Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To compare the efficacy and side effects of 0.2 mg intrathecal (IT) morphine with 0.125% epidural bupivacaine, 62 women in labor were studied. They were randomly divided into three groups: group 1 (n = 20) received IT morphine; group 2 (n = 22) received epidural bupivacaine; and group 3 (n = 20) received a combination of both using a combined spinal-epidural (CSE) technique. According to a visual analogue scale for assessing analgesia, neither IT 0.2 mg morphine nor 10 ml 0.125% epidural bupivacaine was effective in producing adequate pain relief in labor, whereas the combination produced excellent analgesia. The use of IT morphine significantly reduced the dosage requirement of epidural bupivacaine. The incidence of nausea, vomiting, and pruritus was significantly higher when IT morphine had been administered, whereas that of urinary retention did not differ. No serious respiratory depression occurred in any of the patients. When the course of labor was studied, the prior use of IT morphine significantly prolonged the duration of the first stage of labor and the total duration of labor. We conclude that the administration of 0.2 mg IT morphine in combination with epidural administration of 0.125% bupivacaine provides better analgesia than the administration of either drug alone.
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PMID:Intrathecal morphine 0.2 mg versus epidural bupivacaine 0.125% or their combination: effects on parturients. 200 53

The analgesic efficacy of subcutaneous wound infiltration with 20 ml of 0.5% bupivacaine after elective lower segment section Caesarean section was studied in 28 patients in a double-blind randomised controlled manner using a patient-controlled analgesia system. The mean 24-hour morphine consumption of the placebo group and the bupivacaine group was similar (76 mg and 68 mg respectively). Analysis of the cumulative hourly morphine consumption failed to show any statistically significant differences between the groups. However, on a weight-adjusted basis statistically significant differences in morphine consumption were demonstrated, although these may not be clinically important. Subjective experiences of pain, nausea and drowsiness assessed by linear analogue scoring were similar in both groups.
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PMID:Wound infiltration of local anaesthetic after lower segment caesarean section. 175 Jun 26

From October 1, 1987 through December 31, 1989, 517 patients who were undergoing both thoracic and abdominal surgical procedures were treated for postoperative pain with epidural fentanyl citrate infusion under the direction of an anesthesia pain service. Infusion rates of 4 micrograms/mL of solution were essentially the same for all subjects. Sixty-five percent of patients experienced superior pain control without the use of adjunctive analgesia. Twenty-eight percent of subjects achieved satisfactory pain control but required additional low-dose analgesics. Only 7% of patients remained uncomfortable despite additional intravenous narcotic administration. There were no deaths or respiratory arrests. Six percent of patients experienced nausea, and 0.8% of the cohort required catheterization for urinary retention. This technique of postoperative pain control was safe and provided excellent results. Catheter position was a major determinant of the efficacy of the method.
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PMID:An extensive experience with postoperative pain relief using postoperative fentanyl infusion. 203 55

Sixty unpremedicated outpatients undergoing elective extracorporeal shock wave lithotripsy using an unmodified Dornier HM-3 lithotriptor were randomly assigned to receive an intravenous infusion of either alfentanil or ketamine as an adjuvant to midazolam for sedation and analgesia. Although both drug regimens allowed the maximal number of shock waves and energy level, the alfentanil group had significantly better calculi fragmentation (78% vs. 50% of patients with fragments less than 2 mm). Ketamine infusion provided superior intraoperative cardiorespiratory stability; however, it was associated with more disruptive movements (22 vs. 5) and dreaming (35% vs. 5%) during the procedure (P less than 0.05). Postoperatively, confusion also occurred more frequently in the ketamine-treated patients (31% vs. 5%, P less than 0.05). Alfentanil infusion was associated with more episodes of hemoglobin oxygen desaturation to less than 90% (12 vs. 2, P less than 0.05), itching (23% vs. 4%, P less than 0.05), and ability to recall intraoperative events (45% vs. 12%, P less than 0.05). The incidence of postoperative nausea was decreased (not significantly) in the alfentanil group (32% vs. 54%). The mean anesthesia time was similar in both groups; however, discharge times (means +/- standard deviations) were shorter in the alfentanil group (142 +/- 42 min vs. 161 +/- 31 min, P = 0.05). These data suggest that although both techniques proved effective for anesthesia in outpatients undergoing immersion lithotripsy, alfentanil is superior to ketamine as part of a sedative-analgesic technique because of the improved recovery profile and calculi fragmentation.
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PMID:Comparison of alfentanil and ketamine infusions in combination with midazolam for outpatient lithotripsy. 204 57

A prospective, open, clinical trial is described in which 20 patients having upper abdominal surgery were randomly allocated to receive fentanyl for postoperative analgesia by patient-controlled demand analgesic computer by either the epidural or intravenous route. Hourly pain, sedation and nausea scores were very similar in the two groups during the first 24 hours after surgery. What few differences there were favoured the epidural group. There was a highly significant difference in fentanyl consumption between the two groups, with the intravenous group demanding consistently more than twice as much as the epidural group.
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PMID:Patient-controlled on-demand epidural fentanyl. A comparison of patient-controlled on-demand fentanyl delivered epidurally or intravenously. 180 36

Forty cancer patients were randomly assigned to two groups (n = 20). All had incapacitating pain unresponsive to the usual non opioid analgesic drugs. An epidural catheter was set up at the level of the most painful metamere, and made to pass subcutaneously so as to exit either in the supraclacicular fossa, or on the patient's flank. At T0, the patients were given 4 mg morphine hydrochloride diluted in 10 ml normal saline. Thirty min later, patients in the naloxone group (group N) were given a 0.4 mg bolus, followed by a constant rate infusion of 5 micrograms.kg-1.h-1, of naloxone hydrochloride during 18 h. Patients in group P (placebo) were given normal saline instead. The degree of pain was studied with a visual analogue scale and analgesia was assessed by a clinician on a five point scale. These two parameters were obtained half an hour after the injection of morphine and 2, 4, 6 and 24 hours later. At the same time, the patients were questioned about adverse side-effects: nausea, vomiting, pruritus, dysuria, urinary retention. Respiratory depression was assessed clinically and biologically (blood gas measurements at the afore mentioned times). Heart rate, systolic and diastolic blood pressure were also measured. There was no statistically significant difference between the groups in quality and duration of analgesia. Pain reached its lowest level 4 h after the injection of morphine, returning to half its original value at the 24th h. This was also true for the incidence of nausea (11 in group N, 5 in group P), vomiting (3 in both groups), and urinary retention (6 in group P, 5 in group N).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevention by naloxone of adverse effects of epidural morphine analgesia for cancer pain]. 205 46

Twenty-two patients of ASA physical status 1 or 2 undergoing surgery of the perineal region received intrathecal pethidine as the sole agent. The anesthetic effect of 0.5 mg.kg-1 (group 1) or 0.7 mg.kg-1 (group 2) of pethidine was evaluated and compared. Patients were randomly assigned to one of the two groups (12 in group 1 and 10 in group 2). Subarachnoid puncture was performed with the patient in the sitting position, using a 25 gauge spinal needle at the lumbar vertebral level of L4/5 or L5/S. The patients remained sitting for 5 min before being placed in the supine position. Two patients in the group 1 had inadequate sensory blockade and they were excluded from further study. The average segmental level of analgesia was S1 in group 1 and L2 in group 2. Motor blockade of the anal sphincter was seen in all patients. During the operation, the patients were stable hemodynamically and no respiratory depression was noticed. Prolonged postoperative analgesia was obtained and some patients did not require additional analgesics during postoperative period. Four patients complained of itching, two patients of nausea and two developed arrhythmias.
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PMID:[Spinal anesthesia with pethidine as the sole agent]. 207 94

Intravenous ketorolac tromethamine was compared with morphine sulfate for the relief of moderate to severe postoperative pain and for side effects in 125 women undergoing major abdominal gynecologic surgery. Patients were randomly assigned to receive an initial intravenous dose of ketorolac 10 mg, ketorolac 30 mg, morphine 2 mg, or morphine 4 mg, administered in a double-blind fashion. No other narcotics were administered in the 3 hours preceding the first dose of study drug. A second dose was administered on request, but no sooner than 15 minutes after the initial dose. Patients who required additional analgesia within the 6-hour observation period were remedicated with a backup analgesic and withdrawn from the study. Pain scores and side effect evaluations were performed at baseline, 30 minutes, 1 hour, and then hourly for up to 6 hours or until the subject terminated the study. No significant differences among the treatments were noted in terms of area under the time-effect curves for pain intensity differences or pain relief. In each treatment group, 70-80% of patients withdrew within 1 hour and approximately 90% within 3 hours of the initial drug dose because of inadequate analgesia. With the dosage regimens used, neither drug adequately controlled moderate to severe pain in the immediate postoperative period. Patients receiving ketorolac experienced significantly less drowsiness than those given morphine, and some subjects in each experienced nausea. No serious adverse effects were reported.
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PMID:Intravenous ketorolac tromethamine versus morphine sulfate in the treatment of immediate postoperative pain. 208 6

The analgesic and adverse effects of intrathecal methadone 5 mg, 10 mg and 20 mg were assessed and compared with intrathecal morphine 0.5 mg. The study was conducted on 38 patients who underwent total knee or hip replacement surgery. The intrathecal opioid was administered at the end of surgery and assessments began 1 h thereafter and continued for 24 h. Pain measurements, supplementary analgesia requirements, and adverse effects were recorded. Intrathecal morphine 0.5 mg provided effective and prolonged analgesia. Intrathecal methadone 5 mg, 10 mg, and 20 mg produced good analgesia of 4 h duration. Thereafter the median pain scores with intrathecal methadone were consistently higher (worse) than those with intrathecal morphine (P less than 0.05). The time to the onset of discomfort severe enough to require supplemental morphine was longer after intrathecal morphine than following methadone (15 h with morphine 0.5 mg; 6.25 h, 6.5 h and 6 h with methadone 5 mg, 10 mg, and 20 mg respectively: P less than 0.05). Central nervous system depression manifesting as respiratory depression, hypotension, and excessive drowsiness occurred in 3 of 8 patients injected with methadone 20 mg intrathecally. Generalized pruritus, nausea, vomiting, and urinary retention were common and equally distributed among the treatment groups. We conclude that both intrathecal morphine 0.5 mg and methadone 5, 10, and 20 mg provide excellent analgesia but that morphine has a more prolonged effect. Methadone 20 mg produced unacceptable side effects. Clinical evidence for rostral spread of methadone within the CSF, as indicated by facial itching and excessive drowsiness, was less apparent with 5 mg than with 10 and 20 mg. Various explanations for the observed differences between the drugs are discussed.
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PMID:Intrathecal methadone: a dose-response study and comparison with intrathecal morphine 0.5 mg. 208 26

In a double blind trial the additional analgesic effect of the combination of epidural lignocaine 2% + epinephrine 1/200,000 with varying epidural Sufentanil doses was studied per- and postoperatively in patients undergoing arthroscopy of the knee. Fifty patients were randomly divided into five groups. They received epidural lignocaine 2% + epinephrine 1/200,000 in addition with respectively 0, 20, 30, 40 or 50 micrograms Sufentanil. There was no additional surgical analgesia when Sufentanil was added. On the other hand, at 40 and 50 micrograms of Sufentanil significantly more patients demonstrated respiratory depression and pronounced sedation during surgery as compared to lignocaine alone. Patients in these groups had better postoperative analgesia. In addition nausea, vomiting and pruritus were seen in some patients at all doses of Sufentanil.
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PMID:Surgical analgesia for knee arthroscopy with epidural lignocaine and sufentanil--effect of varying sufentanil doses. 215 Jul 38


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