of 120 patients, 22 of whom withdrew. There was no statistically significant difference between the treatments for the primary outcome efficacy variable. However, gabapentin provided significantly better pain relief (p=0.015) compared with placebo. More patients had at least a 30% pain reduction with gabapentin compared with placebo (p=0.040) and pain interfered significantly less with sleep during gabapentin treatment compared with placebo (p=0.0016). Both the Patient (p=0.023) and Clinician (p=0.037) Global Impression of Change indicated a better response with gabapentin compared with placebo. Gabapentin was well tolerated. The most common adverse effects were dizziness and tiredness.
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| 4. |
- Gordh, Torsten E., et al.
(author)
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Reporting of Trials of Gabapentin
- 2010
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In: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 362:17, s. 1641-1641
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Journal article (peer-reviewed)
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| 5. |
- Gordh, Torsten E., et al.
(author)
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Swedenborg, Linnaeus and brain research and the roles of Gustaf Retzius and Alfred Stroh in the rediscovery of Swedenborg's manuscripts
- 2007
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In: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 112:2, s. 143-164
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Journal article (peer-reviewed)abstract
- Emanuel Swedenborg (1688 - 1772) at the end of his long life became famous as a visionary mystic and founder of a new religion. However, at younger age, he was recognized as a prominent mining engineer and natural philosopher, particularly interested in geology, mineralogy, cosmology, paleontology and last but not least physiology of the brain. In his Oeconomica regni animalis (1740) and in several posthumously published extensive manuscripts, he described and analyzed e. g. the structural and functional organization of the cerebral cortex, the hierarchical construction of the nervous system, the localization of the cerebrospinal fluid and the secretory functions of the pituitary gland. In these fields, he presented remarkable insights and far reaching conclusions which in some cases have been experimentally verified in modern times. In spite of family relations Swedenborg rarely met the 19 years younger Linnaeus. Linnaeus was not only the founder of the systemic botany but as physician a keen and to some extent original observer of neurological symptoms; one of the first who adequately described motor aphasia. To regard these two men, among the few Swedish authors of the 18(th) century whose names are still internationally well known, as early precursors of neurological research, seems justified. The young Canadian, Alfred H. Stroh (1878 - 1922), had a crucial importance for the research on the works of Swedenborg, and the rediscovery of his manuscripts. His work was supported and financed to a large extent by professor Gustaf Retzius, at that time the most prominent Swedish researcher in anatomy and histology. There are many reasons to be thankful for the important contributions made by Alfred Stroh and Gustaf Retzius to stimulate the interest for Emanuel Swedenborg in Sweden and internationally.
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| 6. |
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| 7. |
- Lindh, Anne-Li, et al.
(author)
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Research on genes predisposing for chronic pain : a challenge for pain researchers in Scandinavia
- 2009
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In: Scandinavian Journal of Pain. - 1877-8860. ; 1:S1, s. S24-S26
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Journal article (peer-reviewed)abstract
- Finding predisposing factors or vulnerability genes for chronic pain development would provide opportunities to tailor treatment for each patient. Such knowledge also pinpoints crucial functions required for the pathophysiological process. Both these outcomes are necessary for further improving chronic pain prevention and treatment. Pain can be modulated by a myriad of processes including endogenous opioid production, inflammation and tissue repair, which can trigger synaptic plasticity both centrally and peripherally, affecting both excitatory and inhibitory signaling by neurons, as well as glial signaling contributing to these processes. The genetic foundation for this web of interactions should provide future drug targets for chronic pain prevention and treatment. As the body of data grows, with increased patient cohort sizes, and more standardized characterizations of the pain state, we can hope to identify many new gene candidates for treatment of chronic pain. We are convinced that pain researchers in the Nordic countries have excellent possibilities for networking and cooperation, to carry out successful projects in the field of the genetics of pain. The “New Scandinavian Association for the Study of Pain” (newSASP) may provide an important facilitating arena to achieve this goal.
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| 8. |
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| 9. |
- Schistad, Elina Iordanova, et al.
(author)
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A population-based study of inflammatory mechanisms and pain sensitivity
- 2020
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In: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 161:2, s. 338-350
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Journal article (peer-reviewed)abstract
- Two recent studies suggest that experimental pain sensitivity is associated with low-grade systemic inflammation. However, only 2 biomarkers have been identified, and the studies were conducted in adult individuals where confounding effects of comorbid diseases cannot be excluded. We therefore tested associations between pain sensitivity and 119 inflammation-related serum biomarkers in 827 healthy adolescents (15-19 years) in the population-based Tromso Study: Fit Futures. The main outcome measure was cold-pressor pain tolerance (CPT), tested by placing the dominant hand in circulating cold (3 degrees C) water for a maximum of 105 seconds. Secondary outcomes were heat and pressure pain threshold and tolerance. Twelve proteins and 6 fatty acids were significantly associated with CPT after adjustment for possible confounding factors and correction for multiple comparisons. Of these, all fatty acids and 10 proteins were protective, ie, higher biomarkers levels were associated with increased CPT, whereas 2 biomarkers were associated with lower tolerance. Taken together, these biomarkers predicted completion of the tolerance test with a C-statistic of 0.65. Results for heat and pressure pain tolerance were remarkably similar, strengthening the generalizability of our findings. In this cohort of young healthy individuals, we found a relationship between inflammation-related biomarkers and pain tolerance and thresholds. Biomarkers with anti-inflammatory and analgesic effects predominated, suggesting that the development of prophylactic dietary or pharmaceutical treatments may be possible.
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| 10. |
- Søreide, E, et al.
(author)
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Shaping the future of Scandinavian anaesthesiology: a position paper by the SSAI.
- 2010
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In: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 54:9, s. 1062-70
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Journal article (peer-reviewed)abstract
- Traditionally, Scandinavian anaesthesiologists have had a very broad scope of practice, involving intensive care, pain and emergency medicine. European changes in the different medical fields and the constant reorganising of health care may alter this. Therefore, the Board of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) decided to produce a Position Paper on the future of the speciality in Scandinavia. The training in the various Scandinavian countries is very similar and provides a stable foundation for the speciality. The Scandinavian practice in anaesthesia and intensive care is based on a team model where the anaesthesiologists work together with highly educated nurses and should remain like this. However, SSAI thinks that the role of the anaesthesiologists as perioperative physicians is not fully developed. There is an obvious need and desire for further training of specialists. The SSAI advanced educational programmes for specialists should be expanded and include formal assessment leading to a particular medical competency as defined by the European Union of Medical Specialists (UEMS). In this way, Scandinavian anaesthesiologists will remain leaders in perioperative, intensive care, pain and critical emergency medicine.
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