Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A hundred patients scheduled for elective abdominal surgery were randomized to either general anaesthesia (low-dose fentanyl) and systemic morphine for postoperative pain or combined general anaesthesia and epidural analgesia with etidocaine 1.5% intraoperatively (T4-S5) and bupivacaine 0.5% 5 ml/4 h for 24 h and morphine 4 mg/12 h for 72 h. Postoperative pain was better controlled by the epidural regimen (P less than 0.0001). We found no significant reduction in postoperative mortality (6% to 2%), pneumonia (28% to 20%), cardiac dysrhythmia (10% to 5%) and wound complications (14% to 11%) by the epidural analgesic regimen. The incidence of deep venous thrombosis (125I-fibrinogen scan) was 32% after general anaesthesia and low-dose heparin and 34% after epidural analgesia with no prophylactic antithrombotic treatment (P greater than 0.9). Postoperative weight loss and decrease in serum-albumin and serum-transferrin, as well as the reduction in haemoglobin and the need for postoperative transfusions, were similar in the two groups. Convalescence, as assessed by postoperative fatigue, restoration of bowel function (flatus, bowel movement and food intake) and the time until the patients were self-aided at their preoperative level, was not reduced by epidural analgesia. Since 50% of the patients in each group suffered from one or more of the above-mentioned postoperative complications, this epidural regimen was not effective in reducing postoperative morbidity after major abdominal surgery despite the achievement of adequate pain relief.
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PMID:A controlled study on the effect of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery. 408 79

43 non-surgical patients presenting with calf pain and a clinical diagnosis of deep venous thrombosis (DVT) were studied by arthrography, venography, and ultrasound. Only 14 had venographic evidence of DVT; 5 of these had popliteal cysts, which in 4 cases probably contributed to symptoms. 11 patients had popliteal cysts and normal venograms, and 9 of these cysts were thought likely to be the cause of the symptoms. In 18 patients all investigations were normal. Physical signs were not helpful in distinguishing between the three groups of patients. Ultrasonography detected only 2 of the 16 popliteal cysts. Popliteal cysts should be considered in the differential diagnosis and as a possible coexisting condition in patients suspected clinically of having DVT. Also, the finding of a Baker's cyst should not deter one from doing a venogram.
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PMID:Prospective study of thrombophlebitis and "pseudothrombophlebitis". 610 89

Seven patients with recurrent cervix cancer and concurrent lower extremity edema and pain were studied with contrast venography. Five patients (83%) were proven to have deep venous thrombosis. Significant objective and subjective response to therapeutic intravenous heparinization was obtained in all patients with DVT. The low morbidity and high rate of efficacy of treating this problem should encourage the physician to investigate this problem, in order to offer palliation.
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PMID:Lower extremity edema due to deep vein thrombosis in patients with recurrent cervix cancer. 620 44

Impedance plethysmography (IPG) and the Doppler ultrasonographic probe were used to assess whether thrombophlebitis, initiated by injection of a sclerosant into superficial varicose veins, extended to involve the deep veins of the leg. Sixty-seven legs were treated with compression sclerotherapy in 50 patients (26 men, 24 women) whose mean age was 53 years. Indications for this therapy were unacceptable appearance (n = 37), pain (n = 13), cramps (n = 11), and stasis ulcer (n = 6). Each leg received an average of six injections (range, three to 11) of 0.5 mL of sodium tetradecyl sulfate. Blood flow in the deep veins was studied immediately before injection of the sclerosant and one week and two weeks afterward. In each leg, no change in either of these studies was found at one and two weeks following injection treatment. In nine extremities, delayed venous emptying was found on IPG. This persisted after sclerosis and was interpreted as evidence of a previous deep vein thrombosis.
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PMID:Sclerosant treatment of varicose veins and deep vein thrombosis. 649 33

Postphlebitic syndrome occurs in 20 per cent of patients with deep vein thrombosis. Symptoms are nonspecific; they include heaviness, fatigue, pain, and vary from patient to patient. The signs of edema, skin pigmentation, dermatitis, varicosities, and ulceration are a result of the increased retrograde venous pressure secondary to the valve destruction by the phlebitic process. The aim of therapy is to improve venous support by graduated elastic stockings and to ensure good skin care and exercise.
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PMID:Postphlebitic syndrome. 653 97

Primary thrombosis of the deep veins of the upper arms accounts for less than 2% of total cases of deep venous thrombosis, and fewer than 10 reported cases of venous thromboembolism in association with oral contraceptive (OC) use have involved the upper extremity. This article describes the case of a 20-year old woman with recurrent arm swelling and pain who had been in good health until developing a small area of redness in her right arm and fever to 99.8 degrees Fahrenheit 6 weeks previously. The condition had been diagnosed as spider bite, for which no medication was given, and cellulitis with axillary lymphadenopathy, for which oral antibiotics were prescribed. Gradual improvement in pain and swelling occurred, but the arm did not return to normal size or consistency. Hospitalization and treatment with 9 days of intravenous Cefamandole provided some resolution. The patient had taken OCs for 2 1/2 years to regulate menses and was a cigarette smoker. She was discharged on oral Tetracycline but was referred for further evaluation because of persistent symptoms. The physical examination was normal except for an increased right upper extremity circumference, increased turgor of upper arm tissues, and some tenderness along the axillary vein and in the axilla itself. A venogram showed complete obstruction of the axillary and subclavian veins on the right with remarkable collateral circulation. The superior vena cava was patent. Treatment with intravenous Heparin followed by oral Warfarin produced no improvement in clinical condition. Primary upper extremity thrombosis is generally a disease of young men. In this case OCs may have served as a thrombogenic risk factor.
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PMID:A painful swollen arm in a young woman. 657 28

Venography remains the standard method for the diagnosis of deep venous thrombosis but it is invasive and frequently causes discomfort. A randomised double-blind study was performed to determine the efficacy of lidocaine in reducing pain and discomfort associated with venography. Sixty patients undergoing ascending venography received 40 mg of lidocaine (2 ml of 2% lidocaine mixed with 50 ml of contrast medium) in one leg and saline in the other. Assessment of pain was by a standard questionnaire administered by an investigator unaware of the sequence of administration of lidocaine or saline placebo. Twenty-four patients reported no difference in pain or discomfort between the two limbs. Of the 36 patients experiencing an overall difference in pain between the two legs, 12 reported more pain in the leg receiving lidocaine and 24 reported more pain in the leg receiving saline (p = 0.023). There were no significant side effects attributable to lidocaine. These results indicate that lidocaine is beneficial in reducing pain and discomfort associated with venography.
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PMID:Lidocaine and the reduction of post-venographic pain. 659 8

The records and radiographs of 162 patients with 224 total knee replacements were reviewed for evidence of complications. Early complications included cardiovascular abnormalities, in particular deep vein thrombosis (3%), and limitation of motion requiring manipulation under anesthesia (7%). Late problems included patellofemoral arthritis (11%), heterotopic bone formation (10%), loosening (7%), deformity (4%), fracture (3%), and infection (2%). Patellofemoral pain and arthritis is the most common and often the most disabling complication.
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PMID:Complications of total knee replacement. 660 86

We have reviewed our experience with the treatment of 250 patients with deep vein thrombosis diagnosed by contrast venography. The level of thrombosis was recorded according to the anatomic level to which it extended. A third of the patients had cancer, and the most common clinical findings were swelling and pain. The risk of the development of pulmonary embolism, based on the anatomic level of initial deep vein thrombosis, revealed the following: 12 of 115 patients (10 percent) with level I (calf) deep vein thrombosis developed pulmonary embolism, as did 2 of 27 patients (7 percent) with level II (popliteal) disease, 5 of 60 (8 percent) with level III (thigh) disease, 1 of 19 patients (5 percent) with level IV (groin) disease, and 2 of 26 patients (8 percent) with level V (iliac) disease. Based on our favorable experience with heparin we believe that heparin is the treatment of choice for deep vein thrombosis regardless of the anatomic level. The incidence of pulmonary embolism does not appear to be influenced significantly by the level of the deep vein thrombosis.
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PMID:Therapeutic and clinical course of deep vein thrombosis. 663 64

Seventeen women with thrombosis during pregnancy were studied prospectively. The deep venous thrombosis (DVT) was diagnosed objectively with phlebography, plethysmography and thermography. In many cases (13/17) the dominant symptom was diffuse pain in the lower abdomen and/or leg which in several cases caused a delay in the diagnosis. The traditionally typical thrombotic signs were often missing. Proximal thrombi were predominant (13/17) as were left-sided ones (14/17). During pregnancy and lactation the patients were treated with heparin which, after the initial parenteral administration, was given subcutaneously by self-administration. In conclusion, DVT must be suspected and non-invasive diagnostic tests be liberally performed in cases of uncharacteristic lateral and/or declive abdominal pain or leg pain during pregnancy. The DVT must always be objectively verified before treatment. In patients with pregnancy DVT there is no indication for early labor induction and the patients can be delivered by the normal vaginal route. It is recommended that patients with DVT during pregnancy should be treated with heparin subcutaneously which can be self-administered. The post-partum treatment may be continued for 2-3 months with heparin subcutaneously or peroral anticoagulants.
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PMID:Deep vein thrombosis during pregnancy. A prospective study. 666 57


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