Abstract | BACKGROUND:
Ischemia-reperfusion (I/R) injuries consist of enhanced oxidative and inflammatory responses along with microvascular dysfunction after prolonged ischemia and reperfusion. Because I/R injuries induce chronic postischemia pain ( CPIP) in laboratory animals, it is possible that surgical procedures using prolonged ischemia may result in chronic postoperative pain. Glycemic modulation during ischemia and reperfusion could affect pain after I/R injury because glucose triggers oxidative, inflammatory, and thrombotic reactions, whereas insulin has antioxidative, antiinflammatory, and vasodilatory properties. METHODS: One hundred ten rats underwent a 3-h period of ischemia followed by reperfusion to produce CPIP. Rats with CPIP had previously been divided into six groups with differing glycemic modulation paradigms: normal feeding; fasting; fasting with normal saline administration; fasting with dextrose administration; normal feeding with insulin administration; and normal feeding with insulin and dextrose administration. Blood glucose concentration was assessed during I/R in these separate groups of rats, and these rats were tested for mechanical and cold allodynia over the 21 days afterward (on days 2, 5, 7, 9, 12, and 21 after I/R injury). RESULTS: CONCLUSION: Study results suggest that glucose levels at the time of I/R injury significantly modulate postinjury pain thresholds in rats with CPIP. Strict glycemic control during I/R injury significantly reduces CPIP and, conversely, hyperglycemia significantly enhances it, which could have potential clinical applications especially in the surgical field.
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Authors | Marie-Christine Ross-Huot, André Laferrière, Cho Min Gi, Mina Khorashadi, Thomas Schricker, Terence J Coderre |
Journal | Anesthesiology
(Anesthesiology)
Vol. 115
Issue 3
Pg. 614-25
(Sep 2011)
ISSN: 1528-1175 [Electronic] United States |
PMID | 21795964
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Blood Glucose
- Hypoglycemic Agents
- Insulin
- Glucose
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Topics |
- Animals
- Blood Glucose
(metabolism)
- Chronic Disease
- Cold Temperature
- Fasting
(physiology)
- Foot
(blood supply, pathology)
- Functional Laterality
(drug effects)
- Glucose
(pharmacology)
- Hot Temperature
- Hyperglycemia
(complications, drug therapy, etiology)
- Hypoglycemic Agents
(therapeutic use)
- Insulin
(therapeutic use)
- Male
- Pain
(drug therapy, etiology)
- Pain Measurement
- Physical Stimulation
- Rats
- Rats, Long-Evans
- Regional Blood Flow
(physiology)
- Reperfusion Injury
(complications)
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