Muscle Relaxant Effects Research Articles

Efektivitas Progressive Muscle Relaxation dan Mindfulness sebagai Manajemen Nyeri Kepala

This study aims to determine the effect of Progressive Muscle Relaxation and Mindfulness as mind-body therapy for headache management to children and adults. The method used is a systematic review of articles obtained from databases pubmed, proquest, Google Scholar, and scopus. The results showed that Progressive Muscle Relaxation and Mindfulness with and without combination are effective to reduce headache, improve quality of life, improve sleep quality, and reduce stress level. Conclusion, mind-body therapy such as Progressive Muscle Relaxation and Mindfulness are useful to headache management for all ages.
 
 Keywords : Headache Management, Mindfulness, Progressive Muscle Relaxation.

Nonpharmacological Interventions for Management of the Pain-Fatigue-Sleep Disturbance Symptom Cluster in Breast Cancer Patients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

The pain-fatigue-sleep disturbance symptom cluster is commonly experienced by breast cancer patients, and a variety of nonpharmacological interventions are used to treat this symptom cluster. To compare the efficacy of nonpharmacological interventions in improving the symptoms of the pain-fatigue-sleep disturbance symptom cluster in breast cancer patients. A comprehensive literature search was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, CNKI, and Wanfang databases to identify randomized controlled studies from database inception to May 2022. Two reviewers independently performed data retrieval and risk of bias assessments. The consistency model was used to conduct network meta-analyses (NMA) based on the frequentist framework to assess the interventions, which were ranked by the surface under the cumulative ranking curve (SUCRA). Finally, the CINeMA application was used to evaluate the results of the NMA and the evidence of quality. The results Twenty-three eligible studies assessing 14 interventions were included. According to SUCRA values, among the management effects of the three symptoms, the effect of progressive muscle relaxation (PMR) ranked first, followed by mindfulness-based stress reduction (MBSR). The overall evidence quality of our study ranges from very low to moderate. PMR and MBSR were effective interventions for the pain-fatigue-sleep disturbance symptom cluster in breast cancer patients. Clinical recommendations prioritize PMR for symptom management, followed by MBSR. However, this should be interpreted cautiously, as the confidence in the evidence was not high.

The effectiveness of progressive muscle relaxation technique in reducing cancer-related pain among palliative care patients: A randomized controlled trial.

Cancer-related pain (CRP) is a common and distressing symptom experienced by many patients receiving palliative care. The purpose of this trial was to evaluate the effectiveness of the progressive muscle relaxation (PMR) technique in reducing CRP in patients receiving palliative care. A total of 148 patients diagnosed with cancer and receiving palliative care were randomly allocated to either an intervention or control group. The intervention group received a 4-week daily course of PMR technique, while the control group received only usual care. Data was collected using a demographic and clinical characteristics form, as well as the Brief Pain Inventory (BPI). Blind evaluations were conducted prior to the start of the intervention (T0), at the end of the 4-week PMR intervention (T1), and at 1-month follow-up (T2). The results of this trial demonstrated a significant decrease in pain intensity scores for the PMR group compared to the control group at both T1 and T2 (p < 0.05). Furthermore, the PMR group also exhibited significant improvements in pain interference with general activity, mood, relations with others, sleep, and enjoyment of life scores compared to the control group at both T1 and T2 (p < 0.05). The results of this trial suggest that the PMR technique may be an effective intervention for reducing pain intensity and improving pain interference with life activities in cancer patients receiving palliative care. However, further research is needed to provide more robust evidence for the effectiveness of this intervention.Clinical trial registration number: NCT04436705. Registered at ClinicalTrials.gov.

Efficacy and safety of a daytime anxiolytic containing technologically processed antibodies to the S100 protein. Overview of clinical studies

The review presents the results of clinical studies of the efficacy and safety of Tenoten and Tenoten children’s in the treatment of anxiety, neurotic, stress-related and somatoform disorders and adjustment disorders. Technologically processed antibodies to the S100 protein in Tenoten and Tenoten children’s drugs change the conformation of the S100 protein, which is considered as a pathological link in the development of anxiety states, as well as neurodegenerative diseases. Tenoten is a well-studied daytime anxiolytic that combines a favorable safety profile with high anxiolytic activity. The efficacy of Tenoten in the treatment of anxiety disorders is comparable to that of benzodiazepine drugs. Tenoten has no inhibitory and muscle relaxant effects, does not cause drug tolerance, addiction, "withdrawal" syndrome, as well as drug interactions. Tenoten for children has been shown to be effective in the treatment of anxiety in children, including those with somatic manifestations, attention deficit hyperactivity disorder, and learning disabilities.

Effect of Midazolam on the Incidence of Agitation in Patients Undergoing Electroconvulsive Therapy: A Randomized Clinical Trial

Objectives Electroconvulsive therapy (ECT) is one of the treatment methods for neuropsychiatric patients. Midazolam is a relatively short-acting benzodiazepine drug used as a pre-anesthetic drug and has sedative, anticonvulsant, and muscle relaxant effects. This study aims to investigate the effect of midazolam on agitation in patients undergoing ECT. Methods This double-blinded clinical trial was conducted on 80 patients (aged 18-75 years) diagnosed with psychotic disorders indicating the need for ECT. The patients were selected by a convenience sampling method and allocated to two placebo and intervention groups by the envelope method. In the control group, the patients were injected with 2cc of distilled water, 2 mg/kg nesdonal, 0.5 mg/kg atropine, and 0.5 mg/kg succinylcholine. In the intervention group, in addition to these drugs, 0.2 mg/kg midazolam was injected at 4 sessions. The Richmond agitation sedation scale (RASS) was used to assess agitation immediately and one hour after ECT. Data were analyzed in SPSS software, version using independent t-test, Man-Whitney U test, and chi square test. The significance level was set at 0.05. Results The data of 42 patients in the intervention group and 38 in the control group were analyzed. The mean systolic and diastolic blood pressures were significantly lower in the intervention group. Immediately after ECT, 68% and 44% of patients in the intervention and control groups, respectively, were alert and calm. The patients in the midazolam group had a better condition based on the RASS score one hour after ECT (P=0.04). Conclusion Midazolam is able to reduce agitation in patients receiving ECT and can control the changes in systolic and diastolic blood pressures in the long term.

Trigger-free anesthesia : Indications and safe application

The safe anesthesiological care of patients with neuromuscular diseases poses aparticular challenge for anesthetists. Only asmall group of muscle diseases and syndromes are associated with an increased risk of malignant hyperthermia and therefore require trigger-free anesthetic procedures avoiding volatile anesthetics and succinylcholine. These diseases are frequently associated with mutations in the RYR1, CACNA1S or STAC-3 genes. In other neuromuscular diseases, anesthetic-induced rhabdomyolysis can occur. Therefore, volatile anesthetics should be avoided in these patients in addition to the contraindication for succinylcholine. In other neuromuscular diseases the risk of a propofol infusion syndrome or myotonic crises can be elevated or the duration of the effect of non-depolarizing muscle relaxants can be changed in an incalculable way. In every case an individual anesthetic aproach including the avoidance of potential pharmacological or non-pharmacological triggers is essential for the safety of the patients.

Chemical composition, antinociceptive and anti-inflammatory activities of the curzerene type essential oil of Eugenia uniflora from Brazil

Ethnopharmacological relevanceThe Eugenia uniflora leaf infusion is widely used in folk medicine to treat gastroenteritis, fever, hypertension, inflammatory and diuretic diseases. Aim of the studyThis work evaluated the acute oral toxic, antinociceptive, and anti-inflammatory activities of the curzerene chemotype of Eugenia uniflora essential oil (EuEO). Material and methodsEuEO was obtained by hydrodistillation and analyzed by GC and GC-MS. The antinociceptive action in mice was evaluated for the peripheral and central analgesic activity using abdominal contortion and hot plate tests (50, 100, and 200 mg/kg); xylene-induced ear swelling was carried out for the nociception test, and carrageenan-induced cell migration test. Spontaneous locomotor activity was assessed in the open field test to rule out any nonspecific sedative or muscle relaxant effects of EuEO. ResultsThe EuEO displayed a yield of 2.6 ± 0.7%. The major compounds classes were oxygenated sesquiterpenoids (57.3 ± 0.2%), followed by sesquiterpene hydrocarbons (16.4 ± 2.6). The chemical constituents with the highest concentrations were curzerene (33.4 ± 8.5%), caryophyllene oxide (7.6 ± 2.8%), β-elemene (6.5 ± 1.8%), and E-caryophyllene (4.1 ± 0.3%). Oral treatment with EuEO, at doses of 50, 300, and 2000 mg/kg, did not change the behavior patterns or mortality of the animals. EuEO (300 mg/kg) did not cause a reduction in the number of crossings in the open field compared to the vehicle group. The aspartate aminotransferase (AST) level was higher in EuEO-treated groups (50 and 2000 mg/kg) when compared to the control group (p < 0.05). EuEO, at doses of 50, 100, and 200 mg/kg, reduced the number of abdominal writhings by 61.66%, 38.33%, and 33.33%. EuEO did not show increased hot plate test time latency in any of the intervals analyzed. At 200 mg/kg, EuEO decreased paw licking time, with inhibition of 63.43%. In formalin-induced acute pain, EuEO decreased paw licking time at doses of 50, 100, and 200 mg/kg in the first phase, with inhibition of 30.54%, 55.02%, and 80.87%. The groups treated with EuEO at doses of 50, 100, and 200 mg/kg showed ear edema reduction of 50.26%, 55.17%, and 51.31%, respectively. Moreover, EuEO inhibited leukocyte recruitment only at a dose of 200 mg/kg. The inhibitory values of leukocyte recruitment after 4 h of carrageenan application were 4.86%, 4.93%, and 47.25% for 50, 100, and 200 mg/kg of essential oil, respectively. ConclusionThe EuEO, curzerene chemotype, has significant antinociceptive and anti-inflammatory activities and low acute oral toxicity. This work confirms the antinociceptive and anti-inflammatory of this species as the traditional use.

The Effect of Progressive Muscle Relaxation (PMR) Exercise on Blood Pressure Reduction in Hypertensive Clients: A Literature Review

Compliance with taking antihypertensive drugs is low amongst patients with hypertension. Uncontrolled blood pressure causes heart disease, kidney failure, diabetes, and stroke. It is necessary to have alternative support in controlling blood pressure by using progressive muscle relaxation exercises. This study aimed to determine the effect of progressive muscle relaxation on reducing blood pressure in patients with hypertension. The research design used was a literature study with a sample size of 20 journals: Pubmed (n=2), Proquest (n=4), Science Direct (n=8) and Biomed Central (n=6). By using the keyword search data “Progressive Muscle Relaxation AND Blood Pressure AND Hypertension OR Hypertensive” and using analysis techniques with thematic analysis, 95% of the results of the study reported that there was a decrease in systolic and diastolic values in hypertensive patients before and after the progressive muscle relaxation intervention and 5% reported that there was no change. Progressive muscle relaxation is effective for lowering blood pressure in hypertensive patients.&#x0D; Keywords: Progressive Muscle Relaxation, Blood Pressure, Hypertension

Use and Effectiveness of Electrosuit in Neurological Disorders: A Systematic Review with Clinical Implications.

Electrical stimulation through surface electrodes is a non-invasive therapeutic technique used to improve voluntary motor control and reduce pain and spasticity in patients with central nervous system injuries. The Exopulse Mollii Suit (EMS) is a non-invasive full-body suit with integrated electrodes designed for self-administered electrical stimulation to reduce spasticity and promote flexibility. The EMS has been evaluated in several clinical trials with positive findings, indicating its potential in rehabilitation. This review investigates the effectiveness of the EMS for rehabilitation and its acceptability by patients. The literature was collected through several databases following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Positive effects of the garment on improving motor functions and reducing spasticity have been shown to be related to the duration of the administration period and to the dosage of the treatment, which, in turn, depend on the individual's condition and the treatment goals. Moreover, patients reported wellbeing during stimulation and a muscle-relaxing effect on the affected limb. Although additional research is required to determine the efficacy of this device, the reviewed literature highlights the EMS potential to improve the motor capabilities of neurological patients in clinical practice.

The Variation of Muscle Relaxant According to the Circadian Rhythm in Emergency Abdominal Surgery

In the contemporary anesthesiology services, muscle relaxation plays an integral role in emergency abdominal surgery in order to facilitate the work of the surgeons. Circadian rhythms control the behavioral, mental and physical changes of humans on a 24-hour cycle. The term circadian is originated from the Latin word “circa diem” meaning “around a day.” They are regulated by the suprachiasmatic nucleus SCN in the hypothalamus which is the “master clock” of the brain and the body. A study was carried on 50 patients both male and female from eighteen to sixty years old undergoing emergency abdominal surgery. The level of muscle relaxation administered intravenously was monitored using a TOF Watch SX time 08:00 till 14:00 then from 15:00 -20:00. Two different muscle relaxants were used notably “atracurium benzilate and rocuronium bromide” each at a dose of 0.4 mg/kg and 0.5 mg/kg respectively. The time of action for endotracheal intubation, duration and extubation was recorded. As a result, it was demonstrated that there was a significant shorter time of action and shorter duration in surgeries taking place from 15:00 pm-20:00 as compared to 08:00 -14:00 with both relaxants. To conclude, according to the circadian rhythm, effects of muscle relaxants in the evening relatively differed from the morning by having a shorter duration bringing to the fact that the cholinergic system had a role to play.

Effectiveness of Progressive Muscle Relaxation as Complementary Therapy in Managing Blood Pressure Among Adult with Hypertension

Hypertension is a major cause of premature death worldwide. Some complementary health approaches are showing promise to lowering blood pressure, one of which is progressive muscle relaxation (PMR). This study aimed to determine the effectiveness od progressive muscle relaxation as complementary therapy in managing blood pressure among adult with hypertension. This was a quasi-experimental design with pre and post-test with control group approach. Stratified random sampling was done to determine the research area, followed by purposive sampling to recruit the respondents. Sample size was calculated using G-Power analysis. There were 62 respondents for intervention group and 60 respondents for control group. After 12 sessions of PMR in six days, there was a decreased systolic blood pressure to 29.9 mmHg and diastolic blood pressure to 14.7mmHg. PMR significantly decreased systolic and diastolic blood pressure among adult with hypertension. PMR as complementary therapy could be combined with pharmacological therapy to help ensure a maximum decrease in blood pressure

Relaksasi Otot Progresif terhadap Tekanan Darah Pasca Histerektomi pada Lansia

This study aims to determine the effectiveness of progressive muscle relaxation on blood pressure after hysterectomy in the elderly. This research method uses quantitative research with a quasi-experimental design with a pre-post test approach with a control group. The results showed a decrease in blood pressure of 29.2 mmHg in systolic blood pressure and 16.2 mmHg in diastolic blood pressure (p-value = 0.000; α = 0.05). In conclusion, progressive muscle relaxation effectively reduces blood pressure in post-hysterectomy elderly patients.&#x0D; &#x0D; Keywords: Hypertension, Elderly, Progressive Muscle Relaxation

Screening the effective components of Suanzaoren decoction on the treatment of chronic restraint stress induced anxiety-like mice by integrated chinmedomics and network pharmacology

BackgroundSuanzaoren decoction (SZRD) is a classical traditional Chinese prescription. It is widely used to treat mental disorders, including insomnia, anxiety, and depression, in China and other Asian countries. However, the effective components and mechanisms underlying SZRD remained unclear. PurposeWe aimed to develop a new strategy to discover the effects and potential mechanisms of SZRD against anxiety and to further reveal the effective components of SZRD in treating anxiety. Study design and methodsFirst, the chronic restraint stress (CRS)-induced mouse model of anxiety was orally administered SZRD, and behavioral indicators and biochemical parameters were applied to assess efficacy. A chinmedomics strategy based on UHPLC-Q-TOF-MS technology and network pharmacology were then used to screen and explore potentially effective components and therapeutic mechanisms. Finally, molecular docking was applied to further confirm the effective components of SZRD, and a multivariate network for anxiolytic effects was constructed. ResultsSZRD exerted anxiolytic effects by increasing the percentage of entries into open arms and the time spent in open arms; improving hippocampal 5-HT, GABA, and NE levels; and increasing serum corticosterone (CORT) and corticotropin-releasing hormone (CRH) levels caused by CRS challenge. Beside, SZRD exerted a sedative effect by decreasing sleep time and prolonging sleep latency with no muscle relaxation effect in CRS mice. A total of 110 components were identified in SZRD, 20 of which were absorbed in the blood. Twenty-one serum biomarkers involved in arachidonic acid, tryptophan, sphingolipid, and linoleic acid metabolism were identified after SZRD intervention. Finally, a multivariate network including prescription-effective components-targets-pathway of SZRD treating anxiety, including 11 effective components, 4 targets and 2 pathway was constructed. ConclusionThe current study demonstrated that integrating chinmedomics and network pharmacology was a powerful approach to investigating the effective components and therapeutic mechanisms of SZRD and provided a solid basis for the quality marker (Q-marker) of SZRD.

Anxiolytics: Appropriate Use of Benzodiazepine Receptor Agonists

Anxiolytics are a class of drugs that include benzodiazepine receptor agonists and serotonin 1A receptor partial agonists. Although benzodiazepine receptor agonists have anxiolytic, sedative-hypnotic, muscle relaxant, and anticonvulsant effects, their use should be carefully monitored due to their potential for paradoxical reactions, withdrawal symptoms, and dependence. On the other hand, serotonin 1A receptor partial agonists have a slower onset, and their use also presents challenges. In clinical practice, having a thorough understanding of the various types of anxiolytics and their unique features is crucial.

Motor Evoked Potential

Motor evoked potential(MEP)is the most widely used intraoperative neurophysiological monitoring measure. It includes cortical direct stimulation MEP(dMEP), which directly stimulates the primary motor cortex of the frontal lobe identified by short-latency somatosensory evoked potentials, and transcranial MEP(tcMEP), which involves high-current or high-voltage transcranial stimulation using cork-screw electrodes installed in the scalp. dMEP is performed in brain tumor surgery close to the motor area. tcMEP is simple, safe, and widely used in spinal and cerebral aneurysm surgeries. The increase in sensitivity and specificity with compound muscle action potential(CMAP)after peripheral nerve stimulation normalization performed in MEP to remove the effect of muscle relaxants is unclear. However, tcMEP for decompression in compressive spinal and spinal nerve diseases may predict the recovery of postoperative neurological symptoms with CMAP normalization. The anesthetic fade phenomenon can be avoided with CMAP normalization. The cutoff rate of loss of amplitude that causes postoperative motor paralysis in intraoperative MEP monitoring is 70%-80%, and setting an alarm at each facility based on this is necessary.

In silico pharmacology and bioavailability of bioactive constituents from Triclisia subcordata (Oliv), an underutilized medicinal plant in Nigeria

Medicinal plants are rich sources of traditional medicines from which many modern medicines are made. Triclisia subcordata Oliv. is one among the underutilized medicinal plants in the Southwestern part of Nigeria. Therefore, this study was designed to present comprehensive data from the literature on pharmacological uses of T. subcordata and its phytochemistry, and to predict the pharmacology and bioavailability of the phytoconstituents isolated so far from Triclisia subcordata through an in silico approach. T. subcordata has high antioxidant activity and so it isthus used to treat oxidative stress-related diseases such as inflammation and diabetes. It also has antibacterial, antifungal, antimalarial and smooth muscle relaxing properties. It is a potent inhibitor of enzymes such as alpha-amylase and alpha-glucosidase. It has also traditionally been used in cancer treatment. One of the bisbenzylisoquinoline (BBIQ) alkaloids isolated from this plant, cycleanine, showed selectivity for ovarian cancer cell lines. The presence of phytochemicals such as cyanogenic glycosides and tannins in low concentrations in T. subcordata has also been reported to make it edible to humans. The results of predicted absorption, distribution, metabolism, excretion and toxicity was analyzed on the webserver ’ADEMTLab 2.0‘ . Prediction of activity studies for the four bisbenzylisoquinoline alkaloids isolated so far from this plant supported anticancer, antimicrobial, antidiabetic, antiulcer, antimalarial activities as well as muscle relaxant effect. Moreover, new activities including stimulation of leukopoiesis, inhibition of membrane permeability , inhibition of kinase and nicotinic alpha4beta4 receptor agonist properties were also predicted through in silico investigation. From our findings, these phytoconstituents could be lead candidates in drug discovery, since this plant is safe for human consumption.

Detection and isolation of intestinal muscle relaxant substances from the root of Taverniera abyssinica A. Rich

Ethnopharmacological relevanceIn Ethiopian traditional medicine the root of Taverniera abyssinica A.Rich is known as a remedy for sudden gastrointestinal cramping and fever. In this study we have isolated and identified the bioactive principle of Taverniera abyssinica that exerts effects on isolated smooth muscle tissues of the rabbit duodenum and guinea-pig ileum. Aim of the studyTo isolate and purify the bioactive principle from the root of Taverniera abyssinica A.Rich by bioassay-guided fractionation, HPLC purification and masspectrometry, with further investigation of its bioactivity on isolated smooth muscle strips. Materials and methodsRoots of Taverniera abyssinica A.Rich extracted in 75% methanol/water were fractioned with a reverse phase column and then subjected to HPLC purification. Each fraction collected from the HPLC was tested for its bioactivity using electric field stimulation-evoked contractions of the rabbit duodenum and guinea-pig ileum. Finally, detailed structural analysis of the fraction displaying significant bioactivity was made by mass spectrometry. ResultsThrough bioassay-guided fractionation and HPLC purification the bioactive fractions were identified. These were tested for bioactivity on isolated smooth muscle strips which showed about 80% inhibition of contractions evoked by electric field stimulation. These compounds were identified as formononetin, afrormosin and tectorigenin by using masspectrometry applying relevant standards for detection. ConclusionThe traditionally claimed smooth muscle-relaxing effect of the roots of Taverniera abyssinica A.Rich is essentially due the three isolated and purified the two isoflavones formononetin, afrormosin as well as the metoxyisoflavone tectorigenin, along with possibly other not yet purified bioactive substances, however with similar smooth muscle-relaxing properties.

Elabela relaxes rat pulmonary artery and trachea via BKCa, KV, and KATP channels

ObjectiveElabela is a newly discovered peptide hormone. This study aimed to determine the functional effects and mechanisms of action of elabela in rat pulmonary artery and trachea. Materials and methodsVascular rings isolated from the pulmonary arteries of male Wistar Albino rats were placed in chambers in the isolated tissue bath system. The resting tension was set to 1 g. After the equilibration period, the pulmonary artery rings were contracted with 10-6 M phenylephrine. Once a stable contraction was achieved, elabela was applied cumulatively (10-10-10-6 M) to the vascular rings. To determine the vasoactive effect mechanisms of elabela, the specified experimental protocol was repeated after the incubation of signaling pathway inhibitors and potassium channel blockers. The effect and mechanisms of action of elabela on tracheal smooth muscle were also determined by a similar protocol. ResultsElabela exhibited a concentration-dependent relaxation in the precontracted rat pulmonary artery rings (p < .001). Maximal relaxation level was 83% (pEC50: 7.947 CI95(7.824–8.069)). Removal of the endothelium, indomethacin incubation, and dideoxyadenosine incubation significantly decreased the vasorelaxant effect levels of elabela (p < .001). Elabela-induced vasorelaxation levels were significantly reduced after iberiotoxin, glyburide, and 4-Aminopyridine administrations (p < .001). L-NAME, methylene blue, apamin, TRAM-34, anandamide, and BaCl2 administrations did not cause a significant change in the vasorelaxant effect level of elabela (p = 1.000). Elabela showed a relaxing effect on precontracted tracheal rings (p < .001). Maximal relaxation level was 73% (pEC50: 6.978 CI95(6.791–7.153)). The relaxant effect of elabela on tracheal smooth muscle was decreased significantly after indomethacin, dideoxyadenosine, iberiotoxin, glyburide, and 4-Aminopyridine incubations (p < .001). ConclusionsElabela exerted a prominent relaxant effect in the rat pulmonary artery and trachea. Intact endothelium, prostaglandins, cAMP signaling pathway, and potassium channels (BKCa, KV, and KATP channels) are involved in the vasorelaxant effect of elabela. Prostaglandins, cAMP signaling pathway, BKCa channels, KV channels, and KATP channels also contribute to elabela-induced tracheal smooth muscle relaxant effect.

N-methyl-d-aspartate receptors and glycinergic transmission, respectively, mediate muscle relaxation and immobility of pentobarbital in mice

Pentobarbital-induced anesthesia is believed to be mediated by enhancement of the inhibitory action of γ-aminobutyric acid (GABA)ergic neurons in the central nervous system. However, it is unclear whether all components of anesthesia induced by pentobarbital, such as muscle relaxation, unconsciousness, and immobility in response to noxious stimuli, are mediated only through GABAergic neurons. Thus, we examined whether the indirect GABA and glycine receptor agonists gabaculine and sarcosine, respectively, the neuronal nicotinic acetylcholine receptor antagonist mecamylamine, or the N-methyl-d-aspartate receptor channel blocker MK-801 could enhance pentobarbital-induced components of anesthesia. Muscle relaxation, unconsciousness, and immobility were evaluated by grip strength, the righting reflex, and loss of movement in response to nociceptive tail clamping, respectively, in mice. Pentobarbital reduced grip strength, impaired the righting reflex, and induced immobility in a dose-dependent manner. The change in each behavior induced by pentobarbital was roughly consistent with that in electroencephalographic power. A low dose of gabaculine, which significantly increased endogenous GABA levels in the central nervous system but had no effect on behaviors alone, potentiated muscle relaxation, unconsciousness, and immobility induced by low pentobarbital doses. A low dose of MK-801 augmented only the masked muscle-relaxing effects of pentobarbital among these components. Sarcosine enhanced only pentobarbital-induced immobility. Conversely, mecamylamine had no effect on any behavior. These findings suggest that each component of anesthesia induced by pentobarbital is mediated through GABAergic neurons and that pentobarbital-induced muscle relaxation and immobility may partially be associated with N-methyl-d-aspartate receptor antagonism and glycinergic neuron activation, respectively.

The Effectiveness of Progressive Muscle Relaxation on Physiological and Psychological Stress Control of Type 2 Diabetes Mellitus Clients in the Mandailing Batak Tribe

Diabetes mellitusis a chronic disease that is always increasing in prevalence in the world. The Mandailing Batak tribe is one of the tribes in North Sumatra. DM clients experience various physiological complaints such as hyperglycemia, hypoglycemia and fatigue. In addition, complaints of discomfort are also one of the problems that occur in diabetics. This study aims to identify progressive muscle relaxation (PMR) in overcoming hyperglycemia, fatigue and discomfort in type 2 diabetes mellitus sufferers of the Mandailing Batak tribe.This research was conducted in Padangsidimpuan City from April to July 2020. Quasi-experimental is the design used in this study with a one group pretest-posttest only design. The sampling technique used was purposive sampling with a sample size of 20 people. The instruments used were glucotes, piper fatigue scale, verbal comfort rating scale. PMR can be used as a complementary therapy in reducing hyperglycemia, fatigue and discomfort. The average blood glucose level before the intervention was 293 mg/dl and after 207.65 mg/dl. The average score of fatigue before getting 4.45 and after 2.60. Average discomfort score from 4 to 6. PMR can reduce physiological and psychological stress in type 2 diabetes mellitus sufferers in the Mandailing Batak tribe.&#x0D; Keywords: Psychological stress; progressive muscle; diabetes mellitus