Ning Nan Wang - Academia.edu (original) (raw)

Papers by Ning Nan Wang

Regional Anesthesia & Pain Medicine, 2022

IntroductionCoccydynia is a multifactorial complex clinical challenge. A multimodal approach with... more IntroductionCoccydynia is a multifactorial complex clinical challenge. A multimodal approach with both conservative measures and procedural interventions is often recommended. We described a novel approach of radiofrequency (RF) ablation for the management of coccydynia.MethodsThree patients with known history of coccydynia refractory to conservative therapy were referred to our clinic. All received different types of RF ablation before: one with anterior bipolar lesion with no analgesia benefit, one with posterior stripped lesion with good benefit but only after 8 weeks of pain flare and one received anterior monopolar lesion with 50% pain reduction for 2–3 months. All subjects underwent a novel RF ablation to the anterior surface of the sacrococcygeal and intercoccygeal joints with two bipolar lesions using multi-tined needles under fluoroscopy guidance. One bipolar lesion was between two needles: one in the sacrococcygeal and another in the intercoccygeal (between first and secon...

Cannabinoids and Pain, 2021

Cannabinoids are chemicals either derived from cannabis (phytocannabinoids) like cannabidiol (CBD... more Cannabinoids are chemicals either derived from cannabis (phytocannabinoids) like cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC); synthetic medications like nabilone, dronabinol, and rimonabant; or endogenous chemicals that stimulate cannabinoid receptors. Phytocannabinoids consist of natural products capable of either interacting directly with cannabinoid receptors or sharing chemical similarity with endocannabinoids or both. The two most studied phytocannabinoids are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD is a non-intoxicating phytocannabinoid and has low affinity to cannabinoid receptors. It acts as a partial antagonist of CB1R and as a weak inverse agonist of CB2R. CBD also interacts with other non-cannabinoid targets, including serotonin 1A receptor (or 5-TH1A), vanilloid receptor 1 (TRPV1), and adenosine A2A receptors, which regulates perception of pain. CBD has been associated with analgesic, anti-inflammatory, anticonvulsant, anxiolytic, and antipsychotic effects. CBD works synergistically with THC for its analgesic effect while decreasing its psychoactive and cognitive side effects such as sedation and memory impairment of THC. Further studies are required to validate the medicinal applications of CBD.

A&A Practice, 2021

The underlying pathophysiology and treatment of chronic pericardial chest pain remains unclear. W... more The underlying pathophysiology and treatment of chronic pericardial chest pain remains unclear. We describe a clinical case of a 38-year-old patient with chronic chest pain in the context of Marfan syndrome, status post-valve-sparing aortic root repair, and recurrent pericarditis. The patient suffers from chronic pericardial pain secondary to recurrent pericarditis refractory to pharmacotherapy. A left-sided stellate ganglion block (SGB) was performed for both diagnostic and therapeutic purposes. Postprocedure follow-up demonstrated significant analgesic benefit at 8 months after the procedure.

British Journal of Anaesthesia, 2020

Background: In surgical patients undergoing general anaesthesia, coughing at the time of extubati... more Background: In surgical patients undergoing general anaesthesia, coughing at the time of extubation is common and can result in potentially dangerous complications. We performed a systematic review and meta-analysis to assess the efficacy and safety of i.v. lidocaine administration during the perioperative period to prevent cough and other airway complications. Methods: We searched Medical Literature Analysis and Retrieval System, Excerpta Medica database, and Cochrane Central Register of Controlled Trials for RCTs comparing the perioperative use of i.v. lidocaine with a control group in adult patients undergoing surgery under general anaesthesia. The RCTs were assessed using risk-of-bias assessment, and the quality of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Results: In 16 trials (n¼1516), the administration of i.v. lidocaine compared with placebo or no treatment led to large reductions in post-extubation cough (risk ratio [RR]: 0.64; 95% confidence interval [CI]: 0.48e0.86) and in postoperative sore throat at 1 h (RR: 0.46; 95% CI: 0.32e0.67). There was no difference in incidence of laryngospasm (risk difference [RD]: 0.02; 95% CI: e0.07 to 0.03) or incidence of adverse events related to the use of lidocaine. Conclusions: The use of i.v. lidocaine perioperatively decreased airway complications, including coughing and sore throat. There was no associated increased risk of harm.

Canadian journal of anaesthesia = Journal canadien d'anesthesie, Jan 14, 2015

Anesthesia & Analgesia, 2013

Cannabinoids and Pain, 2021

Cannabis includes several species, the popular ones being Cannabis sativa, Cannabis indica, and C... more Cannabis includes several species, the popular ones being Cannabis sativa, Cannabis indica, and Cannabis ruderalis. Cannabinoids are chemicals either derived from cannabis (phytocannabinoids) like cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC); synthetic medications like nabilone, dronabinol, and rimonabant; or endogenous chemicals that stimulate cannabinoid receptors. Cannabinoids have shown increasing evidence for analgesic effects in several studies and systematic reviews for acute and chronic pain (Meng et al. Anesth Analg. 125(5):1638–52, 2017) along with signs of becoming a potential alternative to combat opioid abuse (Olfson et al. Am J Psychiatry. 175(1):47–53, 2018). Phytocannabinoids are natural products derived from cannabis either interacting directly with cannabinoid receptors or sharing chemical similarity with endocannabinoids or both. Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol (CBN) are among the most studied phytocannabinoids. THC is the main psychoactive compound of the cannabis plant. Routes of administration (ROA) of THC range from vaporizing (inhalation), oral spray, edibles, other oromucosal/sublingual routes (e.g., capsules, oils, lozenges), transdermal topicals (cannabis-infused lotions, balms, oils), intravenous routes (syringe) to rectal routes (suppositories). Their applied pharmacology and pharmacokinetics differ greatly between different ROA. THC produces pharmacological effects ranging from cognitive changes and psychoactive, anti-inflammatory, antipruritic, bronchodilatory, anti-spasmodic, and muscle relaxant activities. It is also associated with side effects like anxiety, impaired memory, and immunosuppression. Further research and human studies are required to validate the role of THC for medicinal purposes.

Regional Anesthesia & Pain Medicine, 2022

IntroductionCoccydynia is a multifactorial complex clinical challenge. A multimodal approach with... more IntroductionCoccydynia is a multifactorial complex clinical challenge. A multimodal approach with both conservative measures and procedural interventions is often recommended. We described a novel approach of radiofrequency (RF) ablation for the management of coccydynia.MethodsThree patients with known history of coccydynia refractory to conservative therapy were referred to our clinic. All received different types of RF ablation before: one with anterior bipolar lesion with no analgesia benefit, one with posterior stripped lesion with good benefit but only after 8 weeks of pain flare and one received anterior monopolar lesion with 50% pain reduction for 2–3 months. All subjects underwent a novel RF ablation to the anterior surface of the sacrococcygeal and intercoccygeal joints with two bipolar lesions using multi-tined needles under fluoroscopy guidance. One bipolar lesion was between two needles: one in the sacrococcygeal and another in the intercoccygeal (between first and secon...

Cannabinoids and Pain, 2021

Cannabinoids are chemicals either derived from cannabis (phytocannabinoids) like cannabidiol (CBD... more Cannabinoids are chemicals either derived from cannabis (phytocannabinoids) like cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC); synthetic medications like nabilone, dronabinol, and rimonabant; or endogenous chemicals that stimulate cannabinoid receptors. Phytocannabinoids consist of natural products capable of either interacting directly with cannabinoid receptors or sharing chemical similarity with endocannabinoids or both. The two most studied phytocannabinoids are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD is a non-intoxicating phytocannabinoid and has low affinity to cannabinoid receptors. It acts as a partial antagonist of CB1R and as a weak inverse agonist of CB2R. CBD also interacts with other non-cannabinoid targets, including serotonin 1A receptor (or 5-TH1A), vanilloid receptor 1 (TRPV1), and adenosine A2A receptors, which regulates perception of pain. CBD has been associated with analgesic, anti-inflammatory, anticonvulsant, anxiolytic, and antipsychotic effects. CBD works synergistically with THC for its analgesic effect while decreasing its psychoactive and cognitive side effects such as sedation and memory impairment of THC. Further studies are required to validate the medicinal applications of CBD.

A&A Practice, 2021

The underlying pathophysiology and treatment of chronic pericardial chest pain remains unclear. W... more The underlying pathophysiology and treatment of chronic pericardial chest pain remains unclear. We describe a clinical case of a 38-year-old patient with chronic chest pain in the context of Marfan syndrome, status post-valve-sparing aortic root repair, and recurrent pericarditis. The patient suffers from chronic pericardial pain secondary to recurrent pericarditis refractory to pharmacotherapy. A left-sided stellate ganglion block (SGB) was performed for both diagnostic and therapeutic purposes. Postprocedure follow-up demonstrated significant analgesic benefit at 8 months after the procedure.

British Journal of Anaesthesia, 2020

Background: In surgical patients undergoing general anaesthesia, coughing at the time of extubati... more Background: In surgical patients undergoing general anaesthesia, coughing at the time of extubation is common and can result in potentially dangerous complications. We performed a systematic review and meta-analysis to assess the efficacy and safety of i.v. lidocaine administration during the perioperative period to prevent cough and other airway complications. Methods: We searched Medical Literature Analysis and Retrieval System, Excerpta Medica database, and Cochrane Central Register of Controlled Trials for RCTs comparing the perioperative use of i.v. lidocaine with a control group in adult patients undergoing surgery under general anaesthesia. The RCTs were assessed using risk-of-bias assessment, and the quality of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Results: In 16 trials (n¼1516), the administration of i.v. lidocaine compared with placebo or no treatment led to large reductions in post-extubation cough (risk ratio [RR]: 0.64; 95% confidence interval [CI]: 0.48e0.86) and in postoperative sore throat at 1 h (RR: 0.46; 95% CI: 0.32e0.67). There was no difference in incidence of laryngospasm (risk difference [RD]: 0.02; 95% CI: e0.07 to 0.03) or incidence of adverse events related to the use of lidocaine. Conclusions: The use of i.v. lidocaine perioperatively decreased airway complications, including coughing and sore throat. There was no associated increased risk of harm.

Canadian journal of anaesthesia = Journal canadien d'anesthesie, Jan 14, 2015

Anesthesia & Analgesia, 2013

Cannabinoids and Pain, 2021

Cannabis includes several species, the popular ones being Cannabis sativa, Cannabis indica, and C... more Cannabis includes several species, the popular ones being Cannabis sativa, Cannabis indica, and Cannabis ruderalis. Cannabinoids are chemicals either derived from cannabis (phytocannabinoids) like cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC); synthetic medications like nabilone, dronabinol, and rimonabant; or endogenous chemicals that stimulate cannabinoid receptors. Cannabinoids have shown increasing evidence for analgesic effects in several studies and systematic reviews for acute and chronic pain (Meng et al. Anesth Analg. 125(5):1638–52, 2017) along with signs of becoming a potential alternative to combat opioid abuse (Olfson et al. Am J Psychiatry. 175(1):47–53, 2018). Phytocannabinoids are natural products derived from cannabis either interacting directly with cannabinoid receptors or sharing chemical similarity with endocannabinoids or both. Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol (CBN) are among the most studied phytocannabinoids. THC is the main psychoactive compound of the cannabis plant. Routes of administration (ROA) of THC range from vaporizing (inhalation), oral spray, edibles, other oromucosal/sublingual routes (e.g., capsules, oils, lozenges), transdermal topicals (cannabis-infused lotions, balms, oils), intravenous routes (syringe) to rectal routes (suppositories). Their applied pharmacology and pharmacokinetics differ greatly between different ROA. THC produces pharmacological effects ranging from cognitive changes and psychoactive, anti-inflammatory, antipruritic, bronchodilatory, anti-spasmodic, and muscle relaxant activities. It is also associated with side effects like anxiety, impaired memory, and immunosuppression. Further research and human studies are required to validate the role of THC for medicinal purposes.