Rasmussen - Revision history

M.bennett at 02:08, 10 October 2021

2021-10-10T02:08:29Z

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M.bennett at 05:26, 1 November 2020

2020-11-01T05:26:01Z

Gordoben: Imported from Wikispaces

2019-01-18T06:29:21Z

Imported from Wikispaces

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Evidence of a centrally mediated anti-inflammatory or direct anti-nociceptive effect of hyperbaric oxygen following a standard experimental thermal burn model

**Clinical Bottom Line:'''
1. HBO reduced the area of secondary hyperalgesic response in this burn model
2. There was no difference shown in the area of primary hyperalgesia
3. Combined, these findings suggest the action of HBO is centrally mediated and may be anti-nociceptive or anti-infammatory. 

'''Citation/s:''' 1. Rasmussen VM, Borgen AE, Jansen EC, Rotbøll Nielsen PH, Werner MU. Hyperbaric oxygen therapy attenuates central sensitization induced by a thermal injury in humans. Acta Anaesthesiologica Scandinavica. 2015 Jul 1;59(6):749-62 

'''Lead author's name:''' Per Rotboll Nielsen E-mail: per.rotboll.nielsen@regionh.dk 

'''Three-part Clinical Question:''' For volunteers subjected to a thermal injury model, does a hyperbaric oxygen exposure, compared to no specific intervention, result in any evidence of an anti-nociceptive action? 
Search Terms: Thermal burn; volunteer; nociception

'''The Study:''' Non-blinded randomised cross-over trial with intention-to-treat.
'''The Study Patients:''' Adult healthy male volunteers recruited from those previously volunteering for a thermal injury studies. 
Control group (N = 19; 17 analysed): Thermal injury to calf area by application of a probe at 47C, immediately followed by observation in a 1ATA air environment 
Experimental group (N = 19; 17 analysed): As above but injury followed immediately by one 90 minute session breathing 100% oxygen at 2.4 ATA 

**The Evidence:'''

{|
| '''Measure''' |||| '''Control Group''' |||| '''HBO Group''' || '''P-value'''
|-
|^ || '''Median''' || '''95% CI''' || '''Median''' || '''95%CI''' ||^
|-
| '''Area under curve of secondary hyperalgesia per min (cm2) over 237 minutes''' || 42 || 31.1 to 71.4 || 34.6 || 22.9 to 39.8 || 0.01
|-
| '''Area under curve of secondary hyperalgesia per min (mN) over 237 minutes''' || 124 || 55 to 209 || 155 || 101 to 226 || 0.01
|-
|}

**Comments:'''
1. Warm detection threshold, cool threshold and heat pain thresholds were not different between groups

2. There was a statistically evident reduction in secondary hyperalgesia in the control group who had previously had the HBO exposure. (A crossover effect).

3. There is a possibility of bias due to the lack of blinding.

'''Appraised by:''' Mike Bennett Friday, 18 January 2019

Email: [[mailto:m.bennett@unsw.edu.au | m.bennett@unsw.edu.au]] 

Kill or Update By: December 2024





[[File:sumhorsa.gif|center]]

'''[[Burns | BACK]]'''

@@ Line 1: / Line 1: @@
 <span style="font-size: 22pt;">Evidence of a centrally mediated anti-inflammatory or direct anti-nociceptive effect of hyperbaric oxygen following a standard experimental thermal burn model</span>
-**<span style="font-size: 120%;">Clinical Bottom Line:</span>'''
-<span style="font-size: 120%;">1. HBO reduced the area of secondary hyperalgesic response in this burn model</span>
+**<span style="font-size: 120%;">Clinical Bottom Line:</span>
 <span style="font-size: 120%;">2. There was no difference shown in the area of primary hyperalgesia</span>
-<span style="font-size: 120%;">3. Combined, these findings suggest the action of HBO is centrally mediated and may be anti-nociceptive or anti-infammatory. </span>
+<span style="font-size: 120%;">1. HBO reduced the area of secondary hyperalgesic response in this burn model</span> <span style="font-size: 120%;">2. There was no difference shown in the area of primary hyperalgesia</span> <span style="font-size: 120%;">3. Combined, these findings suggest the action of HBO is centrally mediated and may be anti-nociceptive or anti-infammatory.</span>
-<span style="font-size: 120%;">'''Citation/s:''' 1. Rasmussen VM, Borgen AE, Jansen EC, Rotbøll Nielsen PH, Werner MU. Hyperbaric oxygen therapy attenuates central sensitization induced by a thermal injury in humans. Acta Anaesthesiologica Scandinavica. 2015 Jul 1;59(6):749-62 </span>
+<span style="font-size: 120%;">'''Citation/s:''' 1. Rasmussen VM, Borgen AE, Jansen EC, Rotbøll Nielsen PH, Werner MU. Hyperbaric oxygen therapy attenuates central sensitization induced by a thermal injury in humans. Acta Anaesthesiologica Scandinavica. 2015 Jul 1;59(6):749-62</span>
-<span style="font-size: 120%;">'''Lead author's name:''' Per Rotboll Nielsen E-mail: per.rotboll.nielsen@regionh.dk </span>
+<span style="font-size: 120%;">'''Lead author's name:''' Per Rotboll Nielsen E-mail: per.rotboll.nielsen@regionh.dk</span>
-<span style="font-size: 120%;">'''Three-part Clinical Question:''' For volunteers subjected to a thermal injury model, does a hyperbaric oxygen exposure, compared to no specific intervention, result in any evidence of an anti-nociceptive action? </span>
+<span style="font-size: 120%;">'''Three-part Clinical Question:''' For volunteers subjected to a thermal injury model, does a hyperbaric oxygen exposure, compared to no specific intervention, result in any evidence of an anti-nociceptive action? </span> <span style="font-size: 120%;">Search Terms: Thermal burn; volunteer; nociception</span>
-<span style="font-size: 120%;">'''The Study:''' Non-blinded randomised cross-over trial with intention-to-treat.</span>
+<span style="font-size: 120%;">'''The Study:''' Non-blinded randomised cross-over trial with intention-to-treat.</span> <span style="font-size: 120%;">'''The Study Patients:''' Adult healthy male volunteers recruited from those previously volunteering for a thermal injury studies. </span> <span style="font-size: 120%;">Control group (N = 19; 17 analysed): Thermal injury to calf area by application of a probe at 47C, immediately followed by observation in a 1ATA air environment </span> <span style="font-size: 120%;">Experimental group (N = 19; 17 analysed): As above but injury followed immediately by one 90 minute session breathing 100% oxygen at 2.4 ATA</span>
-**<span style="font-size: 120%;">The Evidence:</span>'''
 {|
 |-
-|^   || <span style'''"display: block; text-align: center;">'''<span style'''"font-size: 110%;">Median</span>'''</span> || <span style'''"display: block; text-align: center;">'''<span style'''"font-size: 110%;">95% CI</span>'''</span> || <span style'''"display: block; text-align: center;">'''<span style'''"font-size: 110%;">Median</span>'''</span> || <span style'''"display: block; text-align: center;">'''<span style'''"font-size: 110%;">95%CI</span>'''</span> ||^
+| <span>'''<span>Measure</span>'''</span>
 |-
-| '''<span style'''"font-size: 110%;">Area under curve of secondary hyperalgesia per min (cm2) over 237 minutes</span>''' || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">42</span></span> || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">31.1 to 71.4</span></span> || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">34.6</span></span> || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">22.9 to 39.8</span></span> || <span style'''"display: block; text-align: center;"><span style="font-size: 110%;">0.01</span></span>
+| ^
 |-
-| '''<span style'''"font-size: 110%;">Area under curve of secondary hyperalgesia per min (mN) over 237 minutes</span>''' || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">124</span></span> || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">55 to 209</span></span> || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">155</span></span> || <span style'''"display: block; text-align: center;"><span style'''"font-size: 110%;">101 to 226</span></span> || <span style'''"display: block; text-align: center;"><span style="font-size: 110%;">0.01</span></span>
+| '''<span>Area under curve of secondary hyperalgesia per min (cm2) over 237 minutes</span>'''
 |-
 |}
-**<span style="font-size: 120%;">Comments:</span>'''
 <span style="font-size: 120%;">1. Warm detection threshold, cool threshold and heat pain thresholds were not different between groups</span>
@@ Line 40: / Line 60: @@
 <span style="font-size: 120%;">'''Appraised by:''' Mike Bennett Friday, 18 January 2019</span>
-<span style="font-size: 120%;">Email: [[mailto:m.bennett@unsw.edu.au | m.bennett@unsw.edu.au]] </span>
+<span style="font-size: 120%;">Email: [[mailto:m.bennett@unsw.edu.au| m.bennett@unsw.edu.au]]</span>
 <span style="font-size: 120%;">Kill or Update By: December 2024</span>
-<span style="display: block; text-align: center;">
+&nbsp;
-[[File:sumhorsa.gif|center]]
+&nbsp;
-<span style="color: #7c00ff; display: block; font-size: 26px; text-align: center;">'''[[Burns | BACK]]'''</span>
+<span style="color: #7c00ff; display: block; font-size: 26px; text-align: center;">'''[[Burns|BACK]]'''</span>