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#pediatric analgesia
china-cryogenic-tanks · 6 months
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Nitrous Oxide Gas
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Nitrous Oxide Gas Suppliers
Medical  N2O Gas 40L cylinder 99.9%-99.999% industrial laughing gas, medical grade nitrous oxide Ammonium Nitrate produces food-grade N2O. Widely used for hospital applications. Another common application is Nitro booster in high-speed racing cars. Common purity: 99.9% Electronic purity: 99.999% DSW Nitrous Oxide has been exported to many countries like India, Pakistan, Malaysia, Indonesia, Australia, Netherlands, and Mexico.
Categories: Gases, Nitrous Oxide gasTags: industrial laughing gas, medical nitrous gas
Description
Medical grade nitrous oxide
Medical grade nitrous oxide can lower the mental consciousness of patients. This helps them tolerate pain and longer surgical processes. Nitrous oxide is a clear, colorless, slightly sweet-smelling, non-irritating gas used as a sedative and analgesic and supplied in blue (ultramarine) cylinders as determined by AS4484. Commonly referred to as laughing gas, nitrous oxide is used in surgery and dentistry for its pain-blocking and reducing effects.
Medical nitrous oxide is used in adults and children for: General anesthesia – usually as an adjuvant to other volatile or intravenous anesthetics Pain relief – employed with oxygen for analgesia in moderately painful procedures, such as dentistry, obstetrics, and fractures Conscious sedation is an effective and safe technique for reducing stress in the apprehensive or anxious individual.
Nitrous Oxide will support combustion and can detonate at temperatures over 650° C (1202° F). Over 80 percent of the Nitrous Oxide market is used as an analgesic property in the medicine/dentist industry.
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Nitrous Oxide Cylinder sizes
Product packagingsize10L40LOutside Diameter140/152/159 mm219mmHeight950/890/790mm1333mmWeight13.4/12.6/12.7 KGS48 KGSWorking pressure150BAR150BARTest pressure250BAR250BARMaterial37Mn37MnWall thickness4.1/4.4/4.4 mm5.7MMStandardISO9809-3ISO9809-3Filling weight( N2O)5 KGS20/24 KGS
medical grade laughing gas
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What is laughing gas?
Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, nitro, or nos, is a chemical compound, an oxide of nitrogen with the formula N2O. At room temperature, it is a colorless, non-flammable gas, and has a slightly sweet scent and taste. At elevated temperatures, nitrous oxide is a powerful oxidizer similar to molecular oxygen.
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Purity 99.9% NO Nitric Oxide Gas Medical Grade With Colorless Appearance CAS No.: 10102-43-9 EINECS No.: 233-271-0 UN No.: UN1660 Purity: 99.9% Dot Class: 2.3 Appearance: Colorless Grade Standard: Medical Grade
Nitric oxide dosing information Usual Pediatric Dose for Respiratory Failure:
Recommended dose: 20 ppm Duration of therapy: 14 days or until the underlying oxygen desaturation has resolved Weaning off: Down-titrate in several steps, pausing several hours at each stage to monitor for hypoxemia
Comments: -Doses above 20 ppm are not recommended -Avoid abrupt discontinuation Use(s): To improve oxygenation and reduce the need for extracorporeal membrane oxygenation in term and near term (over 34 weeks gestation) neonates with hypoxic respiratory failure associated with clinical or echocardiographic evidence of pulmonary hypertension in conjunction with ventilatory support and other appropriate agents
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zonemed · 6 months
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The Lifeline of Modern Medicine: The Intricate World of Infusion Pumps
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In today's rapidly advancing world of medicine, technology has revolutionized patient care. One of the most critical innovations in healthcare is the infusion pump, an essential device used to administer fluids, medications, and nutrients directly into a patient's bloodstream. This article explores the intricacies of infusion pumps, their various types, applications, and the significant impact they have on modern healthcare.
The Basics of Infusion Pumps
An infusion pump is a medical device designed to deliver fluids, such as medications, nutrients, or blood, into a patient's circulatory system in a controlled and precise manner. It ensures that the right substances enter the patient's body at the right rate, thereby preventing underdosing or overdosing, and allowing for accurate and safe therapy.
Types of Infusion Pumps
There are several types of infusion pumps, each serving specific purposes:
Volumetric Infusion Pumps: These pumps are commonly used to deliver medications and fluids in predefined volumes over a set period. They are commonly used in hospitals for tasks like administering intravenous (IV) fluids, antibiotics, and chemotherapy drugs.
Syringe Pumps: Syringe pumps are designed to infuse fluids at a precise and constant rate using a syringe as a reservoir. They are typically used for delivering smaller volumes of medication, such as in neonatal care or for pain management.
Elastomeric Pumps: These disposable, mechanical pumps operate on the principle of an elastomeric balloon that pushes fluid through a small opening. Elastomeric pumps are often used for ambulatory and home-based care.
PCA (Patient-Controlled Analgesia) Pumps: PCA pumps allow patients to self-administer pain medication within specified limits, providing them with a sense of control over their pain management.
Enteral Feeding Pumps: Designed for the delivery of liquid nutrition directly into the stomach or small intestine, enteral feeding pumps are vital for patients who cannot consume food or require specialized nutrition.
Applications in Healthcare
Infusion pumps play a crucial role in various medical settings, including:
Hospitals: Volumetric and syringe pumps are extensively used for precise administration of medications and fluids to hospitalized patients.
Ambulatory Care: Elastomeric pumps are increasingly popular for patients requiring continuous infusions, allowing them to move around with relative freedom.
Home Healthcare: As healthcare shifts towards a more patient-centric approach, infusion pumps are becoming common in home settings, particularly for the management of chronic diseases, enteral feeding, and pain control.
Oncology: Chemotherapy pumps deliver anticancer drugs precisely, helping to minimize side effects while effectively targeting cancer cells.
Neonatal and Pediatric Care: Syringe pumps are favored for delivering small doses of medication, making them ideal for neonatal and pediatric patients.
Benefits and Advancements
Infusion pumps have transformed healthcare delivery in several ways:
Precision: They ensure precise and accurate drug administration, reducing the margin for error.
Reduced Labor: Infusion pumps can significantly decrease the workload of healthcare professionals, allowing them to focus on other aspects of patient care.
Remote Monitoring: Many modern infusion pumps can be remotely monitored, enabling healthcare providers to track patients' progress and make necessary adjustments in real-time.
Enhanced Patient Comfort: Patients can receive continuous care, including pain management, at home, improving their quality of life.
Reduced Hospital Stays: Home-based infusion therapy can reduce hospital admissions and associated costs, making healthcare more affordable.
Challenges and Safety Measures
While infusion pumps offer numerous advantages, there are also challenges to consider, such as the risk of device-related errors or malfunction. Healthcare professionals must follow stringent safety protocols, including regular maintenance and calibration, proper training, and vigilant monitoring of patients using these devices.
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austinpublications · 8 months
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Is the Patient State Index Recorded with the Sedline Sedation Monitor Correlated with the Duration of Emergence after Pediatric Surgery: An Exploratory, Single-Center, Blinded, Prospective Cohort Study
Mitrev L1,2; Pasch S1; Brotman I1,2*; Gourkanti B1,2; Habib F1,2; Schwartz M1,2; van Helmond N2
Austin J Anesthesia and Analgesia. 2023; 11(2): 1114.
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celatum-apis · 11 months
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Continuous Epidural Analgesia Versus Continuous Peripheral Nerve Block in Unilateral ... - Cureus
This was a matched case comparison study of pediatric patients (ages 8-17) undergoing unilateral lower limb surgery (41 CEA and 36 CPNB). Patients ... from Google Alert - nerve surgery https://ift.tt/tZ6m3HB
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drbrianblick · 1 year
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Advances in pediatric anesthesia: From pharmacology to perioperative care
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Introduction
The field of pediatric anesthesia is rapidly evolving, with a growing body of research and practice focused on optimizing the perioperative experience for children. This article will explore some major advances in pediatric anesthesia, including pharmacology, physiology and pathophysiology, pharmacotherapeutics and perioperative care.
Advances in anesthetic pharmacology
Dissociative agents, opioids, benzodiazepines and alpha-2 agonists are the main classes of drugs used for anesthesia.
Dissociative agents such as ketamine have been used since the 1960s. They work by blocking NMDA receptors and causing a dissociation from reality. These agents can be used in pediatric patients to produce surgical anesthesia or analgesia; however there is little evidence supporting their use in children under 12 years old due to concerns about their safety profile (elevated risk of hallucinations) and lack of long term studies showing their efficacy over other options available today (such as propofol).
Opioids are another common class of medications used during anesthesia because they're effective at producing sedation while also providing analgesia following surgery or injury-related pain relief until other treatments kick in like opioids don't work well on their own which is why we often pair them with another drug like ketamine so that patients stay asleep throughout the procedure without waking up too soon after coming out from under general anesthesia
Advances in perioperative care
Perioperative care, which includes preoperative counseling and preparation, is an integral part of pediatric anesthesia. The main goals of perioperative care are to ensure that your child has no adverse reactions to sedation or anesthesia and is ready for surgery with minimal discomfort.
The following steps can help you prepare your child for surgery:
·        Preoperative counseling--Discussing the procedure in advance helps ensure that your child understands what will happen during surgery and can prepare him or her for it mentally. Your doctor may recommend reading books like "When I Get Bigger" by Dr Seuss (which addresses many common fears children have) or watching videos about surgeries on YouTube so they know what's going on before going into surgery.
·        Preoperative fasting--Your doctor will likely advise you not to feed your child anything after midnight the night before his or her procedure so his/her body doesn't have anything left in it when he/she wakes up from general anesthesia later that morning
Advances in anesthetic pharmacology and advances in perioperative care
Advances in Anesthetic Pharmacology
Advances in perioperative care and perioperative management are important to the practice of pediatric anesthesia. These advances include advances in anesthetic pharmacology, which include:
·        New drugs that were developed specifically for use in children, such as propofol (Diprivan), ketamine (Ketalar), rocuronium (Zemuron), and remifentanil (Ultiva). These medications have fewer side effects than older medications and can be used safely in children with a lower risk of adverse events. They also allow for faster recovery times after surgery; however, some studies show long-term effects on brain development from these drugs when used during critical periods of brain growth such as adolescence or childhood
Conclusion
Advances in anesthetic pharmacology and advances in perioperative care have led to safer, more effective anesthesia for children. The ability to customize the anesthetic for each patient's unique needs is especially important, as children differ from adults in terms of how quickly they metabolize drugs and recover from surgery.
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drcarloschacon · 1 year
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Moderate Procedure Sedation and Analgesia Practice Guidelines
You can pick which level of sedation to utilize during surgical operations using the Practice Guidelines for Moderate Procedural Sedation. You should assess your patient's physical condition and medical background before delivering any sedative. A focused physical examination of the patient's airway should also be performed. Review your patient's current prescriptions and allergies as well.
The AORN recently modified its analgesia and moderate sedation recommendations. The recommendations strongly emphasize the necessity of competent patient assessment and monitoring. The proposal also contains examples of patient care that highlight particular issues with mild sedation.
Hospitals in California that limit procedural sedation are depriving their patients of the best level of comfort. Additionally, these limitations compel emergency physicians to employ less efficient and secure sedatives. It would be beneficial for emergency physicians to make informed judgments and enhance the standard of care given to patients if there was a formal assessment of the present procedural sedation limitations in California hospitals.
Additionally, the CMS's guideline incorrectly divides the idea of sedation into two groups: anesthesia and analgesia. This disorientation may result in dangerous sedation. Separating procedural sedation from analgesia is also crucial. Anesthesia and analgesia are connected yet serve completely different purposes. To avoid needless hazards, ED doctors must manage the sedation continuum and be aware of these variations.
Only a qualified doctor should deliver moderate procedural sedation in hospitals. Although this method is secure, any untoward incidents must be attended to by a qualified physician. They must be able to analyze the airways of patients and determine their risk factors. In addition, they should be aware of the hazards and the procedures' techniques and equipment.
The Practice Guidelines for Moderate Procedural Sedation from the CMS guarantee that patients receiving moderate sedation receive the best possible treatment. The broadest spectrum of specialists should be involved in this activity, which should be multidisciplinary. An interdisciplinary team should likewise do the development of solutions to these problems.
A growing amount of evidence describes how moderate sedation can be used safely on kids and teenagers. Guidelines from the Paediatric Sedation Research Consortium and the American Academy of Pediatrics are also included in this material body. These recommendations should assist medical professionals in sedating children securely while they receive diagnostic or therapeutic procedures.
Although PSA is a fundamental skill in emergency care, different hospitals have different standards. Based on norms from medical associations, hospital-based committees create guidelines for PSA in the ED. Preprocedural fasting is not necessary for ED PSA, for instance. ETCO2 monitoring is not standard of care. Hence it should be done according to regional regulations.
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mcdonaldpridgen · 1 year
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Area Set up Plastic Mixture Fibers along with their Program within Fiber Strengthened Upvc composite.
Aim: We all considered usefulness, protection, submission through healthcare professionals, and satisfaction including father or mother total satisfaction of an revised NCA standard protocol in contrast to fixed-dose analgesia for the most part used for postoperative pain alleviation inside child fluid warmers people. Methods: A potential study layout ended up being executed within pediatric sufferers that have major medical procedures within a university or college medical center. Within the pre-NCA period, sufferers acquired a conventional fixed-dose opioid following surgical procedure. Within the NCA cycle, nurses might begin 2 additional small doasage amounts autonomously, since given, when the initial bolus had been inferior. Final result actions had been the quantity of average to serious ache ratings, respiratory system despression symptoms, complying by simply nursing staff, and also parent or guardian fulfillment. Final results: There are 117 and 113 individuals within the pre-NCA and NCA phases, respectively. Discovery of reasonable to significant pain bigger compared to Equates to A couple of episodes within All day and h soon after medical procedures was substantially larger from the NCA phase specifically in average in order to significant discomfort processes. Breathing major depression has not been seen in either stage. Many nursing staff showed beneficial thinking to be able to schedule using an altered NCA process. Parent satisfaction was high in equally groups. Finish: Your perspective of nurse practitioners to the altered NCA protocol had been good plus it significantly improved recognition of episodes of reasonable to be able to serious postoperative pain, that keeping that in mind increased affected individual attention and also pain relief without extreme unpleasant consequences.Since T cell difference brings about an extended selection associated with chemokine receptors, the subgroup associated with H protein-coupled receptors, we all hypothesized how the collection of Grams proteins could be changed inside parallel. We all examined the large quantity associated with mRNA and/or health proteins of six to eight H health proteins alpha-subunits in human being CD4(+) and also CD8(+) Big t mobile or portable subsets coming from bloodstream. Although many G proteins alpha-subunits have been in the same manner portrayed in all subsets, the actual great quantity regarding Gary alpha(e), the proteins not earlier referred to within hematopoietic cellular material, was greater inside storage versus unsuspecting cells. In line with these information, activation regarding trusting CD4(+) Capital t tissue in vitro substantially improved your great quantity regarding H alpha dog(e) in tissue ignited underneath nonpolarizing as well as Capital t(L)18 (however, not T()A single as well as Big t()Only two)-polarizing circumstances. In useful studies, the use of a chimeric H protein alpha-subunit, G Panobinostat in vitro alpha dog(qo5), indicated that chemokine receptors might pair to H alpha(to)-containing Gary healthy proteins.
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palesoultaco · 2 years
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Drug Infusion Market Growth, Global Survey, Analysis, Share, Company Profiles and Forecast by 2028
The report talks about the shift in demands and emerging trends that are expected to drive the growth of the Drug Infusion market. The rising demand for the Drug Infusion market is expected to drive the demand for Drug Infusion market, thereby bolstering the growth of the industry. Moreover, the report also studies the impact of the COVID-19 pandemic on the market.
The global drug infusion systems market size reached USD 10.56 Billion in 2020 and is expected to register a CAGR of 7.1%, during the forecast period, according to latest analysis by Emergen Research. Increasing demand for safe and precise drug delivery systems is a key driver expected to drive global drug infusion systems market revenue growth over the forecast period. Increasing application of drug infusion systems for chronic pain management is expected to further propel revenue growth of the global drug infusion systems market in the near future.
Increasing integration of advanced equipment and up-gradation of drug infusion systems, such as flow monitoring and microflow regulators, is expected to boost global drug infusion systems market revenue growth going ahead. However, lack of skilled healthcare professional to operate drug infusion systems is expected to hamper growth of the global drug infusion systems market to a certain extent over the forecast period.
Click the link to get info@ https://www.emergenresearch.com/industry-report/drug-infusion-systems-market
The complete regional analysis covers:
North America (U.S., Canada, Mexico)
Europe (U.K., Italy, Germany, France, Rest of EU)
Asia Pacific (India, Japan, China, South Korea, Australia, Rest of APAC)
Latin America (Chile, Brazil, Argentina, Rest of Latin America)
Middle East & Africa (Saudi Arabia, U.A.E., South Africa, Rest of MEA)
Competitive Landscape:
The latest report encases an in-depth summary of the intensely competitive landscape of the global Drug Infusion Systems market, with systematic profiling of the companies operating across this industry. In this section of the report, experts have listed down the strategic initiatives undertaken by these market rivals for proposed business expansion. Additionally, it highlights the key developments and financial positions of these companies to explain the overall market scenario. The company profiles of the established and new players have also been assessed in the report through effective analytical tools like SWOT analysis.
Key players in the market include Medtronic plc, Arcomed Ag, Baxter International Inc., Insulet Corporation, Smiths Group plc, Becton, Dickinson and Company, Halyard Health, Inc., ICU Medical, Inc., Flowonix Medical Inc., and Zyno Medical LLC
Emergen Research has segmented the global drug infusion systems market on the basis of control systems, infusion type, administration route, application, end-use, and region:
Control Systems Outlook (Revenue, USD Billion; 2018–2028)
Open Loop System
Closed Loop System
Infusion Type Outlook (Revenue, USD Billion; 2018–2028)
Continuous Infusion
Intermittent Infusion
Patient Controlled Infusion
Total Parenteral Nutrition
Administration Route Outlook (Revenue, USD Billion; 2018–2028)
Enteral
Subcutaneous
Intravenous
Arterial
Epidural
Application Outlook (Revenue, USD Billion; 2018–2028)
Pediatrics
Diabetes
Nutrition
Hematology
Analgesia
Chemotherapy
End-Use Outlook (Revenue, USD Billion; 2018–2028)
Diagnostic Centers
Hospitals
Ambulatory Surgical Centers
Key takeaways of the Global drug infusion systems Market report:
The report sheds light on the fundamental drug infusion systems market drivers, restraints, opportunities, threats, and challenges.
It elaborates on the new, promising arenas in the leading market regions.
It examines the latest research & development projects and technological innovations taking place in the key regional segments.
The research report reviews the regulatory framework for creating new opportunities in various regions of the market
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What Sets Us Apart
Dental Staff with a passion for high quality pediatric and orthodontic dental care.
Our Doctors and Staff at Kids Dental Care are committed to providing your child with the highest quality pediatric and orthodontic dental care in a gentle, efficient and professional manner. We place a great deal of importance on establishing lasting relationships with our families, based upon mutual trust and open communication. We invite your questions and value any suggestions that you may have.
Dr. Buccino and Dr. Oliveira have extensive training and experience in all areas of pediatric dentistry and orthodontics. They are committed to staying abreast of the latest techniques and scientific advances in pediatric dentistry and orthodontics by reviewing current dental journals and attending continuing education courses. Our office provide comprehensive services such as preventive dentistry, sealants, restorative dentistry, orthodontics, Invisalign,  infant dental care, pediatric dental trauma, oral surgery, nitrous oxide analgesia (laughing gas), conscious sedation (a way of using medication to relax a child without the loss of consciousness), and the option of treatment under general anesthesia in the hospital.
Our office uses the same state-of-the-art heat sterilization techniques as those in hospitals.  In fact, our office meets or exceeds all the sterilization and infection control guidelines as set forth by state and federal government, the American Academy of Pediatric Dentistry, The American Association of Orthodontists,  and the American Dental Association. This includes heat and chemical sterilization of our dental handpieces (drills) and instruments and high level disinfection of all operatory surfaces between patients.
We are proud of our office and welcome any questions you may have about our practice or your child’s treatment.
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scifigeneration · 5 years
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Brain over body: Hacking the stress system to let your psychology influence your physiology
by Vaibhav Diwadkar and Otto Muzik
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Researchers imagine tapping into your body’s reactions to extreme cold to reap psychological benefits. Ratushniak/Shutterstock.com
There are people who show incredible resistance to extremes of temperature. Think of Buddhist monks who can calmly withstand being draped in freezing towels or the so-called “Iceman” Wim Hof, who can remain submerged in ice water for long periods of time without trouble.
These people tend to be viewed as superhuman or special in some way. If they truly are, then their feats are simply entertaining but irrelevant vaudevillian acts. What if they’re not freaks, though, but have trained their brains and bodies with self-modification techniques that give them cold resistance? Could anyone do the same?
As two neuroscientists who have studied how the human brain responds to exposure to cold, we are intrigued by what happens in the brain during such resistance. Our research, and that of others, is beginning to suggest these kinds of “superpowers” may indeed result from systematically practicing techniques that modify one’s brain or body. These modifications may be relevant for behavioral and mental health, and can potentially be harnessed by anyone.
The body’s drive for balance
Behavioral modification techniques like yoga and mindfulness seek to modulate physiological equilibrium – what scientists call homeostasis. Homeostasis is a basic survival need and crucial for an organism’s physical integrity.
For example, when someone is exposed to cold, certain brain centers initiate changes in how the body responds. These include decreasing the blood flow to the extremities and activating deep-layer muscle groups to produce heat. These changes let the body hold onto more of its heat and occur automatically without conscious control.
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Messages go back and forth from brain to body, working to keep systems in homeostatic equilibrium. Diwadkar and Muzik, CC BY-ND
Homeostasis is maintained when peripheral organs (“the body”) collect sensory data and forward it to the processing center (“the brain”), which organizes and prioritizes this data, generating action plans. These directives are then conveyed to the body, which executes them.
It’s the balance between bottom-up physiological mechanisms and top-down psychological mechanisms that mediates homeostasis and guides actions. Our idea is that this balance between physiology and psychology can be “hacked” by training the brain to deal with exposure to cold. This is a very interesting trick – and we believe the brain changes that occur extend beyond just cold tolerance.
Brain systems for responding to cold
Brain systems for maintaining homeostasis form a complex hierarchy. Anatomical regions in the primitive brainstem (midbrain, pons) and the hypothalamus form a homeostatic network. This network creates a representation of the body’s current physiologic state.
Based on what this representation describes about the body’s conditions right now, regulatory processes trigger physiological changes in the periphery via the nervous system. The representation also generates basic emotional responses to physiologic changes – “cold is unpleasant” – that trigger actions – “I need to get indoors.”
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The midbrain, colored red in this illustration, is tucked deep inside the human brain. Life Science Databases(LSDB)/Wikimedia, CC BY-SA
In human beings, an area in the back of the midbrain called the periaqueductal gray is the control center that sends messages about pain and cold to the body. This area releases opioids and cannabinoids, brain chemicals also associated with mood and anxiety. The periaqueductal gray sends these chemical signals both to the body, via the descending pathway that suppresses the experience of pain and cold, and via other neurotransmitters to the brain.
Lower-order primitive networks, like those associated with the brain stem, evolved before higher-order regions of the brain, like those in its cortex. And, lower-order networks exert a greater influence on higher-order networks. Here’s a clear example: Being severely cold will interfere with rational thinking, a condition that in hypothermia is catastrophic. But one cannot simply imagine a sunny beach to wash away the unpleasantness associated with feeling very cold. In this instance, the “physiological” system outweighs the “psychological” system.
This asymmetry of causal effects in brain networks has been taken for granted. But could strategies that target innate physiological mechanisms induce top-down psychological control? Emerging research suggests that techniques that combine physiologic stressors with focused meditation may “break” this asymmetry, allowing the psychological to modulate the physiological. That’s what we observed in recent studies we performed on the “Iceman” Wim Hof.
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Otto Muzik prepares Wim Hof for fMRI scanner in order to see how his brain responds to cold exposure. Wayne State University, CC BY-ND
Hof’s self-modification techniques include controlled breathing (hyperventilation and breath retention) and meditation. In our study, he performed these techniques before we repeatedly exposed him to cold by pumping ice-cold 39 degrees Fahrenheit water through a whole-body wet suit he wore.
Breath retention and cold form two physiologic stressors, whereas meditation is a form of psychological control. When normal subjects are exposed to cold, body temperature changes, triggering homeostatic drives. But Hof’s skin temperature remained unchanged, unaffected by cold exposure. Moreover, unlike control subjects, he robustly activated the periaqueductal gray region of his brain, an area important for regulating pain. His self-taught technique appears to change his brain’s ability to deal with cold by modulating pain pathways.
Extending the benefits
What might explain our findings with the “Iceman”?
Cold exposure appears to trigger a stress-induced pain-relieving response in the homeostatic brain network, already primed by breath retention. Activation of the periaqueductal gray suggests a decrease in pain perception and therefore anxiety. These sustained changes in Hof’s homeostatic brain network increase his tolerance to cold. The effects are enhanced by focused meditation which generates the expectation of positive outcomes.
Here’s the crucial part: This expectation is likely to extend the effects of stress-induced pain relief beyond immediate cold exposure. If such an expectation – “I confronted the cold and feel invigorated” – is fulfilled, it will lead to the release of additional opioids or cannabinoids from the periaqueductal gray. This release can affect the levels of neurotransmitters such as serotonin and dopamine, further enhancing a feeling of overall well-being. This positive feedback loop is implicated in the well-known “placebo effect.”
More generally, techniques such as those Hof uses appear to exert positive effects on the body’s innate immune response as well. We expect them to also have positive effects on mood and anxiety because of the release of opioids and cannabinoids. Though these effects have not yet been well studied, by evoking a stress-induced analgesia reaction, we think that practitioners may assert “control” over key components of brain systems related to mood and anxiety.
At present, millions of people use drugs to help with feelings of depression and anxiety. Many of these drugs carry unwelcome side effects. Behavioral modification techniques that train users in ways to influence their brain’s homeostatic system could someday provide some patients with drug-free alternatives. Efforts to understand links between the brain’s physiology and its psychology may indeed hold the promise for a happier life.
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About The Authors:
Vaibhav Diwadkar is Professor of Psychiatry at Wayne State University and Otto Muzik is Professor of Pediatrics and Radiology, also at Wayne State University
This article is republished from our content partners at The Conversation under a Creative Commons license. 
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purkinjejunior · 5 years
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EMERGENCY MEDS 21: Fentanyl
CLASS: narcotic agonist/analgesic
MECHANISM OF ACTION
- elevates pain threshold by acting on pain receptors in the brain
- depresses CNS, depresses brain stem respiratory centers, decreases responsiveness to changes in PaCO2
- vasodilation, reducing preload and afterload
INDICATIONS
- analgesia (especially burns, renal colic, MI)
- post-intubation sedation
- RSI adjunct
CONTRAINDICATIONS
- hypersensitivity
- elevated intracranial pressure
- head injury with ALOC (relative)
- asthma (relative)
- abdominal pain (relative)
ADVERSE FX
CV
- bradydysrhythmias
- hypotension
- tachydysrhythmias
Resp
- respiratory depression/arrest
CNS
- excess sedation
- seizure
- pupil constriction
GI
- nausea/vomiting
Derm
- histamine release may cause local/general urticaria
ADULT DOSE
- 25-50 mcg increments slow IV/IO/IM/IN, total dose not to exceed 200 mcg
PEDIATRIC DOSE
12 months to 17 years old
- 1-2 mcg/kg increments IV/IO/IM/IN, total dose not to exceed 50 mcg
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