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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-seven per cent of surgical patients receiving undiluted diazepam experienced pain on injection while 6-16%, depending on the dose, manifested evidence of clinical thrombophlebitis. This was improved when diazepam, 10 mg, was diluted to 20-40 ml with intravenous solution. In contrast, lorazepam appeared to have minimal irritative or injurious effects on veins whether undiluted or diluted. In view of these results and clinical studies reporting a higher patient acceptance of lorazepam than diazepam, lorazepam may be a superior drug for use in anaesthesia.
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PMID:Pain and clinical thrombophlebitis following intravenous diazepam and lorazepam. 2 30

The successful termination of 19 consecutive late 1st and 2nd trimester pregnancies using a combination of intravenous prostaglandin E2 (PGE2) and oxytocin (Syntocinon) is reported. PGE2 (5 mg in 500 ml of 5% glucose) was initially infused at the rate of 2.5 mcg/minute and then increased to 5 mcg/minute after half an hour. The infusion was increased to a maximum of 10 mcg/minute. Oxytocin was infused 2 hours after the PGE2 at a constant rate of 128 mU/minute. Mean total dose of PGE2 used was 5.9 mg at an overall rate of 6.1 mcg/minute. Average induction/delivery interval was 16 hours, with only 1 patient taking more than 24 hours. Abortion was complete in 13 cases (68%). Vomiting occurred in 13 women; pain was minor and was controlled by pethidine. Mild and transient thrombophlebitis was also reported. There were no reported cases of diarrhea and or cervical damage. Compared to the use of intravenous PG alone, PG given intraamniotically alone or with intravenous oxytocin, and PG given extraamniotically alone or with intravenous oxytocin, this study shows that a combination of intravenous PGE2 and oxytocin at the dose level described is closer to meeting all the desired criteria for the acceptability of any abortion method (ease and safety of administration, side effects, lengths of induction delivery interval, and effectiveness in terms of success rate and uterine evacuation).
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PMID:Letter: Intravenous prostaglandins and oxytocin for mid-trimester abortion. 4 97

The efficacy of an organo-heparinoid ointment (Hirudoid 40,000) compared with a placebo ointment was tested in a double blind trial on 40 patients with post-operative infusion thrombophlebitis. It was possible to provide objective data by means of the 125I-fibrinogen test for accelerated regression of thrombi following treatment with organo-heparinoid. The differences found between the 2 treatment groups were statistically significant. The clinical results conformed largely to the measured data. Especially pain and swelling were favourably affected by treatment with the active compound. 1 case of local allergic reaction to organo-heparinoid was observed. No further side-effects were seen.
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PMID:[Controlled study on the efficacy of external treatment in surface-near thrombophlebitis]. 6 96

A number of technical and clinical conditions reportedly associated with diazepam-related thrombophlebitis were investigated. Diazepam alone and in combination with fentanyl and methohexital was administered intravenously to 519 healthy, predominantly young adult patients undergoing routine oral surgery for removal of third molars. Indirect evidence is provided to show that two slightly different vasculopathies are involved: thrombophlebitis, in which pain and induration are both present but in which there is a slight delay in the time of inception of the condition; and phlebothrombosis, in which the reaction is almost immediate but pain is not significant and induration of the vein is the predominant feature. The overall incidence was 2.3% for thrombophlebitis and 9.8% for phlebothrombosis. There were four significant variables associated with phlebothrombosis: use of tobacco, use of oral contraceptives, multiple injections of diazepam, and pain during injection. The only significant variable associated with thrombophlebitis was the site of injection.
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PMID:Thrombophlebitis after intravenous use of anesthesia and sedation: its incidence and natural history. 29 Jul 73

Spontaneous rupture of a renal allograft in the early posttransplant period is associated with tachycardia, hypotension, oliguria, swelling, pain, a falling hematocrit level, and tenderness at the transplant site. Occasionally, the ruptured allograft can be saved by control of the hemorrhage. Deep vein thrombophlebitis, a common occurrence after prolonged surgery and cortocosteroid therapy, is less common in renal allograft transplantation, but may be associated with renal vein thrombosis. The simultaneous occurrence of deep vein thrombophlebitis, renal vein thrombosis, and allograft rupture contraindicates anticoagulent therapy. We present a patient in whom ipsilateral deep vein thrombophlebitis developed eight days after a cadaveric renal allograft, followed in two days by hypotension, a falling hematocrit level, oliguria, and a painfall mass at the allograft site. Surgical exploration revealed a ruptured allograft with iliofemoral and renal vein thrombosis and profuse hemorrhage. A transplant nephrectomy was performed.
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PMID:Renal allograft rupture with iliofemoral thrombophlebitis. 34 49

In 104 patients undergoing anaesthesia of short duration, two different solvents, propylene glycol and cremophor, were compared in a double-blind trial. Diazepam 10 mg in a coded solution was injected into a superficial vein of the hand using a small-gauge needle. The vein was examined after 14 days. The frequency of thrombophlebitis with propylene glycol was 62.2% and with cremophor 3.4% (P less than 0.001). The frequency of pain on injection was also in favour of the new solvent (P less than 0.001). The possibility of anaphylactic reactions accredited to cremophor, however, restricts the use of the new injection.
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PMID:Prevention of diazepam-induced thrombophlebitis with cremophor as a solvent. 38 62

Transcutaneous electrical nerve stimulation (TENS) afforded significant relief of the pain associated with acute and recurrent thrombophlebitis in 90% of 39 patients so treated. The method is simple to administer, noninvasive, and apparently free of side effects. It can be self-administered by the patient after appropriate instruction. TENS can be given in conjunction with analgesics, anticoagulant therapy, and other supportive measures to achieve greater relief and mobility in patients with thrombophlebitis whose occupations and other activities are severely limited by their pain. Further clinical trials involving larger numbers of patients, and clarification of the analgesic mechanisms involved, are warranted because of the magnitude of this problem. TENS therapy can be uniquely beneficial in certain clinical situations. They include the contraindication of conventional treatments for the pain of thrombophlebitis, pelvic vein phlebitis, and the presence of concomitant painful orthopedic and neurologic disorders.
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PMID:Transcutaneous electrical nerve stimulation in the symptomatic management of thrombophlebitis. 44 90

Rupture of a popliteal cyst and dissection of its contents into the calf may produce pain, swelling, a positive Homan's sign and other findings closely resembling thrombophlebitis of the calf. The correct diagnosis is not often made, and the patient is subjected to needless long term anticoagulant therapy with its potential complications. To avoid this, it is essential that this possibility be kept in mind in all patients in whom the diagnosis of thrombophlebitis is considered. The history of preexisting arthritis of the knee, joint effusion and popliteal cyst are strongly suggestive of a ruptured popliteal cyst. This diagnosis can be verified by arthrography, ultrasonography, computed tomography and radionuclide scanning. Arthrography is preferred because it reveals superior anatomic detail thereby making differentiation between an encapsulated calf cyst, with smooth walls, and rupture, with irregular feathery margins, possible. Three illustrative cases are presented and the literature is reviewed.
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PMID:Rupture of a non-rheumatoid popliteal cyst: a syndrome mimicking thrombophlebitis. 54 66

Although pain and subsequent thrombophlebitis are complications in patients receiving intravenous (IV) diazepam, the mechanism and accompanying histology are unknown. To further elucidate the pathogenesis for this and determine whether it can be minimized, adult female rats received IV diazepam, diazepam vehicle, lidocaine, a combination of lidocaine and diazepam, or N saline solution, and underwent subsequent tissue light microscopy. Vascular tissue from animals receiving IV diazepam alone revealed marked inflammation with inflammatory edema and intramural polymorphonuclear-cell infiltration. Intravascular thrombosis and complete vein-wall destruction were also present in some animals as early as 48 hours after IV diazepam. Diazepam vehicle and diluted diazepam produced similar morphologic alterations. Lidocaine or saline IV resulted in no histologic alterations, while lidocaine added to diazepam did not reduce the inflammatory response. These results represent the first systematic morphologic evaluation of vein response to intravascular diazepam and suggest that it produces rapid and detrimental morphologic alterations. The dilution of diazepam or combination with lidocaine does not appear to alter these findings, and diazepam vehicle appears to assume a role in the production of the vascular injury.
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PMID:Thrombophlebitis after intravenous diazepam--can it be prevented? 55 43

Necrosis of the skin is a rare complication of oral anticoagulation therapy by coumarin congeners. Three males receiving prophylactic warfarin anticoagulation therapy following cardiac valve replacement and one female similarly receiving anticoagulation drugs because of bilateral deep thrombophlebitis associated with carcinoma of the pancreas had typical skin necrosis develop. The lesions passed rapidly through stages beginning with pain, edema, erythema and petechiae. Ecchymoses followed in the localized area with a large bullae containing deep red fluid. Biopsy of the skin revealed involvement of the dermovascular loops with localized necrosis from extensive occlusion of dermal capillaries and venulae by fibrin thrombi. There was red cell extravasation, but inflammatory changes were inconstant. In the patients, in our study, the involvement ranged from small localized lesions of the trunk to extreme extensive skin involvement of both legs with full thickness necrosis in areas. This condition is not dose related nor the result of simple hypoprothrombinemia. It appears to be a conditioned and localized toxicity, although hypersensitivity has not been excluded. Once the diagnosis is made, orally administered anticoagulant drugs must be stopped immediately, and heparinization may be beneficial in confining the process.
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PMID:Warfarin induced necrosis of the skin. 64 27


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