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Principles and Targets Underlying Spinal Analgesia

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Neuraxial Therapeutics

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Abstract

Afferent traffic generated high-intensity stimuli or that activity arising from tissue and nerve injury activates second-order projection neurons in the dorsal horn. This input/output function is dynamic with a variety of linkages that can serve to increase or decrease the gain of this function. The biology of the linkages relevant to nociception has been the subject of voluminous research that defines the role of various mediators on membrane and cellular excitability and more importantly that the activation of these spinal elements after neuraxial delivery can predictably alter pain behavior. The richness of these pharmacological substrates is an indication of the complexity of the processing circuitry that encodes the content of the nociceptive message provided to higher centers to underlie the integrated behavioral phenotype defined as pain. The ameliorating effects of manipulating this extracranial afferent traffic on not just pain threshold, but on the complex behaviors evoked by injury and inflammation, emphasize the pivotal role played by these changes in of the spinofugal message content evoked by the neuraxial intervention on not just the sensory but the emotive components of the pain phenotype as well.

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Authors and Affiliations

  1. Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA

    Linda S. Sorkin

  2. Department of Anesthesiology, University of California, San Diego, San Diego, CA, USA

    Elayne Vieira Dias

  3. Departments of Anesthesiology and Pharmacology, University of California, San Diego, La Jolla, CA, USA

    Tony L. Yaksh

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  1. Linda S. Sorkin
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  2. Elayne Vieira Dias
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  3. Tony L. Yaksh
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Correspondence to Linda S. Sorkin .

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  1. (CTF-312), UC San Diego-Anesthesia Res Lab 081 (CTF-312), La Jolla, CA, USA

    Tony Yaksh

  2. University Hospital, Case Western Reserve University, Cleveland, OH, USA

    Salim Hayek

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Sorkin, L.S., Dias, E.V., Yaksh, T.L. (2023). Principles and Targets Underlying Spinal Analgesia. In: Yaksh, T., Hayek, S. (eds) Neuraxial Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-031-39558-1_20

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