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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A double-blind random study compared the effects of lorazepam and pantopon an intra-muscular premedication in healthy women for uterine curettage (D & C). Anxiety, as assessed by a self-rating test by the patient and by a trained observer, showed a significant reduction at one and one-half hours after lorazepam and a smaller reduction after pantopon, which was not significant. Sedation was satisfactory with no significant difference between the two drugs in the change before and after the premedication. Lorazepam showed much more amnesia than pantopon (p less than 0.001). The patients who had lorazepam required higher doses of thiopentone for the operation, and this, in part, led to longer intervals in recovery times after lorazepam. However, it is suggested that lorazepam itself was partly responsible for the longer recovery. Pantopon was followed by more nausea, vomiting and headaches, than lorazepam. The intra-muscular injection of lorazepam hurt more patients than did pantopon, but other local complications were negligible and comparable in both groups. The results of this study show that lorazepam produces better reduction of anxiety and much more amnesia than pantopon, with comparable sedation and much less nausea and vomiting. The only disadvantage of lorazepam is the lack of analgesia and, therefore, the need for more anaesthesia during the operation. The conclusion is that lorazepam is a very satisfactory premedication and warrants more use as such.
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PMID:Lorazepam as a premedication. 0 77

The clinical effects of oral flunitrazepam (2 mg on the night before operation followed by 2 mg on the morning of operation) and placebo as premedicants were tested in a double-blind study in 81 gynaecological patients. The separate or total concentrations of flunitrazepam and its demethylated metabolite in plasma (measured by gas chromatography) were correlated with the clinical effects of flunitrapam premedication, assessed both sugjectively and objectively. In most parameters tested (sleep on the night before operation, sedation, apprehension, headache, pulse rate), there was a positive, significant difference between the flunitrazepam group (n = 44) and the placebo group (n = 37). No significant difference was found between the two groups in emetic effect, excitement, systolic blood pressure increase, and vene-puncture, but the patients receiving flunitrazepam felt significantly more dizziness. The temperature of the left forefinger before, during and after the anaesthesia did not vary significantly between the two groups. There was no correlation between the plasma concentration of flunitrazepam and its demethylated metabolite (separate or total concentrations) and any of the parameters tested before induction of anaesthesia. Flunitrazepam is a new oral premedicant with prominent sedative and anxiolytic actions. When the drug is given as a sedative on the night before operation, followed by a second dose on the morning of operation, the beneficial effects last for at least 8 hours after the second dose.
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PMID:Flunitrazepam versus placebo premedication for minor surgery. 4 32

140 women who had received peridural anaesthesia (PDA) during childbirth at the University Gynaecological Hospital, Basel, in 1977, were retrospectively questioned on the occurrence of backache and headache during the puerperium subsequent to peridural anaesthesia. The "matched pairs" technique was employed for the controls. The inquiry revealed that in the PDA group 69 women (49%) and in the control group 39 women (28%) complained of increased backache during the puerperium. For 30 patients (44%) the complaints were a frequently disturbing factor in their everyday work. In the control group, this was true of 11 women (28%). 46 patients (33%) of the PDA group complained of increased headache during the puerperium, against 16 patients (11%) of the control group. 22 women (49%) of the PDA group felt disturbed in their daily work against 4 women (25%) among the controls. The findings are compared with data in literature, and the aetiology of the symptoms is discussed.
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PMID:[Possible late complications after peridural anaesthesia (author's transl)]. 15 46

Certain pain disorders may be difficult to diagnose because their presenting symptoms are confusing and difficult to classify, or because they occur so infrequently that they are not commonly considered. This article has presented a classification and discussion of selected pain states which the practitioner may find difficult to diagnose. When faced with a perplexing pain problem, the dentist is encouraged to perform a careful evaluation to determine whether the patient's pain is or is not of dental origin. Certain pain states require that the patient be referred for evaluation to other dental or medical specialists. The value of local anesthesia as a diagnostic aid in evaluating face and head pain has been presented.
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PMID:Selected pain states and the use of anesthesia in dentistry. 27 26

The effects of Lidocaine and the new local anaesthetic carticaine in spinal anaesthesia were compared in a double blind study in 120 elderly male patients scheduled for small urological procedures. The variables investigated were: analgesia examined by pin prick method, loss of tactile sensation, motor block, and skin temperature on the big toe. Both local anaesthetics seem to act similarly, but the loss of tactile sensation and motor block began somewhat earlier with carticaine. The differences have hardly any clinical significance. The incidence of hypotension and postanaesthetic headache was similar in each group.
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PMID:A comparison of carticaine and lidocaine in spinal anaesthesia. 36 Sep 57

A study of 400 consecutive cases of bupivacaine spinal anaesthesia is presented. The anaesthesia was for surgery on the lower abdomen or on the lower limbs. The patients' ages ranged from 19--91 years with the majority (60%) being over 60 years old. The patients were graded according to the A.S.A. (American Society of Anaesthesiologists physical status grade and 43% of the patients were graded as III or more. The duration of surgery lasted up to 3 hours yet analgesia always outlasted the surgery. The quality of analgesia achieved was assessed and in 94% of patients this was either good or perfect. No serious complications was observed but a common sequela was hypotension which was easily controlled by etilefrine (Effortil). There were a few cases of post-spinal headache but this was never severe or long lasting.
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PMID:Bupivacaine in spinal anaesthesia. 36 49

Headaches form an essential part of the syndrome after concussion of the brain. The origin of these may be extracranial (neuralgias in scar tissue and hematomas, neuralgiform headache as a result of injury to the cervical spine) as well as diffuse in the sense of vasomotr cephalalgia which are due to central regulation disorders of the circulation caused by psychogenic mechanisms and compensatory neurosis. Methods of therapy include the use of vasoactive substances especially for vasomotor cephalalgia, immobilisation and local anesthesia in neuralgias, and psychopharmocological as well as psychotherapeutic aid in psychogenic complaints.
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PMID:[Commotio cerebri and headache: (author's transl)]. 40 43

In order to quantify the pain associated with first trimester abortions and to analyze its influences, patient observations by doctors and attending counselors and patient interviews were conducted. Of the 2299 patients, 86% received 20 cc of lidocaine as paracervical anesthesia (14% received less) and 76% choose to receive 5 mg oral diazepam preoperatively (4% received 3-8 intravenously during the procedure). Patients compared their pain with other familiar types of pain. Doctors and counselors rated the pain during each of 8 specific stages of the abortion (examination, speculum insertion, tenaculum placement, administration of paracervical local anesthesia, uterine sounding, cervical dilatation, vacuum aspiration, and sharp curettage) as compared with the average pain they had observed. In addition, counselors rated the degree of apprehension with which the patient faced the procedure. These methods were analyzed on the basis of internal consistency among each group and agreement across the 3 sources and were found to be sufficiently dependable for the purpose at hand. The pain most often experienced was less severe than an earache or toothache, more severe than a menstrual pain or headache. Physicians and counselors agreed that vacuum aspiration is the most painful stage followed by dilatation and sharp curettage. Pain was positively associated with 1) age of 15 years or less, 2) with gestation of less than 7 weeks or more than 12 and with dilatation on a curvilnear basis, and 3) with patient fear. Despite expectations to the contrary, administration of 5 mg oral diazepam did not reduce pain.
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PMID:Pain of first-trimester abortion: its quantification and relations with other variables. 44 87

A prospective study was made in 255 patients following spinal anaesthesia to detect the incidence of post operative headache, reference also being made to the size of needle used for lumbar puncture. There was a difference in the frequency of headache related to the size of needle used (9.7% with 22 gauge needle as against 6.7% with 25 gauge needle). Also the value of prophylaxis of headache by means of an epidural blood patch was shown (1.3%). Age also played a role, the older the patient, the less the risk of headache. The social class of the patient played no role at all.
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PMID:[Postspinal headache -- a clinical problem (author's transl)]. 52 46

Directional characteristics of spinal injections delivered via a 22 gauge Whitacre needle were confirmed in twenty-one obstetric patients undergoing elective Caesarean section. Caudad injection was inadequate for elective Caesarean section, while cephalad or lateral injection provided good sensory levels for the duration of the surgery. It is speculated that along with the low incidence of postspinal headache and ease of administering the block with a more rigid 22 gauge needle, low dose caudally directed injections may provide a superior means of administering saddle block analgesia for obstetric patients.
Anaesthesia 1978 Feb
PMID:Directional spinals in obstetric analgesia. 63 77


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