The Experts below are selected from a list of 180 Experts worldwide ranked by ideXlab platform
Jose L Ochoa - One of the best experts on this subject based on the ideXlab platform.
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sympathetically maintained pain i Phentolamine block questions the concept
Neurology, 1994Co-Authors: Renato J Verdugo, Jose L OchoaAbstract:Patients with “reflex sympathetic dystrophy” or “causalgia” underwent sympathetic blocks. In protocol A (77 patients), we infused placebo (saline) for 30 minutes followed by Phentolamine (35 mg). In protocol B (23 patients), the saline phase was followed by double-blind infusion of Phentolamine or phenylephrine (500 μg), a second phase of saline, and then the other active drug. We assessed magnitudes of pain and mechanical hyperalgesias on a 0-to-10 pain scale and monitored sensory and sympathetic effects. With protocol A, pain diminished significantly (≥ 50%) during placebo in 22 patients (28.9%) and during Phentolamine in seven (9.2%). With protocol B, four patients (17.3%) had relief of pain during placebo, four (17.3%) during phenylephrine, and two (8.7%) during Phentolamine. All “Phentolamine responders” had progressive pain relief from placebo. Two patients expressed relief during phenylephrine and worsening during Phentolamine. Most patients did not respond significantly to saline or drugs. Thus, pharmacologica manipulation of the alpha-1 adrenergic receptor by either agonist or antagonist drug does not influence neuropathic pains. These results raise questions about the existence of “sympathetically maintained pain,” as diagnosed by sympathetic blocks improperly controlled for placebo.
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Phentolamine sympathetic block in painful polyneuropathies ii further questioning of the concept of sympathetically maintained pain
Neurology, 1994Co-Authors: Renato J Verdugo, Mario Campero, Jose L OchoaAbstract:To test for the presence of “sympathetically maintained pain” (SMP), we administered placebo-controlled Phentolamine sympathetic blocks to 14 patients with painful polyneuropathies. Six received IV infusion of saline for 30 minutes, followed by Phentolamine (35 mg). In eight patients, the saline phase was followed by double-blind infusion of Phentolamine or phenylephrine (500 μg), a second saline phase, and then the other active drug. We measured magnitudes of spontaneous pain and mechanical hyperalgesias on a 0-to-10 pain scale every 5 minutes and monitored sensory and sympathetic effects clinically and through quantitative thermotest and thermography. Five patients reported significant diminution of pain (> 50%), all in response to placebo. Neither Phentolamine nor phenylephrine provided relief, although all patients had signs of physiologic abnormalities reputed to be determinants or predictors of SMP. These results complement previous studies demonstrating the nonexistence of SMP among “reflex sympathetic dystrophy” patients and further question the concept of SMP.
Renato J Verdugo - One of the best experts on this subject based on the ideXlab platform.
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sympathetically maintained pain i Phentolamine block questions the concept
Neurology, 1994Co-Authors: Renato J Verdugo, Jose L OchoaAbstract:Patients with “reflex sympathetic dystrophy” or “causalgia” underwent sympathetic blocks. In protocol A (77 patients), we infused placebo (saline) for 30 minutes followed by Phentolamine (35 mg). In protocol B (23 patients), the saline phase was followed by double-blind infusion of Phentolamine or phenylephrine (500 μg), a second phase of saline, and then the other active drug. We assessed magnitudes of pain and mechanical hyperalgesias on a 0-to-10 pain scale and monitored sensory and sympathetic effects. With protocol A, pain diminished significantly (≥ 50%) during placebo in 22 patients (28.9%) and during Phentolamine in seven (9.2%). With protocol B, four patients (17.3%) had relief of pain during placebo, four (17.3%) during phenylephrine, and two (8.7%) during Phentolamine. All “Phentolamine responders” had progressive pain relief from placebo. Two patients expressed relief during phenylephrine and worsening during Phentolamine. Most patients did not respond significantly to saline or drugs. Thus, pharmacologica manipulation of the alpha-1 adrenergic receptor by either agonist or antagonist drug does not influence neuropathic pains. These results raise questions about the existence of “sympathetically maintained pain,” as diagnosed by sympathetic blocks improperly controlled for placebo.
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Phentolamine sympathetic block in painful polyneuropathies ii further questioning of the concept of sympathetically maintained pain
Neurology, 1994Co-Authors: Renato J Verdugo, Mario Campero, Jose L OchoaAbstract:To test for the presence of “sympathetically maintained pain” (SMP), we administered placebo-controlled Phentolamine sympathetic blocks to 14 patients with painful polyneuropathies. Six received IV infusion of saline for 30 minutes, followed by Phentolamine (35 mg). In eight patients, the saline phase was followed by double-blind infusion of Phentolamine or phenylephrine (500 μg), a second saline phase, and then the other active drug. We measured magnitudes of spontaneous pain and mechanical hyperalgesias on a 0-to-10 pain scale every 5 minutes and monitored sensory and sympathetic effects clinically and through quantitative thermotest and thermography. Five patients reported significant diminution of pain (> 50%), all in response to placebo. Neither Phentolamine nor phenylephrine provided relief, although all patients had signs of physiologic abnormalities reputed to be determinants or predictors of SMP. These results complement previous studies demonstrating the nonexistence of SMP among “reflex sympathetic dystrophy” patients and further question the concept of SMP.
N Fredotovich - One of the best experts on this subject based on the ideXlab platform.
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comparative study of papaverine plus Phentolamine versus prostaglandin e1 in erectile dysfunction
The Journal of Urology, 1997Co-Authors: A Bechara, A Casabe, G Cheliz, S V Romano, N FredotovichAbstract:AbstractPurpose: We compared the efficacy and short-term adverse effects of 1 ml. 30 mg./ml. papaverine plus 0.5 mg./ml. Phentolamine versus 1 ml. 30 micro g./ml. prostaglandin E1 in patients undergoing pharmacological erection testing.Materials and Methods: A total of 60 patients (mean age 58 years) with a history of sexual erectile dysfunction longer than 6 months was randomly classified into 6 groups to be tested 1 week apart with the 2 solutions and with placebo to evaluate erection response and short-term adverse effects.Results: Of the patients tested with papaverine plus Phentolamine 54% responded with erections adequate for penetration, compared to 50% of those tested with prostaglandin E1 (p >0.05). Prolonged erection occurred in 18% of patients tested with papaverine plus Phentolamine and 15% of those tested with prostaglandin E1 (p >0.05). Pain was reported by 15 and 35% of patients, respectively (p <0.05).Conclusions: One ml. 30 mg./ml. papaverine plus 0.5 mg./ml. Phentolamine has the same eff...
Sara Fowler - One of the best experts on this subject based on the ideXlab platform.
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reversal of pulpal and soft tissue anesthesia by using Phentolamine a prospective randomized single blind study
Journal of Endodontics, 2013Co-Authors: Spencer Elmore, John Nusstein, Melissa Drum, Al Reader, Mike Beck, Sara FowlerAbstract:Abstract Introduction Phentolamine mesylate has been reported to be an effective local anesthetic reversal agent for soft tissue but has not been studied regarding reversal of pulpal anesthesia. The authors conducted a prospective randomized, single-blind study comparing the reversal of pulpal and soft tissue anesthesia when Phentolamine was administered at 30 minutes versus 60 minutes after the administration of an inferior alveolar nerve (IAN) block. Methods Ninety adult subjects received 2 sets of injections consisting of an IAN block followed by an injection of Phentolamine at 30 minutes and a sham injection at 60 minutes or a sham injection given at 30 minutes and a Phentolamine injection given at 60 minutes in 2 separate appointments. The authors used an electric pulp tester to test the first and second molars, premolars, and incisors for pulpal anesthesia in 4-minute cycles for 120 minutes. Lip and tongue soft tissue anesthesia was also monitored. Results Phentolamine significantly ( P Conclusions Phentolamine would be beneficial for patients who would like to experience a faster return to normal soft tissue function and sensation after the administration of local anesthesia. However, because pulpal anesthesia is also reversed fairly rapidly, Phentolamine should be administered at the end of the dental appointment.
B Goldwasser - One of the best experts on this subject based on the ideXlab platform.
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papaverine Phentolamine and prostaglandin e1 versus papaverine Phentolamine alone for intracorporeal injection therapy a clinical double blind study
The Journal of Urology, 1995Co-Authors: Ofer Z Shenfeld, J Hanani, Arieh L Shalhav, Y Vardi, B GoldwasserAbstract:AbstractPurpose: A study was designed to compare intracorporeal injections of papaverine plus Phentolamine (2-drug solution) and papaverine plus Phentolamine and prostaglandin E1 (3-drug solution) for the treatment for impotence.Materials and Methods: A total of 20 impotent patients received intracorporeal injections of the 2-drug or 3-drug solution alternately during 2 sessions, and the quality and duration of erections were assessed.Results: Of the patients 73 percent achieved a full erection with the 3-drug solution compared to 28 percent with the 2-drug solution. The average duration of erections was 57 minutes and 33.6 minutes, respectively. The complication rate was similar for the 2 treatments.Conclusions: Papaverine plus Phentolamine and prostaglandin E1 is superior to papaverine plus Phentolamine alone for the treatment of impotence.