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Introduction: Neuropathic pain (NP) is caused by damage to the somatosensory system. Nerve damage often results in chronic pain states, including hyperalgesia and allodynia. This study aims to evaluate the anti-nociceptive effects of atorvastatin, vitamin C, and their combination on various laboratory tests in an experimental model NP in rats., Methods: To assess the analgesic effects of atorvastatin (5 and 10 mg/kg), vitamin C (500 mg/kg), and their co-administration on chronic constriction injury (CCI) was induced in rats. Behavioral tests, motor nerve conduction velocity (MNCV), pro-inflammatory cytokines, and oxidative markers were measured. Furthermore, histopathological examination was performed., Results: In the present study, it was found that the CCI model can significantly cause hyperalgesia and allodynia on the 21 st postoperative day. It was found that the co-administration of vitamin C and atorvastatin has attenuating effects on allodynia and hyperalgesia. Co-administration of vitamin C and atorvastatin also improved MNCV. In the treatment groups, the inflammatory reactions and oxidative markers decreased. Moreover, the co-administration of atorvastatin and vitamin C decreased the perineural inflammation around the sciatic nerve., Conclusion: The results of this study showed that vitamin C potentiates the analgesic effects of atorvastatin in this model of experimental pain, and simultaneous consumption of these medications may be considered as effective therapeutics for NP. The protective properties of atorvastatin, and vitamin C, and their combination on the NP that were assessed can be regarded as a novelty for this study., Highlights: The co-administration of atorvastatin and vitamin C significantly decreases inflammatory cytokines.The co-administration of atorvastatin and vitamin C significantly decreases stress oxidant markers.The co-administration of atorvastatin and vitamin C significantly attenuated nociceptive effects., Plain Language Summary: Nerve damage causes the deposition of inflammatory factors and or oxidative stress at the site of injury, which in turn activates glial cells that are involved in increasing the inflammatory process by producing and releasing pro-inflammatory agents and oxidative stress. Among statins, atorvastatin is a drug to reduce inflammation, and its effectiveness has been recorded as an antioxidant effect. Vitamin C is known as a neuroprotective agent. Ascorbate inhibits the production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in monocytes in high doses (20 mM) by inhibiting them. The rats were randomly divided into 7 groups of 10 animals as follows: 1: Sham-operated, 2: Chronic constriction injury (CCI), 3: CCI+vitamin C (500 mg/kg), 4: CCI+atorvastatin (5 mg/kg), 5: CCI+atorvastatin (10 mg/kg), 6: CCI+vitamin C (500 mg/kg)+atorvastatin (5 mg/kg), and 7: CCI+vitamin C (500 mg/kg)+atorvastatin (10 mg/kg). The results of the present study indicated that the anti-inflammatory, antioxidant, and neuroprotective properties of vitamin C and atorvastatin improved the effects of CCI in an empirical neuropathic in rats. Moreover, it was shown that the associated treatment with vitamin C and atorvastatin can reduce inflammatory factors, such as TNF-α and IL-6, and oxidative markers, such as glutathione peroxidase (GPx), superoxide dismutase (SOD), and malonaldehyde (MDA), while the nerve conduction velocity enhanced and inflammation decreased in histology studies in CCI rats., Competing Interests: The authors declared no conflict of interest., (Copyright© 2023 Iranian Neuroscience Society.)

Introduction  Headache after spinal anesthesia is a common complication, which is caused after dural puncture due to discharge of cerebrospinal fluid and reduction in the volume and pressure. Studies have shown that a variety of factors are involved including needle shape, needle size, patient's sex, age, duration of surgery, history of spinal anesthesia, and history of headaches. One possible factor is the phase of the menstrual cycle. Many studies have investigated the effect of the menstrual cycle on factors such as postoperative nausea, vomiting, propofol injection pain, and sore throat after intubation. Also, many studies have investigated the effect of different phases of the menstrual cycle on migraine headaches. Therefore, we decided to investigate the effect of different phases of the menstrual cycle on headache after spinal anesthesia. Materials and Methods  To determine the relationship between headache after spinal anesthesia and menstrual cycle, the study included all the patients undergoing spinal anesthesia in Shohada Ashayer and Asalian Hospitals of Khorramabad. This cohort study included 279 patients, and data collection tool was a questionnaire. The data from the questionnaire included age, menstrual phase, surgical procedures, pain location, pain intensity, history of spinal anesthesia, history of headache, and headache after spinal anesthesia. Results  There was no statistically significant difference between the location of headache, the history of spinal anesthesia, the location of headache, the history of headache, and menstrual phase. Conclusion  Considering the high incidence of postdural puncture headache in follicular phase, it is recommended that patients with a high risk of headaches undergo spinal anesthesia and surgery in the luteal phase.

Aim: The purpose of this study was to evaluate the antinociceptive interaction between bupivacaine and Artemisia aucheri. L encapsulated nanoparticles., Methods and Materials: The effect of bupivacaine and Artemisia aucheri.L alone, and their encapsulated co-administration was assessed using the 3% formalin test in rat. Increasing doses of bupivacaine (31.6, 100, 178, and 316 mg/kg) or Artemisia aucheri.L (5.6, 10, 17.8, and 31.6 mg/kg) were given i.p. 10 min before 3% formalin administration., Results: The possible mechanism(s) of action were analyzed for the encapsulated co-administration, naloxone (1 mg/kg) and N (G)-nitro-L-arginine methyl ester (L-NAME) (3 mg/kg) were used. Interaction index and isobolographic analysis and the demonstrated a synergistic effect. The experimental ED30 was lower as compared with theoretical ED30. Naloxone was shown to reduce the antinociceptive effect of the encapsulated co-administration., Discussion: These data suggest that the bupivacaine and Artemisia aucheri.L encapsulated nanoparticles gave a synergistic effect., Competing Interests: None., (© Georg Thieme Verlag KG Stuttgart · New York.)

Local infiltrations and regional blocks have been some of the effective ways employed to manage and control post-operative pain. One of the limitations of administration of local anesthesia drugs in post-operative conditions is its inability to act for a longer period of time. Multi-vesicular liposomes made up of bupivacaine have been progressively used for their increased duration of action. Compared to bupivacaine HCL, local infiltration of liposomal bupivacaine have shown to have a significantly increase the duration and delay in peak plasma concentration. In this article, we attempt to compare liposomal bupivacaine and bupivacaine based on available clinical literatures. Liposomal bupivacaine has been demonstrated to have promising implications in post- operative pain control resulting in increased patient satisfaction; reduced hospital admission and opioid induced adverse events. Clinical studies have identified liposomal bupivacaine to be effective in delivering increased post-operative pain control. The purpose of this review is to give a comprehensive comparison between bupivacaine liposomal and conventional bupivacaine based on reported clinical trials., Competing Interests: The authors have no conflict of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

Aims: Varicocelectomy is the most common operation carried out by doctors for male infertility treatment. The aim of varicocele treatment is to hinder the refluxing venous drainage to the testis, retaining arterial inflow, and lymphatic drainage. A lot of pain is generated after this surgery, and the use of opium should be reduced to nearest minimum, as all drugs are toxins. Thus the aim of the present study is to facilitate morphine usage reduction after varicocelectomy surgery., Material and Methods: One-hundred (100) patients who were varicocelectomy candidate were randomized into two groups: experimental group contain 50 patients and control group contain 50 patients as well. In experimental group, 2 mL magnesium sulfate in 2 mL normal saline was injected into patient immediately after surgery. The control group received only 4 mL normal saline. Morphine dosage administered, and severity of pain monitoring was accessed and recorded with a visual analogue scale (VAS)., Result: Result indicated that administration of morphine dosage in the test group 0.21 ± 0.64 mg was significantly lower as compared to the control group 0.75 ± 1.30 mg during the first 24-hour after surgery (p = 0.01). Average VAS scores in the experimental and control groups in the first 4-hour interval were 0.91 ± 1.30 and 2.9 ± 2.50 (p = 0.02) respectively. We observed a significant difference in the VAS score for pain severity and the dosages of morphine administered., Conclusions: The experimental group with magnesium sulfate in its drug formulation showed better pain control compared to the control group which received only normal saline, whose pain manifested after every few hours. This can be used for the formulation of opium for this surgery in a large scale.

Prolonged delivery of analgesic drugs at target sites remains a critical issue for efficient pain management. The use of nano-carriers has been reported to facilitate applicable delivery of these agents to target sites with a reduced level of systemic toxicity. Different analgesics have been loaded onto various nano carriers, including those that are natural, synthetic and copolymer, for various medical applications. In this review, we will discuss the concept of nano-formulated carriers for analgesic drugs and their impacts on the field of pain management.

Mortality and morbidity rate among cancer patients is at an alarming rate and its ratio of incidence is increasing as a result of its effects of metastasis and recurrence in its patients. Anesthetists are faced with the challenges daily of handling and treating cancer patients, for surgical resection to removal of the primary tumor. Retrospective analyses and studies have proposed a link between anesthetic technique and cancer outcomes. In this mini-review, we will give a summary of some of the available effects of anesthetic and analgesic techniques on cancer metastasis as derived from experimental cell culture and live animal data and also from clinical studies., Competing Interests: The authors deny any conflict of interest in any terms or by any means during the study. All the fees provided by research center fund and deployed accordingly., (© Georg Thieme Verlag KG Stuttgart · New York.)

Several advancements have been made on the exact release of local anaesthetics formulation and its efficiency at inducing motor and sensory block for an extended time has been harnessed in clinical practice. The use of sustained release formulations delivers analgesia for a lengthier period of time with one administration, thereby reducing complications that usually arise with administration of conventional analgesia. In addition, controlled release of an anaesthetic drug is said to prevent overdosing, reduced side effects, especially cardiotoxicity, neurotoxicity and tissue lesions. The use of nanotechnology knowledge via liposomal formulation has recorded high successful results in pain control and quick patient recovery.

Background: Oleuropein is a potent antioxidant and free-radical scavenger with antiinflammatory properties., Objectives: In the present study, we evaluated the protective effects of oleuropein on myeloperoxidase (MPO) activity, nitrite, urea, creatinine and glomerulosclerosis in alloxan-induced type 1 diabetic rats., Materials and Methods: Thirty Sprague-Dawley male rats were randomly divided into 3 groups: group 1 as control; group 2 as untreated diabetic; and group 3 as treated with oleuropein 15 mg/kg i.p daily. Diabetes was induced in the second and third groups by subcutaneous alloxan injection. After 48 days, the animals were anaesthetized and then the livers and kidneys were removed immediately and used fresh or kept frozen until MPO activity analysis. Blood samples were also collected before sacrificing to measure nitrite, urea, and creatinine. Kidney paraffin sections were prepared to estimate glomerular volume, leukocyte infiltration, and glomerulosclerosis., Results: Oleuropein significantly decreased leukocyte infiltration and glomerulosclerosis in the treated group compared with the diabetic untreated group. Oleuropein significantly decreased the levels of urea, nitrite, and creatinine in the treated group compared with the diabetic untreated group. Moreover, oleuropein significantly decreased MPO activity in the treated group compared with the diabetic untreated group., Conclusions: Oleuropein has antioxidative and antiatherogenic activities and exerts beneficial effects on inflammation and kidney function test and decreases diabetic complication in diabetic rats.