Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative analgesia and the side effects of epidurally injected morphine were investigated in a double-blind study. Following lumbar epidural anesthesia for orthopedic operations, 174 patients received, in a randomized, double-blind fashion, either 0.1 mg/kg of morphine epidurally, 0.1 mg/kg of morphine intramuscularly, or saline epidurally at the end of surgery. Following epidural morphine, postoperative pain was les frequent, less intense and of shorter duration, use of analgesics and sedative was less frequent; and the postoperative feeling of well-being rated better than after systemic morphine or epidural saline. These effects were more frequent when bupivacaine was used for operative epidural anesthesia than when mepivacaine was used. The results were age independent. Side effects following epidural morphine included pruritus and disturbances of micturition. Nausea, vomiting, fatigue, and headache were of comparable frequency in the three groups.
 ...
PMID:Epidural morphine for postoperative analgesia: a double-blind study. 719 36

We present an unusual case of postoperative headache in a child after an epidural block. A seven-year-old girl (ASA 1) was scheduled to undergo a urological procedure under general anaesthesia combined with an epidural technique for intra- and postoperative analgesia. Although there was no evidence of dural puncture when the block was performed, the patient developed a headache postoperatively. The headache, which was accompanied by neck pain, appeared in the sitting or standing position and was relieved by decubitus. According to the mother, her child had never complained of those symptoms in the past. After independent evaluation by an anaesthetist and a neurologist, a postdural puncture headache (PDPH) was considered the most likely diagnosis. As oral analgesics failed to provide relief, and epidural blood patch (EBP) using 10 ml autologous blood was performed under light sedation. This was followed by resolution of the symptoms. Epidural injections of opioids and local anaesthetics are becoming increasingly popular for pain management in children. This implies that there may be an increasing number of unintentional dural punctures that may result in more PDPHs in children. Epidural blood patches are effective in treating PDPHs in adults but their use has been reported very rarely in children. Resolution of the patient's symptoms following EBP supported the diagnosis while illustrating that EBP can be useful in the treatment of PDPH in children.
 ...
PMID:Epidural blood patch in a seven-year-old child. 755 1

Twenty adult male patients undergoing anorectal surgery in the jackknife position under spinal anaesthesia were studied for the anaesthetic properties of 5 ml hypobaric 0.1% bupivacaine. The patients were positioned in the prone, jack-knife position with a pillow under the hips and with an operating table break angulation of 30 degrees with head down tilt of 20 degrees. In this position a 25-gauge Quincke spinal needle was inserted intrathecally through L3-4 and 5 ml solution, prepared by mixing 1 ml bupivacaine 0.5% with 4 ml of distilled water with a specific gravity of 1.001 at 20 degrees C, was given over 15-20 sec. Onset time, progression and upper level of sensory blockade evaluated by pin prick, and the extent of motor block (1 = full motor movement at ankle and knee joint, 2 = restricted motor movements, 3 = full motor block, no movements) were measured at one minute intervals for the first five minutes, then every five minutes for 30 min. The number of dermatomes blocked was also noted. The median level of cephalad sensory blockage was of L1, with a range from T10-L3. On average, nine dermatomes were blocked (range 7-12). Motor blockade was not observed in any patient. Changes in heart rate and blood pressure were minimal. The average duration of postoperative analgesia was 339.5 +/- 182.9 min. Post-spinal headache was not observed in any patients. In conclusion, 5 ml intrathecal hypobaric bupivacaine, 0.1%, provided excellent perioperative analgesia without motor blockade and haemodynamic stability in patients undergoing anorectal surgery in jackknife position.
 ...
PMID:Hypobaric spinal anaesthesia with bupivacaine (0.1%) gives selective sensory block for ano-rectal surgery. 758 7

Ninety-six women undergoing post-partum tubal ligation under spinal anaesthesia were studied to compare 26G Atraucan with 25G Whitacre spinal needles for ease of insertion, number of attempts at needle insertion, cerebrospinal fluid (CSF) flow characteristics through the needles, quality of subsequent analgesia, and incidence of perioperative complications. A higher rate of successful dural puncture at the first attempt (40/50 vs 27/46, P < 0.05) and faster (mean +/- SD, 11.5 +/- 2.2 vs 13.5 +/- 2.4, P < 0.001) CSF flow through the needle was achieved with the Atraucan than with the Whitacre needle. The incidence of failed spinal (4% vs 5%) and post-dural puncture headache (PDPH) (4% vs 4.3%) was similar with both needles, but more patients experienced paraesthesiae during needle insertion with the Whitacre than with the Atraucan needle (15% vs 2%, P < 0.05). We conclude that the use of the 26G Atraucan needle is associated with a higher rate of successful identification of the subarachnoid space at the first attempt, faster CSF backflow, and fewer paraesthesia when compared with the 25G Whitacre needle.
 ...
PMID:Comparison of 26-gauge Atraucan and 25-gauge Whitacre needles: insertion characteristics and complications. 758 10

Spinal anesthesia in day-care surgery is still controversial because of the possibility of postdural puncture headache (PDPH). The use of the Sprotte needle with a conical tip that spreads the dural fibers may reduce the incidence of PDPH. The aim of this study was to compare the 22-gauge and 25-gauge Sprotte needles with respect to PDPH and postoperative complaints in out-patients undergoing arthroscopy. The rate of spinal anesthesia failure and the feasibility of unilateral spinal anesthesia when using a low dose of anesthesia was also verified. For this randomized, prospective study, 234 patients undergoing elective arthroscopy were chosen. Patients were allocated randomly to have spinal anesthesia with either a 22-gauge or 25-gauge Sprotte needle. Dural puncture was performed with the patient in a lateral flexed decubitus position. After the injection of anesthetic solution (0.5-1.2 mL of 1% bupivacaine in 8% glucose) patients remained in the lateral decubitus position for 30 min. The time to regression of analgesia, time of micturition, and all postoperative complaints were recorded. The most frequent side effect was backache (10.2%) with a more frequent incidence in the group using the 22-gauge needle (14.5% and 5.9%, respectively). PDPH was recorded in only one patient (0.8%) in the group using the 22-gauge needle. The failure rate was 0.8%. Unilateral anesthesia was achieved in 88% of 213 patients. Our data indicate that the use of spinal block is a suitable technique in the ambulatory setting, with a low rate of unplanned hospital admission.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Spinal anesthesia in outpatient knee surgery: 22-gauge versus 25-gauge Sprotte needle. 759 86

We designed a prospective, randomized, double-blind study to evaluate the efficacy of the combination of intrathecal sufentanil with a low dose of local anesthetic in an attempt to prolong analgesia in labor. Fifty-two patients received one of the following intrathecal study solutions: 2.5 mg of bupivacaine; 10 micrograms of sufentanil; or 2.5 mg of bupivacaine plus 10 micrograms of sufentanil. The mean duration of analgesia (min +/- SD) was significantly different among all three groups: 70 +/- 34 min for bupivacaine, 114 +/- 26 min for sufentanil, and 148 +/- 27 min for bupivacaine-sufentanil (P < 0.001). Visual analog scale (VAS) scores for pain were significantly higher in the bupivacaine group compared to both the sufentanil group and the bupivacaine-sufentanil group (P < 0.02), and were significantly higher in the sufentanil group compared to bupivacaine-sufentanil at 75 min postinjection and beyond (P < 0.02). Hypotension was not observed in the sufentanil group but occurred transiently in the other two groups (P = 0.09). There was no evidence of motor blockade, excessive somnolence, fetal heart rate (FHR) abnormalities, or postdural puncture headache (PDPH) in any of the patients. The addition of 2.5 mg of bupivacaine to 10 micrograms of intrathecal sufentanil significantly prolonged labor analgesia without adverse maternal or fetal effects.
 ...
PMID:The addition of bupivacaine to intrathecal sufentanil for labor analgesia. 761 20

The rate of low back pain and headache following parturition seems to be higher in patients delivered under epidural analgesia. The aim of this study, performed in the immediate postpartum (up to 3rd day) and including 200 patients delivered vaginally, was to assess the incidence and the risk factors of low back pain and headache. A total of 31.5% of them complained of low back pain (LBP+) after parturition. They were significantly younger than those without low back pain (LBP-) (p < 0.03) and have had significantly more often epidural analgesia (p < 0.05). However, there were no statistically significant differences concerning weight, weight gain, parity, duration of labour and duration of epidural analgesia. The LBP+ patients complained significantly more often of cervical (p < 0.04) and low back pain (p < 0.02) during pregnancy, than the LBP-. In the immediate postpartum period, cervical and dorsal pain as well as headache occurred significantly more often in LBP+ than in LBP+ (p < 0.001). The intensity of low back pain during pregnancy (p < 0.006). Risk factors for postpartum LBP were epidural analgesia (OR = odds ratio = 6.59), LBP (OR = 6.50) and cervical pain (OR = 2.75) during pregnancy. The influence of epidural analgesia is questionable, as there was no difference between duration of labour and duration of epidural analgesia, if used, between the two groups. Patients for whom epidural analgesia was required are probably more susceptible to pain during pregnancy. Patients who suffered from postpartum headache (PPHDA+) were comparable to those who did not (PPDHA-).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Low back pain and headache during immediate postpartum. Role of obstetrical epidural analgesia]. 767 73

Patients with facial pain, without overt dental disease, are often seen in both medical and dental practice. The differential diagnosis includes (a) cluster headache, in which patients have severe unilateral pains lasting 30 to 120 minutes that respond to verapamil, corticosteroids or lithium; (b) migraine, in which attacks are longer and are often accompanied by nausea and visual disturbance, and can be managed using anti-inflammatory analgesics, with or without metoclopramide, or sumatriptan, although frequent attacks are best suppressed by continuous propranolol or pizotifen; (c) trigeminal neuralgia, knifelike unilateral pains usually responsive to carbamazepine; and (d) temporal arteritis, a steadier pain very responsive to corticosteroids. There is no evidence that continuous 'idiopathic facial pain' is a result of malocclusion (i.e. the way in which the teeth fit together), and its aetiology remains obscure, although there is some biochemical evidence linking it to depression. Many patients respond to simple analgesia and firm reassurance from the physician, although antidepressant therapy (e.g. nortriptyline or dothiepin) is often of great value.
 ...
PMID:Orofacial neuralgia. Diagnosis and treatment guidelines. 769 15

Preliminary studies have shown that repeated nasal applications of capsaicin prevented the occurrence of cluster headache attacks. The present study was designed to verify the difference in efficacy of treatment with nasal capsaicin, depending on the side of application. Fifty-two patients affected by episodic form were divided into 2 groups, one receiving the treatment on the same side where the attacks occurred (ipsilateral side), the other on the controlateral side. Eighteen patients with a chronic form alternately received both ipsilateral and controlateral treatments. Seventy percent of the episodic patients, treated on the ipsilateral side, showed a marked amelioration whereas no improvement was noted in the patients treated on the contralateral side. The efficacy of ipsilateral treatment was emphasized by the results obtained in chronic patients. However, in these patients, the maximum period of amelioration lasted no more than 40 days. The difference between the effects of the 2 treatments (contralateral and ipsilateral) was statistically significant in both episodic and chronic sufferers. The efficacy of repeated nasal applications of capsaicin in cluster headache is congruent with previous reports on the therapeutic effect of capsaicin in other pain syndromes (post-herpetic neuralgia, diabetic neuropathy, trigeminal neuralgia) and supports the use of the drug to produce a selective analgesia.
 ...
PMID:Preventative effect of repeated nasal applications of capsaicin in cluster headache. 770 5

Combined spinal epidural block has proven its efficacy in skilled hands. This technique allies advantages of spinal anaesthesia, regarding its speed of action and intensity of motor blockade and advantages of postoperative epidural analgesia. This block must be performed with great care and method to reach a success rate of almost 100%. Local anaesthetics and additives are reviewed and commented. The two main complications, hypotension and post dural puncture headache can be contained in very low limits.
 ...
PMID:[Combined epidural and spinal anesthesia for cesarean section]. 772 10


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>