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Karl B Thor - One of the best experts on this subject based on the ideXlab platform.

  • inhibition of central sympathetic and somatic outflow to the lower urinary tract of the cat by the alpha sub 1 adrenergic receptor antagonist prazosin
    The Journal of Urology, 1995
    Co-Authors: Hansjorg Danuser, Karl B Thor
    Abstract:

    AbstractSelective alpha sub 1 adrenergic receptor antagonists are used to reduce the dynamic component of urethral obstruction in patients with benign prostatic hyperplasia. Their effectiveness is presumed to result from blockade of alpha1 adrenergic receptors within the prostatic smooth muscle. However, a reduction in central sympathetic tone to the prostate might also contribute to their effectiveness. The present experiments examined the effects of the selective alpha1 adrenergic receptor antagonist prazosin on sympathetic activity recorded from the Hypogastric Nerve in chloralose-anesthetized cats. For comparison, the effects of prazosin were also examined on somatic activity recorded from the pudendal Nerve. When the urinary bladder was empty, prazosin reduced spontaneous activity recorded from the Hypogastric Nerve (to 65 percent of control) and reduced evoked reflex activity recorded from the Hypogastric Nerve (to 44 percent of control) and the pudendal Nerve (to 48 percent of control). Interesting...

  • facilitatory and inhibitory effects of selective norepinephrine reuptake inhibitors on Hypogastric Nerve evoked urethral contractions in the cat a prominent role of urethral β adrenergic receptors
    The Journal of Urology, 1994
    Co-Authors: Johannes P Springer, Bradley P Kropp, Karl B Thor
    Abstract:

    AbstractTricyclic antidepressants (TCA), such as imipramine, are well-accepted for the treatment of urinary incontinence and enuresis, but their mechanism of action remains undefined due to their multiple pharmacological actions. To explore only the contribution imparted by sympathomimetic effects on the urethra by norepinephrine (NE) reuptake inhibition, two selective NE reuptake inhibitors (nisoxetine and tomoxetine) that possess no antimuscarininc or serotonergic properties were examined for their effects on sympathetic Hypogastric Nerve (HgN) evoked urethral contractions in chloralose anesthetized cats.Under control conditions, HgN stimulation produced a biphasic response composed of a consistent initial contraction that was prazosin- (α adrenergic antagonist) sensitive, followed by a more variable relaxation that was propranolol- (β adrenergic antagonist) sensitive. Unexpectedly, nisoxetine (0.03 to 1.0mg./kg. intravenously, n = 6) and tomoxetine (0.3 to 3mg./kg. intravenously, n = 3) produced decrea...

  • Facilitatory and inhibitory effects of selective norepinephrine reuptake inhibitors on Hypogastric Nerve-evoked urethral contractions in the cat: a prominent role of urethral beta-adrenergic receptors.
    The Journal of urology, 1994
    Co-Authors: Johannes P Springer, Bradley P Kropp, Karl B Thor
    Abstract:

    Tricyclic antidepressants (TCA), such as imipramine, are well-accepted for the treatment of urinary incontinence and enuresis, but their mechanism of action remains undefined due to their multiple pharmacological actions. To explore only the contribution imparted by sympathomimetic effects on the urethra by norepinephrine (NE) reuptake inhibition, two selective NE reuptake inhibitors (nisoxetine and tomoxetine) that possess no antimuscarinic or serotonergic properties were examined for their effects on sympathetic Hypogastric Nerve (HgN) evoked urethral contractions in chloralose anesthetized cats. Under control conditions, HgN stimulation produced a biphasic response composed of a consistent initial contraction that was prazosin- (alpha adrenergic antagonist) sensitive, followed by a more variable relaxation that was propranolol- (beta adrenergic antagonist) sensitive. Unexpectedly, nisoxetine (0.03 to 1.0 mg./kg. intravenously, n = 6) and tomoxetine (0.3 to 3 mg./kg. intravenously, n = 3) produced decreases (about 50% to 60% of control) in HgN-evoked contractions. These inhibitory effects of the reuptake inhibitors were reversed by propranolol. In cats that were pretreated with propranolol, nisoxetine produced a significant increase in HgN-evoked contractions. In conclusion, these results indicate that inhibition of NE reuptake into the sympathetic Nerve terminal produces a relative increase in the activation of beta adrenergic receptors compared with alpha adrenergic receptors in the urethra. This increased beta receptor stimulation might be due to a greater diffusion of NE away from the neuro-effector junction to extrajunctional sites following blockade of junctional reuptake. These findings should highlight the importance of urethral beta adrenergic receptors, which is not well-recognized in the literature.

Johannes P Springer - One of the best experts on this subject based on the ideXlab platform.

  • facilitatory and inhibitory effects of selective norepinephrine reuptake inhibitors on Hypogastric Nerve evoked urethral contractions in the cat a prominent role of urethral β adrenergic receptors
    The Journal of Urology, 1994
    Co-Authors: Johannes P Springer, Bradley P Kropp, Karl B Thor
    Abstract:

    AbstractTricyclic antidepressants (TCA), such as imipramine, are well-accepted for the treatment of urinary incontinence and enuresis, but their mechanism of action remains undefined due to their multiple pharmacological actions. To explore only the contribution imparted by sympathomimetic effects on the urethra by norepinephrine (NE) reuptake inhibition, two selective NE reuptake inhibitors (nisoxetine and tomoxetine) that possess no antimuscarininc or serotonergic properties were examined for their effects on sympathetic Hypogastric Nerve (HgN) evoked urethral contractions in chloralose anesthetized cats.Under control conditions, HgN stimulation produced a biphasic response composed of a consistent initial contraction that was prazosin- (α adrenergic antagonist) sensitive, followed by a more variable relaxation that was propranolol- (β adrenergic antagonist) sensitive. Unexpectedly, nisoxetine (0.03 to 1.0mg./kg. intravenously, n = 6) and tomoxetine (0.3 to 3mg./kg. intravenously, n = 3) produced decrea...

  • Facilitatory and inhibitory effects of selective norepinephrine reuptake inhibitors on Hypogastric Nerve-evoked urethral contractions in the cat: a prominent role of urethral beta-adrenergic receptors.
    The Journal of urology, 1994
    Co-Authors: Johannes P Springer, Bradley P Kropp, Karl B Thor
    Abstract:

    Tricyclic antidepressants (TCA), such as imipramine, are well-accepted for the treatment of urinary incontinence and enuresis, but their mechanism of action remains undefined due to their multiple pharmacological actions. To explore only the contribution imparted by sympathomimetic effects on the urethra by norepinephrine (NE) reuptake inhibition, two selective NE reuptake inhibitors (nisoxetine and tomoxetine) that possess no antimuscarinic or serotonergic properties were examined for their effects on sympathetic Hypogastric Nerve (HgN) evoked urethral contractions in chloralose anesthetized cats. Under control conditions, HgN stimulation produced a biphasic response composed of a consistent initial contraction that was prazosin- (alpha adrenergic antagonist) sensitive, followed by a more variable relaxation that was propranolol- (beta adrenergic antagonist) sensitive. Unexpectedly, nisoxetine (0.03 to 1.0 mg./kg. intravenously, n = 6) and tomoxetine (0.3 to 3 mg./kg. intravenously, n = 3) produced decreases (about 50% to 60% of control) in HgN-evoked contractions. These inhibitory effects of the reuptake inhibitors were reversed by propranolol. In cats that were pretreated with propranolol, nisoxetine produced a significant increase in HgN-evoked contractions. In conclusion, these results indicate that inhibition of NE reuptake into the sympathetic Nerve terminal produces a relative increase in the activation of beta adrenergic receptors compared with alpha adrenergic receptors in the urethra. This increased beta receptor stimulation might be due to a greater diffusion of NE away from the neuro-effector junction to extrajunctional sites following blockade of junctional reuptake. These findings should highlight the importance of urethral beta adrenergic receptors, which is not well-recognized in the literature.

K. Vaheesan - One of the best experts on this subject based on the ideXlab platform.

  • Superior Hypogastric Nerve block (SHNB) for pain control after uterine fibroid embolization (UFE): technique and troubleshooting.
    CVIR endovascular, 2020
    Co-Authors: K. Pereira, L. Morel-ovalle, Mehdi Taghipour, A. Sherwani, Roshni Parikh, Jerome Kao, K. Vaheesan
    Abstract:

    Superior Hypogastric Nerve Block (SHNB) has been shown to be an effective pain management technique after Uterine Fibroid Embolization (UFE), reducing the need for opiates and allowing same-day discharge after UFE. In this technical note we discuss relevant anatomy and technical details in performing SHNB. The Superior Hypogastric plexus (SHP) is the part of the abdominopelvic sympathetic nervous system that provides a targeted intervention to sympathetic-mediated pain pathways of pelvic organs and a target for an anterior approach Superior Hypogastric Nerve Block after embolization. Vascular structures are in close relation to the intended site of target of the SHP at the L5 vertebral body include aortic bifurcation and IVC confluence, hence a detailed knowledge of this is essential. A step by step technical approach to SHNB includes patient positioning for the block, image guidance and needle positioning, choice and technique of anesthetic injection. Traversing a large fibroid uterus, inadvertent vascular opacification and Local anesthetic systemic toxicity present challenges to performing the block and are addressed. Superior Hypogastric Nerve Block (SHNB) can be a useful tool in the Interventional armamentarium to make UFE a better experience for patients with fibroids, allowing for better pain control as well as facilitating same day discharge. Performing SHNB appear to be can be performed with technical ease for an interventional radiologist.

  • Intraprocedural Superior Hypogastric Nerve Block Allows Same-Day Discharge following Uterine Artery Embolization.
    Journal of vascular and interventional radiology : JVIR, 2020
    Co-Authors: K. Pereira, L. Morel-ovalle, Timothy L. Wiemken, Sakina Kazmi, Siddharth Rode, Anna K. Hardy, K. Vaheesan
    Abstract:

    In a single-arm, nonrandomized, retrospective case-control study, 39 patients (mean age, 44 y) who underwent elective outpatient uterine artery embolization with the use of superior Hypogastric Nerve block (SNHB) for pain control over a period of 3 years were identified. Technical success of SNHB was 87%. Of the 34 patients who received SNHB, 97% did not need a patient-controlled analgesia pump. The median opioid requirement for the 17 patients who needed opioid agents was 7.5 morphine milligram equivalents (interquartile range [IQR], 10). The median length of stay was 2.2 hours (IQR, 1.7 h). SHNB offers a safe and effective intervention that significantly reduces pain and the need for opiate agents and allows same-day discharge after uterine artery embolization.

Bradley P Kropp - One of the best experts on this subject based on the ideXlab platform.

  • facilitatory and inhibitory effects of selective norepinephrine reuptake inhibitors on Hypogastric Nerve evoked urethral contractions in the cat a prominent role of urethral β adrenergic receptors
    The Journal of Urology, 1994
    Co-Authors: Johannes P Springer, Bradley P Kropp, Karl B Thor
    Abstract:

    AbstractTricyclic antidepressants (TCA), such as imipramine, are well-accepted for the treatment of urinary incontinence and enuresis, but their mechanism of action remains undefined due to their multiple pharmacological actions. To explore only the contribution imparted by sympathomimetic effects on the urethra by norepinephrine (NE) reuptake inhibition, two selective NE reuptake inhibitors (nisoxetine and tomoxetine) that possess no antimuscarininc or serotonergic properties were examined for their effects on sympathetic Hypogastric Nerve (HgN) evoked urethral contractions in chloralose anesthetized cats.Under control conditions, HgN stimulation produced a biphasic response composed of a consistent initial contraction that was prazosin- (α adrenergic antagonist) sensitive, followed by a more variable relaxation that was propranolol- (β adrenergic antagonist) sensitive. Unexpectedly, nisoxetine (0.03 to 1.0mg./kg. intravenously, n = 6) and tomoxetine (0.3 to 3mg./kg. intravenously, n = 3) produced decrea...

  • Facilitatory and inhibitory effects of selective norepinephrine reuptake inhibitors on Hypogastric Nerve-evoked urethral contractions in the cat: a prominent role of urethral beta-adrenergic receptors.
    The Journal of urology, 1994
    Co-Authors: Johannes P Springer, Bradley P Kropp, Karl B Thor
    Abstract:

    Tricyclic antidepressants (TCA), such as imipramine, are well-accepted for the treatment of urinary incontinence and enuresis, but their mechanism of action remains undefined due to their multiple pharmacological actions. To explore only the contribution imparted by sympathomimetic effects on the urethra by norepinephrine (NE) reuptake inhibition, two selective NE reuptake inhibitors (nisoxetine and tomoxetine) that possess no antimuscarinic or serotonergic properties were examined for their effects on sympathetic Hypogastric Nerve (HgN) evoked urethral contractions in chloralose anesthetized cats. Under control conditions, HgN stimulation produced a biphasic response composed of a consistent initial contraction that was prazosin- (alpha adrenergic antagonist) sensitive, followed by a more variable relaxation that was propranolol- (beta adrenergic antagonist) sensitive. Unexpectedly, nisoxetine (0.03 to 1.0 mg./kg. intravenously, n = 6) and tomoxetine (0.3 to 3 mg./kg. intravenously, n = 3) produced decreases (about 50% to 60% of control) in HgN-evoked contractions. These inhibitory effects of the reuptake inhibitors were reversed by propranolol. In cats that were pretreated with propranolol, nisoxetine produced a significant increase in HgN-evoked contractions. In conclusion, these results indicate that inhibition of NE reuptake into the sympathetic Nerve terminal produces a relative increase in the activation of beta adrenergic receptors compared with alpha adrenergic receptors in the urethra. This increased beta receptor stimulation might be due to a greater diffusion of NE away from the neuro-effector junction to extrajunctional sites following blockade of junctional reuptake. These findings should highlight the importance of urethral beta adrenergic receptors, which is not well-recognized in the literature.

K. Pereira - One of the best experts on this subject based on the ideXlab platform.

  • Superior Hypogastric Nerve block (SHNB) for pain control after uterine fibroid embolization (UFE): technique and troubleshooting.
    CVIR endovascular, 2020
    Co-Authors: K. Pereira, L. Morel-ovalle, Mehdi Taghipour, A. Sherwani, Roshni Parikh, Jerome Kao, K. Vaheesan
    Abstract:

    Superior Hypogastric Nerve Block (SHNB) has been shown to be an effective pain management technique after Uterine Fibroid Embolization (UFE), reducing the need for opiates and allowing same-day discharge after UFE. In this technical note we discuss relevant anatomy and technical details in performing SHNB. The Superior Hypogastric plexus (SHP) is the part of the abdominopelvic sympathetic nervous system that provides a targeted intervention to sympathetic-mediated pain pathways of pelvic organs and a target for an anterior approach Superior Hypogastric Nerve Block after embolization. Vascular structures are in close relation to the intended site of target of the SHP at the L5 vertebral body include aortic bifurcation and IVC confluence, hence a detailed knowledge of this is essential. A step by step technical approach to SHNB includes patient positioning for the block, image guidance and needle positioning, choice and technique of anesthetic injection. Traversing a large fibroid uterus, inadvertent vascular opacification and Local anesthetic systemic toxicity present challenges to performing the block and are addressed. Superior Hypogastric Nerve Block (SHNB) can be a useful tool in the Interventional armamentarium to make UFE a better experience for patients with fibroids, allowing for better pain control as well as facilitating same day discharge. Performing SHNB appear to be can be performed with technical ease for an interventional radiologist.

  • Intraprocedural Superior Hypogastric Nerve Block Allows Same-Day Discharge following Uterine Artery Embolization.
    Journal of vascular and interventional radiology : JVIR, 2020
    Co-Authors: K. Pereira, L. Morel-ovalle, Timothy L. Wiemken, Sakina Kazmi, Siddharth Rode, Anna K. Hardy, K. Vaheesan
    Abstract:

    In a single-arm, nonrandomized, retrospective case-control study, 39 patients (mean age, 44 y) who underwent elective outpatient uterine artery embolization with the use of superior Hypogastric Nerve block (SNHB) for pain control over a period of 3 years were identified. Technical success of SNHB was 87%. Of the 34 patients who received SNHB, 97% did not need a patient-controlled analgesia pump. The median opioid requirement for the 17 patients who needed opioid agents was 7.5 morphine milligram equivalents (interquartile range [IQR], 10). The median length of stay was 2.2 hours (IQR, 1.7 h). SHNB offers a safe and effective intervention that significantly reduces pain and the need for opiate agents and allows same-day discharge after uterine artery embolization.