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Treatments, Mechanisms, and Adverse Reactions of Anesthetics and Analgesics [Pehme köide]

Edited by (Consultant, Medical Protocol Department, King Abdulaziz Medical City, Ministry of National Guard Heath Affairs, Riyadh, Saudi Arabia), Edited by , Edited by (Professor, Department of Clinical Biochemistry, Kings College Hospital, London, UK; Emeritus Profes), Edited by
  • Formaat: Paperback / softback, 680 pages, kõrgus x laius: 276x216 mm, kaal: 1800 g, Approx. 250 illustrations; Illustrations, Contains 1 Paperback / softback and 1 Digital (delivered electronically)
  • Ilmumisaeg: 14-Feb-2022
  • Kirjastus: Academic Press Inc
  • ISBN-10: 0128202378
  • ISBN-13: 9780128202371
Teised raamatud teemal:
Treatments, Mechanisms, and Adverse Reactions of Anesthetics and AnalgesicsSuurem pilt
  • Formaat: Paperback / softback, 680 pages, kõrgus x laius: 276x216 mm, kaal: 1800 g, Approx. 250 illustrations; Illustrations, Contains 1 Paperback / softback and 1 Digital (delivered electronically)
  • Ilmumisaeg: 14-Feb-2022
  • Kirjastus: Academic Press Inc
  • ISBN-10: 0128202378
  • ISBN-13: 9780128202371
Teised raamatud teemal:
Püsilink: https://www.kriso.ee/db/9780128202371.html
Märksõnad:

Treatments, Mechanisms, and Adverse Reactions of Anesthetics and Analgesics is an essential read for anyone working in pain management. The book addresses the onset of pain, the cause of the pain, and the administration of analgesia or anesthesia. The etiology of pain is complex and multi-factorial, which is made more complex with the use of analgesics and local or general anesthetics. This volume works to clarify all of the subjects pertinent to anesthesia and the brain, from their variety, modes of action, and adverse effects.

  • Provides a broad range of topics related to the neuroscience of analgesics and anesthetics
  • Contains chapter abstracts, key facts, a dictionary of terms, and summary points to aid in understanding
  • Discusses anesthesia types, mechanisms of action and affiliated effects
  • Helps readers navigate key areas for research and further clinical recommendations
Contributors xxi
Preface xxvii
Part I Drugs and agents used in anesthesia and analgesia
1 Anesthesia for malignant hyperthermia susceptible patients
Calim Neder Neto
Mariana Fontes Lima Neville
Helga Cristina Almeida da Silva
Introduction
3(1)
Diseases associated with susceptibility to MH
4(1)
Clinical manifestation-MH crisis
5(1)
Diagnosis and differential diagnosis
6(1)
Treatment of MH crisis
7(2)
Anesthesia for patients susceptible to malignant hypertermia
9(2)
Pre-operative care
9(1)
Perioperative care
10(1)
Applications to other areas
11(1)
Other agents of interest
11(1)
Mini-dictionary of terms
12(1)
Key facts of malignant hyperthermia
12(1)
Summary points
12(1)
References
13(2)
2 Use of dextran in regional anesthesia
Masahiko Tsuchiya
Introduction
15(1)
History of dextran as an LA adjuvant
16(2)
Adrenaline and dextran as LA adjuvant
16(1)
Adverse effects of adjuvant adrenaline
16(2)
Reduction of adrenaline toxicity by dextran addition
18(1)
First appearance of dextran as LA adjuvant
18(1)
Mechanism of dextran as LA adjuvant
18(1)
Application of dextran as LA adjuvant for regional anesthesia
18(5)
Suitability of LA-dextran mixture for compartment nerve block
18(1)
LA-dextran mixture enhances analgesic effects of compartment nerve block
19(1)
LA-dextran mixture used for compartment nerve block remains at injection site more than 24 h
19(2)
Dextran inhibits unintended spread of injected LA
21(2)
Summary of application of dextran as LA adjuvant
23(1)
Future studies
23(1)
Other agents
23(1)
Mini-dictionary or terms
23(1)
Key facts
24(1)
Summary points
24(1)
References
24(3)
3 Intraperitoneal local anesthetic agents in the management of postoperative pain
Karlin Sevensma
Introduction
27(1)
Anatomic considerations and agents
27(3)
Laparoscopic cholecystectomy
27(1)
Laparoscopic appendectomy
28(1)
Gynecologic surgery
28(1)
Instillation at hemidiaphragm for phrenic nerve pain prevention
28(2)
Safety of intraperitoneal anesthetics
30(1)
Applications to other areas
30(1)
Other agents of interest
31(1)
Mini-dictionary of terms
31(1)
Key facts of intraperitoneal local anesthetic agents in the management of postoperative pain
31(1)
Summary points
31(1)
References
31(2)
4 Automatic control of anesthesia via different vital signs
Jerry Chen
Maysam F. Abbod
Jiann-Shing Shieh
Introduction
33(1)
Anesthesia and its interpretation-Hypnosis, nociception, and neuromuscular relaxation
33(1)
Clinical signs and physiological signals in the surgery
34(1)
Modeling and control of anesthesia
35(1)
Automatic control of hypnosis
35(1)
Automatic control of analgesia
36(1)
Automatic control of neuromuscular relaxation
36(1)
The seven stages for automatic control of anesthesia
37(1)
Applications to other areas
38(1)
Other agents of interest
38(1)
Key facts
39(1)
Key facts of anesthetic agents
39(1)
Key facts of Propofol
39(1)
Mini-dictionary of terms
39(1)
Summary points
40(1)
References
40(3)
5 Non-opioid based analgesia in otolaryngology
Yohanan Kim
Anthony Sanchez
Khanh Nguyen
Introduction
43(1)
Patient pain experience in otolaryngology
43(2)
Oral cavity and oropharynx
44(1)
Nasal surgery
44(1)
Otologic surgery
44(1)
Visceral/soft tissue
45(1)
Oncologic surgery
45(1)
Risk factors for greater pain experience
45(1)
Non-opioid analgesia
45(3)
Local anesthetics
45(1)
Acetaminophen
46(1)
NSAI Ds
46(1)
Gabapentinoids
47(1)
Discussion
48(1)
Applications to other areas
48(1)
Other agents of interest
49(1)
Key facts
49(1)
Key facts of patient pain experience in otolaryngology
49(1)
Key facts of pain medication use in otolaryngology
49(1)
Mini-dictionary of terms
50(1)
Summary points
50(1)
References
50(5)
Part II Mechanisms of action of drugs
6 Buprenorphine: Mechanism and applications
Albert Lin
Anuj Aggarwal
Introduction
55(1)
Buprenorphine pharmacology
55(1)
Adverse effects
56(1)
Clinical use of buprenorphine
57(1)
Perioperative management
57(1)
Applications to other areas
58(1)
Other agents of interest
58(1)
Methadone
58(1)
Naltrexone
59(1)
Key facts
59(1)
Key facts of buprenorphine
59(1)
Mini-dictionary of terms
59(1)
Summary points
59(1)
References
60(3)
7 Caffeine as analgesic adjuvant
Thomas W. Weiser
Introduction
63(1)
Caffeine: Mechanism of action and effects in preclinical models of pain
63(1)
Caffeine's analgesic properties in humans
63(1)
Pharmacokinetic properties in man in absence and presence of analgesics
64(1)
Clinical efficacy data in acute pain trials
65(1)
Caffeine and the ceiling effect of NSAI Ds
66(1)
Comparisons of caffeine-containing analgesics with active comparators
66(1)
Caffeine and migraine
67(1)
Caffeine and worsening of headache diseases?
67(1)
Pain and functional impairment
68(1)
Safety of caffeine and caffeine-containing analgesics
68(1)
Effects attributable to caffeine
68(1)
Effects attributable to the analgesic compound
69(1)
Applications to other areas
69(1)
Other agents of interest
70(1)
Key facts of caffeine
70(1)
Mini-dictionary of terms
70(1)
Summary points
70(1)
References
71(2)
8 Chloroprocaine: Features and applications
Barbara Rupnik
Alain Borgeat
Introduction
73(1)
History and controversies
73(1)
Pharmacology overview
73(1)
Structure and properties
74(1)
Pharmacokinetics of 2-chloroprocaine
74(1)
Mechanism of action
74(1)
Clinical application
75(2)
Adverse effects
77(1)
Chloroprocaine 2%: Suggested application
77(1)
Mini-dictionary of terms
77(1)
Key facts of chloroprocaine: Features and applications
78(1)
Summary points
78(1)
References
78(3)
9 Clonidine: Features and applications
Renato Santiago Gomez
Magda Lourenco Fernandes
Introduction
81(1)
Pharmacological characteristics
81(1)
Pharmacodynamics
81(1)
Pharmacokinetics
82(1)
Clinical applications in the perioperative period
82(3)
Pre-anesthetic medication
82(1)
Adjunct to regional anesthesia
83(1)
Protection of the cardiovascular system
83(1)
Controlled hypotension
84(1)
Anti-shivering effect
85(1)
Postoperative agitation
85(1)
Applications to other areas
85(1)
Other agents of interest
86(1)
Conclusions
87(1)
Key facts
87(1)
Mini-dictionary of terms
87(1)
Summary points
87(1)
References
87(3)
10 An excursion into secondary pharmacology of fentanyls with potential implications for drug design: al receptor
Piotr F.J. Lipinski
Edina Silks
Malgorzata Jaroriczyk
Piotr Kosson
Sandor Benyhe
Aleksandra Misicka
Jan Cz Dobrowolski
Joanna Sadlej
The role of fentanyl
90(1)
Secondary pharmacology of fentanyls
90(2)
σ1 receptor: A unique and intriguing protein
92(2)
Affinity of fentanyls for aσ1R
94(1)
Fentanyls and σ1R: Insights from computations
95(1)
Pharmacological relevance of fentanyls' interactions with σ1R
96(1)
Fentanyl structure as scaffold for dual μOR/σ1R ligands
96(1)
Successful realization of the dual itOR/aiR ligands concept
97(1)
Applications to other areas
97(1)
Other agents of interest
98(1)
Key facts of σ1 receptor
99(1)
Mini-dictionary of terms
99(1)
Summary points
99(1)
References
99(2)
11 Isoflurane: Mechanisms and applications
Lady Christine Ong Sio
Marina Varbanova
Alexander Bautista
Introduction
101(1)
Chemical structure and properties
102(1)
Pharmacology and pharmacokinetics
102(1)
Mechanism of action
102(1)
Clinical effects
103(2)
Central nervous system effects
104(1)
Respiratory effects
104(1)
Cardiac effects
104(1)
Skeletal and smooth muscle effects
104(1)
Hepatic effects
104(1)
Renal effects
105(1)
Obstetric effects
105(1)
Adverse effects
105(1)
Malignant hyperthermia
105(1)
Teratogenic effects
105(1)
Environmental effects
105(1)
Metabolism
105(1)
Drug-drug interactions
106(1)
Opioids
106(1)
Nitrous oxide
106(1)
Neuromuscular blocking agents
106(1)
Epinephrine
106(1)
Calcium antagonists
106(1)
Concomitant use of beta blockers
106(1)
Application to other areas
106(1)
Other agents of interest
106(1)
Mini-dictionary of terms
107(1)
Key facts of isoflurane
107(1)
Summary points
107(1)
References
107(2)
12 The lidocaine patch: Features and applications: Post-thoracotomy pain and beyond
Alfonso Fiorelli
Pasquale Sansone
Caterina Pace
Mario Santini
Introduction
109(1)
Search strategy
110(1)
Search results
110(6)
Analysis of the results
116(1)
Discussion
117(1)
Conclusions
118(1)
Key facts of lidocaine patch for controlling acute postoperative pain
118(1)
Summary points
118(1)
References
119(2)
13 Memantine: Features and application in the management of chronic pain
Harsha Shanthanna
Introduction
121(1)
Background: NMDA antagonists and pain
122(1)
Memantine: Fundamental pharmacology
122(2)
Memantine: Preclinical evidence of effect on pain
124(1)
Memantine: Clinical evidence and literature review in chronic pain
124(3)
Memantine: Considerations for clinical use
127(1)
Applications to other areas
127(1)
Other agents of interest
127(1)
Conclusions
128(1)
Key facts
128(1)
Mini-dictionary of terms
128(1)
Summary points
128(1)
References
128(3)
14 Midazolam: Mechanism and perioperative applications
Joe C. Hong
Introduction
131(1)
Mechanism of action
132(1)
Pharmacokinetics
132(1)
Effects on the central nervous system
133(1)
Effects on the respiratory system
134(1)
Effects on the cardiovascular system
134(1)
Clinical uses and dosage
134(1)
Applications to other areas: Palliative care
135(1)
Other agents of interest: Flumazenil
136(1)
Key facts of midazolam
136(1)
Mini-dictionary of terms
136(1)
Summary points
137(1)
References
137(2)
15 Intravenous paracetamol: Features and applications
Ristiawan M. Laksono
Isngadi Ahmad Wagimin
Introduction
139(1)
Chemical structure and pharmacokinetics
139(7)
Paracetamol pharmacokinetics
140(1)
Site of action of paracetamol
141(1)
Inhibition of COX pathway
141(1)
Modulation of endogenous cannabinoid system
141(1)
Inhibition of nitric oxide
141(1)
Pharmacokinetics of intravenous paracetamol in adult
142(1)
The use of intravenous paracetamol in adult
142(2)
Non-superiority of IV paracetamol
144(1)
The role of paracetamol to control breakthrough pain
144(1)
Paracetamol in obstetrics
144(1)
Pharmacokinetics of intravenous paracetamol in children
145(1)
The use of paracetamol in children
145(1)
Side effect of intravenous paracetamol
146(1)
Applications to other areas
146(1)
Other agents of interest
147(1)
Mini-dictionary of terms
147(1)
Key facts of intravenous paracetamol
147(1)
Summary points
148(1)
References
148(3)
16 Prilocaine: Mechanisms and application
Naresh Kumar Katari
Sreekantha B. Jonnalagadda
The journey of local anesthetic
151(1)
Structure
152(1)
Classification of anesthetic drugs
153(1)
Prilocaine
153(4)
Preparation method of prilocaine:
157(1)
Pharmacology and mechanism action of local anesthetic agent-Prilocaine
157(1)
Lipid solubility and protein binding
158(1)
Metabolism and excretion
158(3)
Distribution
159(1)
Elimination
160(1)
Duration of anesthesia
160(1)
Toxicity
160(1)
Methemoglobinemia
160(1)
Applications
161(1)
Other applications of prilocaine
161(1)
Other agents of interest
162(1)
Mini-dictionary of terms
162(1)
Key facts
162(1)
Summary and conclusion
162(1)
References
163(2)
17 Sevoflurane: Features and uses in topical application for wound care
Manuel Geronimo-Pardo
Introduction
165(1)
Systemic effects of sevoflurane and haloethers as general anesthetics
165(1)
Analgesic effects of sevoflurane and haloethers on the central nervous system
166(1)
Peripheral analgesic effects of sevoflurane and haloethers
166(1)
Off-label use of topical sevoflurane on painful chronic wounds
167(5)
Analgesic profile
167(1)
Analgesic effect on different types of wounds and pains
167(5)
Quality of life and opioid-sparing effect
172(1)
Safety issues of topical sevoflurane
172(1)
Local adverse effects
172(1)
Systemic adverse effects for patients
172(1)
Systemic adverse effects for health workers
173(1)
Greenhouse effect
173(1)
Dosages and methods of administration
173(1)
Economic implications
173(1)
Application to other areas
174(1)
Sevoflurane as an antimicrobial agent for infected wounds
174(1)
Sevoflurane as a prohealing agent for hard-to-heal wounds
175(1)
Topical sevoflurane for painful conditions different from wounds
175(1)
Other agents of interest
175(1)
Mini-dictionary of terms
176(1)
Key facts of painful chronic wounds
177(1)
Summary points
177(1)
References
177(4)
18 Tramadol as an analgesic
Ayman M. Mahmoud
Emad H.M. Hassanein
Introduction
181(1)
Mechanism(s) of action
181(1)
Central analgesic mechanism
181(1)
Peripheral local anesthetic mechanism
181(1)
Effect of tramadol on other receptors
182(1)
Pharmacokinetics
182(1)
Absorption
182(1)
Distribution
182(1)
Metabolism
182(1)
Excretion
182(1)
Therapeutic uses
183(2)
Neuropathic pain
183(1)
Osteoarthritis pain
183(1)
Cancer pain
183(1)
Pain in the emergency department
184(1)
Acute myocardial infarction pain
184(1)
Postoperative pain
184(1)
Postoperative shivering
185(1)
Acute renal pain
185(1)
Tramadol as a local anesthetic
185(1)
Use/off-label use
185(1)
Adverse effects and management of tramadol toxicity
185(1)
Dependence, withdrawal, abuse, and tolerance
186(1)
Contraindications
186(1)
Seizure disorders
186(1)
Liver disease
186(1)
Renal dysfunction
186(1)
Respiratory depression
187(1)
Suicidal tendency
187(1)
Conclusion
187(1)
Applications to other areas
187(1)
Other agents of interest
187(1)
Mini-dictionary of terms
187(1)
Key facts
188(1)
Summary points
188(1)
Conflict of interest
188(1)
References
188(7)
Part III Adverse effects, reactions, and outcomes
19 Long-term effects of anesthesia on the brain: an update on neurotoxicity
Rajkumar Rajendram
Vinood B. Patel
Victor R. Preedy
Introduction
195(10)
Neurotransmitters signaling during cerebral development
196(1)
Neurotoxicity of anesthetic agents
197(1)
Historical overview
198(2)
Effect of surgical stress on the developing brain
200(1)
Cognitive and behavioral development in Homo sapiens after childhood surgery
200(2)
The effect of anesthesia on neuronal networks
202(1)
The long-term effects of excessive neurotransmitter modulation during CNS development
202(1)
Studies in nonhuman primates
202(1)
Application to other areas: The aging brain
203(1)
Conclusion
204(1)
Mini-dictionary of terms
205(1)
Key facts of the United States Federal Drug Administration (FDA)
205(1)
Key facts of anesthetic neurotoxicity
205(1)
Key facts of postoperative cognitive dysfunction
205(1)
Other agents of interest
206(1)
Summary points
206(1)
References
206(5)
20 Breastfeeding and mother-baby dyad's competence following neuraxial labor analgesia
Roberto Giorgio Wetzl
Maria LoreIla Gianni
Enrica Delfino
Alessandra Consales
Introduction
211(1)
Human rotational delivery and childbirth pain
211(1)
From prayers to neuraxial analgesia: A brief history of childbirth pain relief
212(1)
The analgesia-breastfeeding issue: Alleged mechanism of interference
213(1)
Exclusive breastfeeding for the first 6 months of infant's life: Health impact
213(1)
The analgesia-breastfeeding issue in the literature
213(5)
Limitations of current knowledge
213(1)
Conflicting study design, sampling strategies and enrolment criteria
213(1)
Different accuracy in reporting labor neuraxial blockade techniques
213(2)
The choice of confounders
215(1)
Methodological flaws
215(3)
Global literature overview
218(1)
The analgesia-breastfeeding issue as a new research opportunity
218(1)
Breastfeeding as a measure of dyadic neurological competence
218(2)
Searching for objective, nonbiased indicators of breastfeeding initiation success
220(1)
Measuring and grading breastfeeding initiation success
221(1)
Conclusion
221(1)
Applications to other areas
221(1)
Other agents of interest
222(1)
Mini-dictionary of terms
222(1)
Key facts of labor analgesia state of art in guidelines and metaanalyses
222(1)
Summary points
223(1)
References
223(4)
21 Mechanistic overview of how opioid analgesics promote constipation
Jesse J. Di Cello
Arisbel B. Gondin
Simona E. Carbone
Daniel P. Poole
Introduction
227(1)
The enteric nervous system: Master regulator of GI function
228(1)
Opioid receptors and their endogenous ligands
229(1)
Opioids inhibit GI function through actions on the ENS
230(1)
How do opioids exert their inhibitory effects on GI motility to promote chronic constipation?
231(1)
General effects of opioids on GI motility
231(1)
Opioid-induced constipation is resistant to tolerance development
231(1)
Application to other areas
232(1)
Other agents of interest
232(1)
Mini-dictionary of terms
232(1)
Key facts of opioid-induced constipation
232(1)
Summary points
233(1)
References
233(2)
22 Cognitive behavioral therapy for chronic pain and opioid use disorder
Marina G. Gazzola
Mark Beitel
Christopher J. Cutter
Declan T. Barry
Introduction
235(1)
Prevalence of chronic pain and OUD
235(1)
Clinical complexity of patients with chronic pain and OUD
236(1)
Provider consideration
236(1)
Necessary pharmacological platform: Medication for opioid use disorder
237(1)
Optimal medical management
237(1)
Overview of CBT for chronic pain and OUD
238(1)
CBT modules
238(1)
Seven clinical problems or challenges
238(3)
Clinical problem 1: Treating chronic pain as if it were acute pain
238(1)
Clinical problem 2: Patient inactivity
238(1)
Clinical problem 3: Decreased distress tolerance
238(2)
Clinical problem 4: Catastrophizing
240(1)
Clinical problem 5: Focusing on what's going wrong
240(1)
Problem 6: Viewing substance use as "just happening" and "beyond their control"
241(1)
Problem 7: Decreased assertiveness
241(1)
Applications to other areas: Real-world delivery of CBT for chronic pain and OUD
241(1)
Alternative therapies
242(1)
Conclusions
242(1)
Mini-dictionary of terms
242(1)
Key facts of CBT for chronic pain and OUD
242(1)
Summary points
242(1)
References
243(4)
23 Preoperative opioid and benzodiazepines: Impact on adverse outcomes
Martin Ingi Sigurosson
Introduction
247(1)
Definition of chronic opioid and BZD usage
247(1)
Prevalence of chronic preoperative opioid and BZD usage
248(1)
Characteristics of patient cohorts with preoperative chronic opioid and BZD usage
248(4)
Perioperative outcomes of patients taking opioids and BZDs preoperatively
252(1)
Inadequate perioperative analgesia
252(1)
Increased risk of complications from analgesia
253(2)
Other short-term outcomes
255(1)
Long-term postoperative outcomes for patients
255(1)
Application to other areas
256(1)
Other agents of interest
256(2)
Mini-dictionary of terms
258(1)
Key facts
258(1)
Summary points
258(1)
References
259(2)
24 Malignant hyperthermia syndrome and hydrogen sulfide signaling: Role of Kv7 channels
Mariarosaria Bucci
Valentina Vellecco
Antonio Mancini
Giuseppe Cirino
Introduction
261(1)
IVCT procedure
262(1)
Hydrogen sulfide
262(1)
Hydrogen sulfide and MH
263(1)
Potassium channels as H2S molecular targets in MHS subjects
264(1)
The paradoxical depolarizing activity of Kv7 channel in MHS subjects
264(1)
Protein posttranslational modifications: Persulfidation (S-sulphydration)
265(1)
Persulfidation of Kv7 channels in MH syndrome
266(1)
Applications to other areas
267(1)
Hydrogen sulfide signaling and SKM: Beyond MH
267(1)
Other agents of interest
268(1)
Future perspectives
268(1)
Mini-dictionary of terms
269(1)
Key facts of "malignant hyperthermia syndrome and hydrogen sulfide signaling role of Kv7 channels"
269(1)
Summary points
269(1)
References
270(3)
25 Problems with epidural catheter
Mustafa Kemal Arslantas
Introduction
273(1)
Problems encountered while inserting an epidural catheter
273(1)
Breakage of epidural catheters
274(1)
Blocked epidural catheter
275(1)
Epidural catheter removal difficulty
275(1)
Spinal epidural hematoma
276(1)
Spinal epidural abscess
277(1)
Application to other areas
277(1)
Other agents of interest
277(1)
Mini-dictionary of terms
277(1)
Key facts
277(1)
Key facts of problems with epidural catheter
277(1)
Summary points
278(1)
References
278(3)
26 Headache after neuraxial blocks: A focus on combined spinal-epidural anesthesia
Haluk Ozdemir
Reyhan Arslantas
Introduction
281(1)
History of PDPH
281(1)
The importance of PDPH
282(1)
The mechanism of PDPH
282(1)
The characteristics of PDPH
282(1)
Combined spinal-epidural anesthesia
282(1)
Combined spinal-epidural anesthesia for special patient groups
283(1)
Effects of application techniques of CSEA on headache
283(1)
Prophylaxis of PDPH after UDP in neuroaxial anesthesia
284(1)
Management of PDPH
285(2)
Supportive treatment
285(1)
Medical management
285(1)
Epidural blood patch
286(1)
Alternative therapies
286(1)
Conclusion
287(1)
Application to other areas
287(1)
Other agents of interest
287(1)
Mini-dictionary of terms
287(1)
Key facts
287(1)
Key facts of headache after neuraxial blocks
287(1)
Summary points
288(1)
References
288(3)
27 Liposomal bupivacaine, pain relief and adverse events
Huseyin Oguz Yilmaz
Alparslan Turan
Introduction
291(1)
Liposomes and DepoFoam
292(1)
Liposomal bupivacaine
292(2)
Clinical pharmacology
294(3)
Release characteristics and stability
294(1)
Pharmacodynamics and mechanism of action
294(1)
Pharmacokinetics
294(3)
Safety and adverse events
297(2)
Central nervous system toxicity
297(1)
Cardiovascular system toxicity
298(1)
Local adverse events
298(1)
Maternal/fetal toxicity
299(1)
Compatibility
299(1)
Clinical uses and efficacy
299(2)
Liposome bupivacaine versus placebo
300(1)
Surgical site infiltration
300(1)
Peripheral nerve blocks and perineural use
300(1)
Neuraxial use
301(1)
Administration
301(1)
Application to other areas
301(1)
Other agents of interest
301(2)
Mini-dictionary of terms
303(1)
Key facts of liposome bupivacaine
303(1)
Summary points
304(1)
References
304(5)
28 Adverse events associated with analgesics: A focus on paracetamol use
Iwona Popiolek
Grzegorz Porebski
Introduction
309(1)
Mechanism of toxicity
310(1)
Clinical and laboratory manifestations of hepatotoxicity
311(1)
Risk factors of liver injury
311(1)
Management of acute poisoning
312(1)
Chronic poisoning
312(1)
Immediate hypersensitivity
313(1)
Delayed hypersensitivity
313(1)
Diagnosis and management of paracetamol-induced hypersensitivity reactions
314(1)
Applications to other areas
314(1)
Other agents of interest
315(1)
Mini-dictionary of terms
315(1)
Key facts of paracetamol-induced toxicity and hypersensitivity
316(1)
Summary points
316(1)
References
316(5)
Part IV Novel and nonpharmacological aspects and treatments
29 Acronychia pedunculata leaves and usage in pain
U.G. Chandrika
W.M.K.M. Ratnayake
Introduction
321(1)
Traditional medicinal system in Sri Lanka
321(1)
Acronychia pedunculata as a Sri Lankan medicinal plant
322(1)
Chemistry and biological activities of A. pedunculata
322(1)
Anti-inflammatory activity of A. pedunculate leaves
323(1)
Identification of anti-inflammatory fractions and active compounds of A. pedunculate leaves
324(1)
Analgesic activity of A. pedunculate leaves
325(1)
Other areas of applications of A. pedunculata
325(1)
Other agents of interest
325(1)
Conclusion
326(1)
Mini-dictionary of terms
326(1)
Key facts
326(1)
Summary
326(1)
A list of other novel plant-based agents used in analgesia or anesthesia
326(1)
References
327(2)
30 Adansonia digitata and its use in neuropathic pain: Prostaglandins and beyond
Aboyeji Lukuman Oyewole
Abdulmusawwir O. Alli-Oluwafuyi
Abdulrazaq Bidemi Nafiu
Aminu Imam
Introduction
329(1)
Brief description of Adansonia digitata
329(1)
Distribution
330(1)
Significance of Adansonia digitata
330(2)
Relevance among local folks
330(1)
Medicinal importance
331(1)
Composition of Adansonia digitata plant
332(1)
Phytochemical constituents
332(1)
Mineral components
332(1)
Impact of Adansonia digitata on pain
332(8)
Effect on pain sensation
332(6)
Effect on neuropathic pain
338(2)
Potential mechanism of actions for A. digitata extract, from prostaglandins and beyond
340(3)
Prostaglandin E2 pathway
340(1)
Inflammatory and oxidative stress pathways
341(1)
Peripheral and central sensitization pathways
341(2)
lons-mediated pathways
343(1)
Applications to other areas
343(2)
Metabolic diseases
343(1)
Malaria
344(1)
Neuroprotection
344(1)
Antiviral
345(1)
Other agents of interest
345(1)
Mini-dictionary of terms
345(1)
Key facts
346(1)
Summary points
346(1)
References
346(5)
31 Andrographis paniculata standardized extract (ParActin) and pain
Rafael A. Burgos
Pablo Alarcon
Juan L. Hancke
Introduction
351(1)
Andrographis paniculata: Classification and composition
351(1)
Preclinical antiinflammatory and analgesic effects of A. paniculata and andrographolide contained in ParActin
352(1)
Mechanism of action of andrographolide, the active principle of ParActin in inflammation and pain
353(1)
Effect of andrographolide on the NF-KB pathway
353(2)
Effects of Andrographolide on MAPK and AP-1
355(1)
Antioxidant effect of andrographolide and role of the Nrf2/keap1 pathway
355(2)
Pharmacokinetics and metabolism
357(1)
Clinical pharmacology and side effects
357(1)
Contraindications and potential interactions
357(1)
Ongoing clinical trials in inflammation and pain
358(1)
Applications to other areas
358(1)
Other agents of interest
358(1)
Mini-dictionary of terms
358(1)
Key facts
359(1)
Summary points
359(1)
References
359(6)
32 Capsaicin: Features usage in diabetic neuropathic pain
Kongkiat Kulkantrakorn
Introduction
365(1)
Capsaicin
365(1)
Diabetic neuropathy
365(1)
Clinical data of capsaicin in painful diabetic neuropathy
366(2)
Early clinical studies
366(1)
Comparative studies
366(2)
Modern-day studies
368(1)
Low dose topical capsaicin
368(1)
High dose topical capsaicin
368(1)
Applications to other areas
369(1)
Other agents of interest
369(2)
Topical lidocaine
369(1)
Vitamin and supplements
370(1)
Mini-dictionary of terms
371(1)
Key facts
371(1)
Summary points
371(1)
References
371(4)
33 Cola nitida and pain relief
L.D. Adedayo
O. Bamidele
S.A. Onasanwo
Introduction on Cola nitida
375(1)
Brief review on Cola nitida
375(1)
Sociocultural values and uses
375(1)
Distribution of Cola nitida
376(1)
Composition of Cola nitida
376(1)
Uses of Cola nitida
376(1)
Traditional uses of Cola nitida
377(1)
Pharmacological potentials of Cola nitida
377(1)
Pain and nociception
377(1)
Causes of pain
377(1)
Classification of pain
378(1)
Nociceptive processing
378(1)
Pathologic pain
378(1)
Peripheral mechanisms of sensory transmission
378(1)
Cola nitida as a therapeutic agent for pain relief
379(2)
Application to other areas
381(1)
Other agents of interest
381(1)
Mini-dictionary
381(1)
Key facts
382(1)
Summary points
382(1)
References
382(3)
34 Analgesic effects of Ephedra herb and ephedrine alkaloids-free Ephedra herb extract (EFE)
Sumiko Hyuga
Shunsuke Nakamori
Yoshiaki Amakura
Masashi Hyuga
Nahoko Uchiyama
Yoshinori Kobayashi
Takashi Hakamatsuka
Yukihiro Goda
Hiroshi Odaguchi
Toshihiko Hanawa
Introduction
385(1)
Ephedra herb and ephedrine alkaloids
386(1)
Novel active ingredients, herbacetin-glycosides, in Ephedra herb and the analgesic effect of herbacetin, an active metabolite of herbacetin-glycosides
386(1)
Development of ephedrine alkaloids-free Ephedra Herb extract (EFE)
387(2)
Adverse effects of EHE and safety of EFE
389(1)
Analgesic effects of EHE and EFE on formalin-induced pain
389(1)
Analgesic effects of ENE, EFE, ephedrine, and pseudoephedrine on formalin- induced pain
390(4)
Analgesic effect of EFE on pain in arthritis model mouse
394(1)
Reduction of capsaicin-induced pain via transient receptor potential vanilloid 1 (TRPV-1) by EHE
394(1)
Application to other areas
395(1)
Conclusions and perspectives
396(1)
Other agents of interest
397(1)
Mini-dictionary of terms
397(1)
Key facts
397(1)
Key facts of formalin test
397(1)
Key facts of Ephedra herb macromolecule condensed-tannin (EMCT)
398(1)
Summary points
398(1)
References
398(4)
35 Euphorbia bicolor (Euphorbiaceae) latex phytochemicals and applications to analgesia
Paramita Basu
Dayna L. Averitt
Camelia Maier
Introduction
402(1)
Medicinal properties of the Euphorbia species
402(1)
Medicinal properties of E. bicolor latex
403(1)
Identification of E. bicolor latex phytochemicals
404(1)
Evidence of pain-relieving properties of the E. bicolor latex phytochemicals
405(8)
Development of E. bicolor phytochemicals as phytomedicines for pain management
413(1)
Mini-dictionary of terms
413(1)
Key facts about coumestans
414(1)
Key facts about diterpenes
414(1)
Key facts about flavonoids
414(1)
Key facts about isoflavones
414(1)
Summary points
414(1)
References
415(4)
36 Analgesic properties and mechanisms of action of Muntingia calabura extracts: A review
Zainul Aminuddin Zakaria
Tavamani Balan
Mohd Hijaz
Mohd Sani
Nurfuzillah Abdul Rani
Introduction
419(1)
Muntingia calabura L
420(1)
Antinociceptive activity of Muntigia calabura leaves extracts
421(3)
Mechanisms of action underlying the antinociceptive activity of Muntingia calabura leaves extracts
424(1)
Conclusion
425(1)
Applications to other areas
425(1)
Other agents of interest
426(1)
Mini-dictionary of terms
427(1)
Key facts of traditional and complementary medicine
427(1)
Summary points
428(1)
References
428(4)
37 Resolving neuroinflammation and pain with maresin 1, a specialized pro-resolving lipid mediator
Victor Fattori
Camila R. Ferraz
Fernanda Soares Rasquel-Oliveira
Tiago H. Zaninelli
Sergio M. Borghi
Rubia Casagrande
Waldiceu A. Verri Jr
Introduction
432(2)
MaR1
434(1)
Analgesic effects of MaR1
434(2)
Clinical analgesic evidence of MaR
R1
and its precursors
436(1)
Application to other areas
437(1)
Other agents of interest
438(1)
Mini-dictionary of terms
439(1)
Key facts
439(1)
Key facts of SPMs
439(1)
Key facts of MaR1
439(1)
Summary points
439(1)
Funding
439(1)
References
440(3)
38 Therapeutic role of naringenin to alleviate inflammatory pain
Manila F. Manchope
Camila R. Ferraz
Sergio M. Borghi
Fernanda Soares Rasquel-Oliveira
Anelise Franciosi
Julia Bagatim-Souza
Amanda M. Dionisio
Rubia Casagrande
Waldiceu A. Verri Jr
Introduction
443(1)
Naringenin actions on transient receptor potential (TRP) channels and inflammatory pain relief
444(2)
Naringenin inhibits the production of endogenous cytokines that mediate inflammatory pain
446(1)
Naringenin targets oxidative stress to reduce inflammatory pain
447(1)
Analgesic pathways actively induced by naringenin
447(1)
Naringenin modulates transcription factors and miRNA
448(1)
Clinical applicability and safety
448(1)
Applications to other areas
449(2)
Other agents of interest
451(1)
Mini-dictionary of terms
452(1)
Key facts of inflammatory pain
452(1)
Summary points
452(1)
Funding
453(1)
References
453(4)
39 Analgesic properties of plants from the genus Solanum L (Solanaceae)
F.J.R. Paumgartten
G.R. de Souza
A.J.R. da Silva
A.C.A.X. De-Oliveira
Introduction
457(2)
Solanum genus L (Solanaceae)
459(1)
Antinociceptive effects of Solanum spp. extracts
459(5)
Antiinflammatory activity of Solanum spp. extracts
464(1)
Type of analgesia produced by Solanum spp. extracts
465(1)
Chemical constituents of active extracts
465(2)
Other pharmaco-toxicological activities of interest
467(1)
Application to other areas
467(1)
Mini-dictionary of terms
467(1)
Key facts of Solanum analgesia
468(1)
Other agents of interest
468(1)
Summary points
468(1)
References
468(5)
40 Dietary constituents act as local anesthetic agents: Neurophysiological mechanism of nociceptive pain
Mamoru Takeda
Yoshihito Shimazu
Introduction
473(1)
Ascending pain pathway in trigeminal system
474(1)
Sensory transduction and noxious transmission
475(1)
Possible molecular targets for local anesthetic agents
476(1)
Generator potential in the nociceptive terminals
476(1)
Action potential in the nociceptive terminals
477(1)
Peripheral mechanism for potential candidates of dietary constituents as local anesthetic agents
477(2)
Modulation of generator potential by dietary constituents
477(1)
Modulation of action potential by dietary constituents
478(1)
Functional significance for dietary constituents as local anesthetic agents
479(1)
Future direction
480(1)
Concluding remarks
480(1)
Mini-dictionary of terms
480(2)
Key facts
482(1)
Summary points
482(1)
References
483(4)
41 Pain response following prenatal stress and its modulation by antioxidants
Che Badariah Abd Aziz
Asma Hayati Ahmad
Hidani Hasim
Introduction
487(1)
Oxidative stress
488(2)
Antioxidant
490(1)
Honey
490(1)
Protective effects of other antioxidants in the prenatally stressed offspring
491(2)
Resveratrol
491(1)
Spirulina
492(1)
Vitamins
492(1)
Applications to other areas
493(1)
Role on cardiovascular disease
493(1)
Role in diabetes mellitus
493(1)
Role as antimicrobial agent
493(1)
Other agents of interest
493(1)
Mini-dictionary of terms
494(1)
Key facts of prenatal stress
495(1)
Key facts of antioxidants
495(1)
Summary points
495(1)
References
495(4)
42 Physical activity and exercise in the prevention of musculoskeletal pain in children and adolescents
Pablo Molina-Garcia
Patrocinio Ariza-Vega
Fernando Estevez-Lopez
Background
499(1)
Physical activity in the prevention of musculoskeletal pain
499(2)
Physical activity recommendations
500(1)
Physical fitness components in the prevention of musculoskeletal pain
501(3)
Cardiorespiratory fitness and aerobic/ anaerobic training
501(1)
Muscular strength and resistance training
501(1)
Flexibility and mobility training
502(2)
Risk factors for MSKP and the preventive role of physical activity and exercise
504(3)
Biomechanical factors: An integrative approach
504(1)
Pediatric obesity
505(1)
Psychosocial factors
506(1)
Atypical brain development
507(1)
Applications to other areas
507(1)
Other agents of interest
508(1)
Mini-dictionary of terms
508(1)
Key facts
508(1)
Summary points
508(1)
References
509(4)
43 Linking aerobic exercise and childhood pain alleviation: A narrative
Tiffany Kichline
Adrian Ortega
Christopher C. Cushing
Introduction
513(1)
Aerobic activity levels in youth with chronic pain
513(1)
Effect of aerobic exercise on pediatric chronic pain intensity
514(1)
Current literature on effect of aerobic exercise on chronic pediatric pain intensity
514(3)
Effect of aerobic activity across pediatric chronic pain conditions
515(2)
Individual differences and the effect of aerobic exercise
517(1)
Aerobic exercise and strength training in pediatric chronic pain
517(1)
Conclusion
517(1)
Application to other areas
518(1)
Other agents of interest
518(1)
Mini-dictionary of terms
519(1)
Key facts
519(1)
Summary points
519(1)
References
519(4)
44 Physical activity and exercise in the management of chronic widespread musculoskeletal pain: A focus on fibromyalgia
Thomas Davergne
Fernando Estevez-Lopez
Ana Carbonell-Baeza
Inmaculada C. Alvarez-Gallardo
Musculoskeletal pain
523(1)
Physical activity in musculoskeletal pain: A historical perspective
523(1)
Levels of physical activity in musculoskeletal pain
524(1)
Interventions to enhance physical activity in musculoskeletal pain: Current evidence and novel approaches
524(1)
Physical exercise in musculoskeletal pain
525(1)
General advice to design physical exercise programs for chronic musculoskeletal pain
525(1)
Physical activity in fibromyalgia
525(1)
Aerobic exercise in fibromyalgia
526(10)
Resistance training in fibromyalgia
536(1)
Multicomponent exercise in fibromyalgia
536(1)
Mind-body exercise in fibromyalgia
536(4)
Exergames in fibromyalgia
540(1)
General exercise recommendations
540(1)
Effectiveness of physical exercise in fibromyalgia: A summary of the evidence
541(1)
Applications to other areas
541(1)
Other agents of interest
541(1)
Mini-dictionary of terms
541(1)
Key facts
541(1)
Summary points
542(1)
References
542(3)
45 Spinal cord stimulation and limb pain
Timothy Sowder
Usman Latif
Edward Braun
Dawood Sayed
History
545(1)
Conventional tonic SCS
545(1)
Dorsal root ganglion stimulation
546(1)
High frequency 10 kHz SCS
546(1)
Burst SCS
546(1)
Ischemic pain
547(1)
Patient selection
547(1)
Indications
547(1)
Failure of conservative treatment
547(1)
Psychological screening
547(1)
Medical comorbidities
548(1)
Screening trial
548(1)
Outcomes
548(2)
Failed back surgical syndrome
548(1)
Complex regional pain syndrome
549(1)
Diabetic neuropathy
550(1)
Ischemic pain
550(1)
Applications to other areas
550(1)
Other agents of interest
550(1)
Mini-dictionary of terms
551(1)
Key facts of spinal cord stimulation and limb pain
551(1)
Summary points
551(1)
References
551(4)
46 Effectiveness of neural mobilization on pain and disability in individuals with musculoskeletal disorders
Carlos Romero-Morales
Cesar Calvo-Lobo
David Rodriguez-Sanz
Daniel Lopez-Lopez
Marta San Antolin
Victoria Mazoteras-Pardo
Eva Maria Martinez-Jimenez
Marta Losa-Iglesias
Ricardo Becerro-de-Bengoa-Vallejo
Introduction
555(2)
Headache and neck pain
557(1)
Cervicobrachial pain
557(1)
Median, cubital, and radial nerves entrapment syndromes
558(1)
Low back pain
559(1)
Lower limb and neurodynamic techniques
559(1)
Clinical applications
560(1)
Application to other areas
561(1)
Other agents of interest
561(1)
Mini-dictionary of terms
561(1)
Key facts of musculoskeletal disorders
561(1)
Summary points
561(1)
References
562(3)
47 Virtual reality and applications to treating neck pain
M. Razeghi
I. Rezaei
S. Bervis
Introduction
565(1)
Neck pain and VR-based rehabilitation
565(1)
VR systems design in NP rehabilitation
566(3)
Clinical efficacy of VR in neck disorders
569(1)
Pain
569(1)
Kinematic impairments
570(1)
Disability
570(1)
Postural control and balance impairment
570(1)
Factors affecting the efficacy of VR-based treatment in NP
570(1)
VR application as an assessment tool in NP
571(1)
Disadvantages of VR application in NP
571(1)
Conclusions
572(1)
Applications to other areas
572(1)
Other agents of interest
572(1)
Mini-dictionary of terms
572(1)
Key facts of VR
572(1)
Summary points
572(1)
References
573(2)
48 Virtual reality induced analgesia and dental pain
Elitsa Veneva
Ani Belcheva
Ralitsa Raycheva
Introduction
575(1)
Distraction as an approach to relieve injection discomfort
575(1)
Virtual reality devices in dental pain management
576(2)
Safety considerations
578(1)
Effectiveness of VR in reduction of injection discomfort
578(1)
Applications to other areas
579(1)
Other agents of interest
579(1)
Mini-dictionary of terms
579(1)
Key facts of the use of VR devices in dental pain management
579(1)
Summary points
579(1)
References
580(3)
49 Vibrotactile devices, DentalVibe, and local anesthesia
Elitsa Veneva
Ani Belcheva
Ralitsa Raycheva
Introduction
583(1)
Non-pharmacological approach to injection discomfort
583(1)
Melzack and Wall's gate control theory of pain
583(1)
Fear of dental injections
584(1)
Reduction of discomfort during local anesthesia
584(1)
Vibrotactile devices for dental use
584(1)
Effectiveness in reduction of injection discomfort
584(1)
Evaluation of the efficacy of vibrotactile devices
585(1)
Applications to other areas
585(1)
Other agents of interest
585(1)
Mini-dictionary of terms
585(1)
Key facts of vibrotactile devices for dental use
585(1)
Summary points
586(1)
References
587(2)
50 Cooled radiofrequency ablation as a treatment for knee osteoarthritis
Antonia F. Chen
Eric J. Moorhead
Introduction
589(1)
Nonpharmacological and pharmacological conservative treatments
589(1)
Minimally invasive and surgical approaches
590(1)
Denervation treatment in knee osteoarthritis
590(1)
Cryoablation
590(1)
Radiofrequency ablation
591(1)
Clinical trials of radiofrequency ablation
592(1)
Other studies of radiofrequency ablation
592(1)
Summary of radiofrequency ablation
593(1)
Cooled radiofrequency ablation
593(1)
Clinical trials of cooled radiofrequency ablation
593(2)
Other studies of cooled radiofrequency ablation
595(1)
Summary of cooled radiofrequency ablation
596(1)
Applications to other areas
596(1)
Other ablative procedures of interest
597(1)
Mini-dictionary of terms
597(1)
Key facts of cooled radiofrequency ablation
597(1)
Summary points
597(1)
References
598(3)
51 Nonpharmacologic analgesic therapies: A focus on photobiomodulation, acustimulation, and cryoanalgesia (ice) therapy
Roya Yumul
Ofelia L. Elvir Lazo
Paul F. White
Introduction
601(1)
Photobiomodulation therapy
602(7)
History
602(1)
Mechanisms of PBMT
602(1)
PBMT treatment parameters
602(3)
How is PBMT administered?
605(2)
PBMT side effects
607(1)
PBMT clinical applications
608(1)
Conclusion
609(1)
Acustimulation
609(1)
Acupuncture
609(1)
Electroanalgesia
610(1)
Cryoanalgesia (ice) therapy
610(2)
Cryoanalgesia administration
611(1)
Clinical applications
611(1)
Conclusion
612(1)
Other agents of interest
612(1)
Mini-dictionary of terms
612(1)
Key facts of nonpharmacologic analgesic therapies
613(1)
Summary points
613(1)
References
613(4)
52 New coping strategies and self-education for chronic pain management: E-health
Victoria Mazoteras-Pardo
Marta San Antolin
Daniel Lopez-Lopez
Ricardo Becerro-de-Bengoa-Vallejo
Marta Losa-Iglesias
Carlos Romero-Morales
David Rodriguez-Sanz
Eva Maria Martinez-Jimenez
Cesar Calvo-Lobo
Introduction
617(1)
The epidemic of chronic pain
618(1)
Effective chronic pain management
619(1)
Pain detection
620(1)
Tools to assess chronic pain
620(1)
Current nonpharmacological interventions in chronic pain
621(2)
E-health in chronic pain
623(1)
Clinical applications
623(1)
Application to other areas
624(1)
Other agents of interest
624(1)
Mini-dictionary of terms
624(1)
Key facts of chronic pain
624(1)
Summary points
625(1)
References
625(4)
53 Postoperative pain management: Truncal blocks in obstetric and gynecologic surgery
Pelin Corman Dincer
Introduction
629(1)
Preparation for the truncal block
630(8)
Patient selection
630(1)
Truncal blocks of the abdominal wall
631(2)
Quadratus lumborum block
633(1)
Rectus sheath block
634(1)
Iliohypogastric and ilioinguinal nerve block
635(1)
Transversalis fascia plane block
636(1)
Lumbar paravertebral block
637(1)
Erector spina plane block
637(1)
Conclusion
638(1)
Application to other areas
638(1)
Other agents of interest
638(1)
Mini-dictionary of terms
638(1)
Key facts
639(1)
Key facts of truncal blocks in obstetric and gynecologic surgery
639(1)
Summary points
639(1)
References
639(4)
Index 643
Dr Rajkumar Rajendram is a clinician scientist with a focus on internal medicine, anaesthesia, intensive care and peri-operative medicine. He graduated with distinctions from Guys, Kings and St. Thomas Medical School, Kings College London in 2001. As an undergraduate he was awarded several prizes, merits and distinctions in pre-clinical and clinical subjects.

Dr Rajendram began his post-graduate medical training in general medicine and intensive care in Oxford. He attained membership of the Royal College of Physicians (MRCP) in 2004 and completed specialist training in acute and general medicine in Oxford in 2010. Dr Rajendram subsequently practiced as a Consultant in Acute General Medicine at the John Radcliffe Hospital, Oxford.



Dr Rajendram also trained in anaesthesia and intensive care in London and was awarded a fellowship of the Royal College of Anaesthetists (FRCA) in 2009. He completed advanced training in regional anaesthesia and intensive care. He was awarded a fellowship of the Faculty of Intensive Care Medicine (FFICM) in 2013 and obtained the European diploma of intensive care medicine (EDIC) in 2014. He then moved to the Royal Free London Hospitals as a Consultant in Intensive Care, Anaesthesia and Peri-operative Medicine. He has been a fellow of the Royal College of Physicians of Edinburgh (FRCP Edin) and the Royal College of Physicians of London (FRCP Lond) since 2017 and 2019 respectively. He is currently a Consultant in Internal Medicine at King Abdulaziz Medical City, National Guard Heath Affairs, Riyadh, Saudi Arabia.

Dr Rajendrams focus on improving outcomes from Coronavirus Disease 2019 (COVID-19) has involved research on point of care ultrasound and phenotypes of COVID-19. Dr Rajendram also recognises that nutritional support is a fundamental aspect of medical care. This is particularly important for patients with COVID-19. As a clinician scientist he has therefore devoted significant time and effort into nutritional science research and education. He is an affiliated member of the Nutritional Sciences Research Division of Kings College London and has published over 400 textbook chapters, review articles, peer-reviewed papers and abstracts.

Victor R. Preedy BSc, PhD, DSc, FRSB, FRSPH, FRSC, FRCPath graduated with an Honours Degree in Biology and Physiology with Pharmacology. After gaining his University of London PhD, he received his Membership of the Royal College of Pathologists. He was later awarded his second doctorate (DSc), for his contribution to protein metabolism in health and disease. He is Professor of Clinical Biochemistry (Hon) at Kings College Hospital and Emeritus Professor of Nutritional Biochemistry at Kings College London. He has Honorary Professorships at the University of Hull, and the University of Suffolk. Professor Preedy was the Founding Director and then long-term Director of the Genomics Centre at Kings College London from 2006 to 2020. Professor Preedy has been awarded fellowships of the Royal Society of Biology, the Royal College of Pathologists, the Royal Society for the Promotion of Health, the Royal Institute of Public Health, the Royal Society for Public Health, the Royal Society of Chemistry and the Royal Society of Medicine. He carried out research when attached to the National Heart Hospital (part of Imperial College London), The School of Pharmacy (now part of University College London) and the MRC Centre at Northwick Park Hospital. He has collaborated with international research groups in Finland, Japan, Australia, USA, and Germany. To his credit, Professor Preedy has published over 750 articles, which includes peer-reviewed manuscripts based on original research, abstracts and symposium presentations, reviews and edited books. Vinood B. Patel, BSc, PhD, FRSC, is currently Professor in Clinical Biochemistry at the University of Westminster. In 2014 Dr Patel was elected as a Fellow to The Royal Society of Chemistry. Dr Patel graduated from the University of Portsmouth with a degree in Pharmacology and completed his PhD in protein metabolism from Kings College London in 1997. His postdoctoral work was carried out at Wake Forest University Baptist Medical School, NC, USA studying structural-functional alterations to mitochondrial ribosomes, where he developed novel techniques to characterize their biophysical properties. Research is being undertaken to study the role of nutrients, antioxidants, phytochemicals, iron, alcohol and fatty acids in the pathophysiology of liver disease. Other areas of interest are identifying new biomarkers that can be used for the diagnosis and prognosis of disease and understanding mitochondrial oxidative stress in neurological disorders and iron dysregulation in diabetes. Dr Patel is a nationally and internationally recognized researcher and has several edited biomedical books related to the use or investigation of active agents or components. These books include The Handbook of Nutrition, Diet, and Epigenetics, Branched Chain Amino Acids in Clinical Nutrition, Cancer: Oxidative Stress and Dietary Antioxidants, Toxicology: Oxidative Stress and Dietary Antioxidants, Molecular Nutrition: Vitamins, The Neuroscience of Pain, Cognitive Behavioural Therapy. He is Editor of the ten-volume series Biomarkers in Disease: Methods, Discoveries and Applications. Colin R. Martin RN, BSc, MSc, PhD, MBA, YCAP, FHEA, C.Psychol, AFBPsS, C.Sci is Professor of Clinical Psychobiology and Applied Psychoneuroimmunology and Clinical Director of the Institute of Health and Wellbeing at the University of Suffolk, UK. He is a Chartered Health Psychologist and a Chartered Scientist. He also trained in analytical biochemistry, this aspect reflecting the psychobiological focus of much of his research within mental health. He has published or has in press well over 300 research papers and book chapters. He is a keen book author and editor having written and/or edited more than 50 books. These outputs include the prophetic insight into the treatment of neurological disease, Handbook of Behavior, Food and Nutrition (2011), Nanomedicine and the Nervous System (2012), Oxidative Stress and Dietary Antioxidants in Neurological Disease (2020), Zika Virus Impact, Diagnosis, Control and Models (2021), Factors Affecting Neurodevelopment: Genetics, Neurology, Behavior and Diet (2021), Diagnosis and Treatment of Spinal Cord Injury (2022), The Neurobiology, Physiology, and Psychology of Pain (2022) and The Handbook of Lifespan Cognitive Behavioral Therapy: Childhood, Adolescence, Pregnancy, Adulthood, and Aging (2023). Professor Martin is particularly interested in all aspects of the relationship between underlying physiological substrates and behavior, particularly in how these relationships manifest in both acute and chronic psychiatric disorder. He has published original research germane to significant mental health disorders including the areas of schizophrenia, anxiety, depression, self-esteem, alcohol and drug dependency, high secure forensic mental health and personality disorder. He has a keen interest in the impact of postviral illness and is actively involved in clinical research post-Covid pandemic and in particular, the impact of Long Covid on psychological, neurological, physiological and social functioning. He is involved in collaborative International research with many European and Non-European countries.