Magnetic tracking of gastrointestinal motility.

OBJECTIVE: Capsule-based methods for assessment of gastrointestinal (GI) motility have seen great improvements in recent decades. The most recent development is the electromagnetic Motilis 3D-Transit system (3D-Transit). The aim of this paper is to review and discuss the development and technical properties of magnetic tracking of GI motility. APPROACH: We performed a comprehensive literature review on magnetic tracking in GI research. MAIN RESULTS: The Motility Tracking System was the first capsule based magnetic system to be used in GI motility research. However, the potential of the system was hampered by its stationary and hospitalizing nature. This led to the development of the electromagnetic Motilis 3D-Transit system. The 3D-Transit system is a portable system that allows for assessment of both whole gut and regional transit times and contraction patterns in a fully ambulatory setting in the patients' home environment with only minor restrictions on movements. The spatiotemporal resolution of 3D-Transit allows assessment of segmental colonic transit times and permits an analysis of gastric and colonic movements with a degree of detail unrivalled by other ambulatory methods, such as the Wireless Motility Capsule. Recently, robust normative data on 3D-Transit have been published. SIGNIFICANCE: This review provides a current perspective on the use of capsule-based magnetic tracking systems in GI research and how they represent a potentially valuable clinical resource for GI physicians and in GI research

Effect of transdermal opioids in experimentally induced superficial, deep and hyperalgesic pain

BACKGROUND AND PURPOSE: Chronic pain and hyperalgesia can be difficult to treat with classical opioids acting predominately at the µ-opioid receptor. Buprenorphine and its active metabolite are believed to act through µ-, κ- and δ-receptors and may therefore possess different analgesic and anti-hyperalgesic effects compared with pure µ-receptor agonists, for example, fentanyl. Here, we have compared the analgesic and anti-hyperalgesic effects of buprenorphine and fentanyl. EXPERIMENTAL APPROACH: Twenty-two healthy volunteers were randomized to treatment with transdermal buprenorphine (20 µg·h(−1), 144 h), fentanyl (25 µg·h(−1), 72 h) or placebo patches in a double-blind, cross-over experimental pain study. The experimental pain tests (phasic pain, sensitization) involved pressure at the tibial bone, cutaneous electrical and thermal stimulation, intramuscular nerve growth factor, UVB light burn injury model and intradermal capsaicin-induced hyperalgesia. Pain testing was carried out at baseline, 24, 48, 72 and 144 h after application of the drugs. KEY RESULTS: Compared with placebo, buprenorphine, but not fentanyl, significantly attenuated pressure at the tibial bone as well as pressure pain in the primary hyperalgesic area induced by UVB light The two drugs were equipotent and better than placebo against cutaneous thermal pain stimulation), but failed to show significant analgesic effect to cutaneous electrical stimulation, nerve growth factor-induced muscle soreness and to capsaicin-induced hyperalgesia. CONCLUSIONS AND IMPLICATIONS: Buprenorphine, but not fentanyl, showed analgesic effects against experimentally induced, bone-associated pain and primary hyperalgesia compared with placebo. These tissue- and modality-differentiated properties may reflect the variable effects of opioid drugs observed in individual patients