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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To test the hypothesis that the postoperative abdominal pain of tubal occlusion is mediated by prostaglandins, the effects of meclofenamate, an analgesic and a potent inhibitor of cyclooxygenase, on postoperative analgesia and incidence of abdominal pain were compared with those of acetaminophen, a weak inhigitor of prostaglandin activity. 100 patients undergoing tubal occlusion under local anesthesia in a Kentucky health facility were studied. Tge patients were randomly divided into 4 equal groups: 1) control; 2) acetaminophen, 1300 mg; 3) meclofenamate, 100 mg; 4) meclofenamate, 200 mg. The fallopian tubes were occluded by electrocautery in 47 patients and by application of Falope rings in 53 patients. Both acetaminophen and meclofenamate provided substantial analgesia for 4 hours after the operation (p0.05). Meclofenamate reduced the incidence of abdominal pain by 1/2 (p0.02), but acetaminophen did not. These results suggest that a portion of pain relief achieved by meclofenamate may be due to suppression of myosalpingian and/or myometrial contractions, a process mediated by prostaglandins.
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PMID:Effects of meclofenamate and acetaminophen on abdominal pain following tubal occlusion. 294 86

In a clinical trial, a physician treated 78 women having an abortion with either a Lamicel tent or a 1 mg gemeprost (Cervagem) pessary 3-4 hours before surgery. Researchers matched the women to age, parity, gestational age, and previous uterocervical surgery. The physician or the assistant chose the specific treatment in strict numerical order from randomly ordered sealed envelopes. Prior to surgery, an assistant used a speculum to empty the vagina of all traces of the Lamicel tent or the gemeprost pessary. Therefore each surgeon remained "blind" to the treatment used to dilate the cervix. Even though there was no significant difference in the blood and fluid loss between the 2 groups (t = .67; p = .5), both surgeons did observe a greater resistance of cervices to dilate after Lamicel than after gemeprost (p .001). Patients who received gemeprost experienced more adverse effects preoperatively, especially abdominal pain (74%) and bleeding (18%), than did those who were treated with Lamicel (50%. and 7.5% respectively). Despite a higher percentage of women experiencing side effects with gemeprost, there was not a corresponding increased need to administer analgesia. Postoperative side effects were similar in both the gemeprost and Lamicel groups. Additionally, no significant differences existed between the 2 groups in regards to postoperative analgesic requirements or preoperative and postoperative temperature, pulse rate, and blood pressure. Notwithstanding the side effects of gemeprost, it was more effective in dilating the cervix, easier to insert, and less uncomfortable than Lamicel.
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PMID:A comparison of gemeprost (Cervagem) pessaries and Lamicel tents for cervical preparation for abortion by dilatation and suction. 305 5

During pregnancy the uterus is maintained in a quiescent state by the secretion of progesterone. Antigestagens antagonize the biological action of progesterone by binding to the nuclear receptor in the target organs. Administration of the antigestagen mifepristone to women induces bleeding during the luteal phase and in early pregnancy by releasing endogenous prostaglandins from the endometrium or decidua. In addition, the sensitivity of the myometrium to exogenous prostaglandins is markedly increased. Although mifepristone will induce bleeding in the majority of women in early pregnancy, the incidence of incomplete abortion or ongoing pregnancies increases with increasing gestational age and is too high to be clinically useful as an agent for therapeutic abortion. However, a single dose of mifepristone (400-600 mg) followed by a vaginal pessary of a prostaglandin analogue (0.5-1.0 mg), gemeprost, induced complete abortion in 95 of 100 women of gestational age less than 42 days (less than or equal to 56 days amenorrhoea). The incidence of diarrhoea (15%) and abdominal pain requiring opiate analgesia (10%) was much lower than when abortion was induced with prostaglandin alone. Vaginal bleeding continued for 13.8 +/- 0.8 days after administration of the prostaglandin. A combination of an antigestagen with a small dose of a prostaglandin analogue is an effective alternative to vacuum aspiration for the therapeutic termination of early pregnancy.
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PMID:Prostaglandins and antigestagens for the interruption of early pregnancy. 319 7

The effectiveness of transcutaneous nerve stimulation (TENS) for pain relief in labour was evaluated by randomizing 280 patients in early labour into 2 groups. Inoperative sham machines were applied to patients in the control group and active units to those in the test group. Neither patients nor attending labour ward staff were aware of which group the patient was in. The intensity of low back pain and abdominal pain was assessed by the patient each hour on a visual analogue pain scale. Each patient served as her own control by switching off the machine for 2 contractions every hour and then recording the intensity of pain. The amount of conventional analgesia each patient received was recorded by labour ward staff. There was no difference in the intensity of pain recorded by each group. Nor was there any difference between the 2 groups in the change of pain experienced when the machine was switched off. Moreover there was no difference in the amount of other analgesia required. Some differences were found when those with little low back pain were excluded from the study. We conclude that TENS is ineffective as a routine method of pain relief in labour. It is likely to benefit only those with severe back pain and then only to a modest degree.
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PMID:An evaluation of transcutaneous electrical nerve stimulation for pain relief in labour. 326 72

The termination of early pregnancy (less than 56 days amenorrhoea) has been investigated using 16,16-dimethyl-trans-delta 2-PGE, methyl ester in a controlled release preparation. The onset of crampy abdominal pain was seen after 270 +/- 39 minutes and bleeding occurred after 603 +/- 95 minutes. Two (15%) patients required no pain relief during treatment, however 5 (38%) requested oral analgesia, and in 6 (46%) individuals the pain was severe enough to warrant parenteral opiates. The overall success rate for complete abortion was 85%. No serious adverse effects were seen, but vomiting occurred in 2 (15%) women, and diarrhoea in 3 (23%). Although the use of this prostaglandin analogue in slow release form provides an effective treatment method for early abortion using a reduced total dose of prostaglandin, the acceptability of the drug as an agent for menstrual induction continues to be limited by the occurrence of troublesome gastro-intestinal side effects.
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PMID:A controlled release form of 16,16-dimethyl-trans-delta 2-PGE, methyl ester for early abortion. 369 93

Acute intermittent porphyria is one of three severe hepatic porphyrias. Clinical manifestations include intermittent acute attacks of abdominal pain and neuropathy with an occasionally outcome. These attacks are often precipitated by endogenous (menstrual cycle and pregnancy in women) or exogenous factors (porphyrinogenic drugs). An epidural analgesia was performed during the labour of a pregnant woman with acute intermittent porphyria just after an acute attack of abdominal pain. Analgesia was obtained using procaine and fentanyl. The choice of drugs was based on available clinical reports and experimental studies of the porphyrinogenicity of drugs in animal models (rat in vivo and chick embryo in ovo).
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PMID:[Peridural anesthesia with procaine and fentanyl in a parturient with acute intermittent porphyria]. 377 77

Inhalation anaesthesia with halothane was compared with i.v. alfentanil in 66 unpremedicated patients undergoing suction termination of pregnancy as outpatients. Blood loss was significantly greater in the halothane group with a mean loss of 213 ml, compared with a mean loss of 89.8 ml in the alfentanil group. There was a greater frequency of nausea and vomiting in the alfentanil group, but no reduction in abdominal pain or need for analgesia after operation. Positive relationships were found between blood loss and duration of anaesthesia and between blood loss and gestational age in the halothane group, but not in the alfentanil group. We conclude that alfentanil-supplemented anaesthesia is satisfactory for suction termination of pregnancy when rapid recovery is required or the duration of the procedure is likely to be long, but that halothane anaesthesia cannot be recommended, especially if the procedure is long.
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PMID:Outpatient termination of pregnancy: halothane or alfentanil-supplemented anaesthesia. 393 28

Postoperative pain was treated by epidural administration of 30 to 50 mg pethidine (5 mg X ml-1) in a group of 36 patients who had undergone retropubic prostatectomy. Surgery was carried out under epidural anaesthesia with lidocaine. Pain was assessed by means of the visual analogue scale. A general study of the effects of injections and reinjections showed that analgesia thus obtained was excellent at the first hour after injection and lasted 3 to 5 h. The effect of the first postoperative injection on spontaneous pain was studied in 14 patients. Statistical analysis (Wilcoxon test) demonstrated that the fall in pain score was significant at the first and third hours after injection, but not significant at the fifth hour. The analgesia to that pain produced by coughing was studied in 11 patients. There was a significant decrease in pain at the first hour after injection; differences in pain scores at the third hour were not significant. No noticeable side-effect was observed. It was concluded that low doses of epidural pethidine were efficient on postoperative pelvic abdominal pain, but that doses should be increased if painless coughing was required.
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PMID:[Postoperative analgesic effect of pethidine injected epidurally]. 398 29

The methods of providing postoperative analgesia by regional anaesthetic techniques with local anaesthetics are outlined. For the use of epidural analgesia, the techniques of inserting an epidural catheter at any level of the spine must be familiar. The block should be regional, restricted to the area of pain and effective at all times after its institution with a minimum of side effects. Bupivacaine is at present the best local anaesthetic and can be administered either as intermittent injections with an interval of 1-2 hours or as a continuous infusion. A dose regimen for thoracic, abdominal, perineal and lower extremity pain is presented. Side effects of the epidural technique and ways to treat and avoid them are discussed. The intercostal nerve block for post-thoracotomy and upper abdominal pain is described with special reference to the recent development of the continuous technique with bupivacaine and the cryoanalgesia technique.
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PMID:Postoperative pain relief and regional techniques. 649 10

A series in which six cases of ruptured uterus occurred following previous lower segment Caesarean section, out of a total of 222 'trials of scar', is presented, and the literature reviewed in an attempt to clarify the term 'relative contra-indication' as applied to this clinical circumstance. The symptoms and signs of ruptured uterus likely to be blocked by an epidural, i.e. maternal tachycardia, scar tenderness and continuous lower abdominal pain, have been shown to be either unreliable (tachycardia and tenderness) or frequently not to occur at all (pain). When pain does occur it is not necessarily masked by an epidural. It is concluded that previous lower segment Caesarean section is not a contraindication to epidural analgesia in a subsequent labour provided certain conditions are fulfilled.
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PMID:Epidural analgesia and previous Caesarean section. 684 63


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