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)

The Authors reported a therapeutic antalgic trial carried out on 50 patients, affected with head-ache, tooth-ache, menstrual pain, muscular and rheumatic pains. They were treated with tablets with ketoprofen covered by sucralfate compared with ASA tamponed tablets for 6 days. Results show that the therapeutic activity of the two drugs is substantially the same, but ketoprofen with sucralfate gastroprotection reports a very good tolerability.
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PMID:[Evaluation of the analgesic activity of a new ketoprofen-sucralfate combination]. 180 95

Subhypnotic doses of thiopentone are considered to have a hyperalgesic effect, while propofol has a hypoalgesic effect. We investigated the effect of these drugs on the nociceptive system by measuring the pain threshold to laser stimulation and the pain evoked potential (power and latency). Nineteen patients (ASA group I) participated. Twelve patients received thiopentone 0.5 mg kg-1 and propofol 0.25 mg kg-1 in random order separated by an interval of 14 h, and seven patients received saline. Immediately after the injection of both agents, the pain threshold was increased significantly (P less than 0.001) and the amplitude of the evoked potential was reduced significantly (P less than 0.05), while the latency of the evoked potential remained constant. It is concluded that, in subhypnotic doses, both thiopentone and propofol decrease the acute pain evoked by argon laser stimulation.
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PMID:Subhypnotic doses of thiopentone and propofol cause analgesia to experimentally induced acute pain. 188 13

We have studied the ability of clonidine to potentiate morphine analgesia in 28 patients (ASA I) after meniscectomy under general anaesthesia. One hour after surgery, morphine 3 mg (n = 10), clonidine 75 micrograms (n = 8) or morphine 3 mg plus clonidine 75 micrograms (n = 10) was injected extradurally. Morphine alone and in combination with clonidine produced similar and significant analgesia as assessed by verbal analogue pain scores. Pain scores did not decrease significantly in patients given clonidine alone. There were statistically, but not clinically significant decreases in systemic arterial pressure after morphine alone and clonidine alone. No patient developed sensory or motor block. One patient given morphine alone developed retention of urine. It is concluded that, in the dose used in this study, clonidine did not potentiate the analgesia produced by extradural morphine.
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PMID:Extradural clonidine does not potentiate analgesia produced by extradural morphine after meniscectomy. 181 28

We compared the postoperative epidural analgesia provided by the continuous epidural infusion of bupivacaine supplemented with patient-controlled injection (PCA) of epidural fentanyl with that provided by a continuous infusion of bupivacaine supplemented with a continuous epidural infusion of fentanyl. Our patient population comprised 16 ASA physical status I or II patients undergoing laparotomy with a midline incision under general anesthesia combined with bupivacaine epidural analgesia. Post-operatively, a continuous epidural infusion of bupivacaine (0.1 mg.kg-1.h-1) was combined with epidural fentanyl given by either (a) PCA (15-micrograms bolus with a lockout interval of 12 min, n = 8) or (b) continuous infusion (1 microgram.kg-1.h-1, n = 8). In the case of inadequate pain relief in the latter group, the fentanyl infusion rate was increased by 10 micrograms/h. Analgesia evaluated by a visual analogue pain score and by a verbal pain score was similarly effective in both groups. The sedation score was also similar in both groups. The total dose of epidural fentanyl administered during the first 24 h was significantly lower in the PCA group than in the continuous infusion group (405 +/- 110 micrograms vs 1600 +/- 245 micrograms, P less than 0.001). The dose of fentanyl given during each 4-h interval ranged between 40 and 160 micrograms in the PCA group and 251 and 292 micrograms in the continuous infusion group. Clinically detectable respiratory depression was not observed in either group. In conclusion, epidural administration of 0.1 mg.kg-1.h-1 bupivacaine combined with fentanyl provides effective postoperative analgesia with a total dose of fentanyl required that is lower when fentanyl is administered by epidural PCA rather than by continuous epidural infusion.
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PMID:Comparison of continuous epidural bupivacaine infusion plus either continuous epidural infusion or patient-controlled epidural injection of fentanyl for postoperative analgesia. 185 27

The efficacy of intravenous (iv) and epidural infusions of alfentanil for postoperative pain relief was investigated in 24 patients (ASA physical status 1-2) who were scheduled for abdominal hysterectomy. The patients were allocated randomly to receive either epidural or iv alfentanil. In both groups, a loading dose of 15 micrograms.kg-1 was administered, followed by a constant rate infusion of 18 micrograms.kg-1.h-1 alfentanil for 20 h. Both routes provided similar degrees of analgesia; however, analgesia occurred earlier in the intravenously treated group (P less than 0.03). Mean plasma alfentanil concentrations (Cps) varied between 42 and 82 ng.ml-1 in the iv group and 23 and 68 ng.ml-1 in the epidural group, with higher concentrations in the iv group for the first 60 min only (P less than 0.01). Cps increased with infusion time, suggesting accumulation of alfentanil. After infusion ended, pain recurred at the same time in both groups, whereas the alfentanil Cps still were greater than 45 ng/ml. Postoperative epinephrine concentrations decreased after 60 min of infusion (P less than 0.02), whereas, after 6 h, cortisol levels decreased to preoperative values. Norepinephrine concentrations decreased only slightly. The only clinically meaningful effect on vital signs that occurred was an abrupt reduction of respiratory rate after the iv loading dose. PaCO2 increased to the same extent in both groups during the first 15 min only. The incidence of opioid-related side effects was similar in both groups. These results suggest that the iv and epidural routes were equally effective for providing postoperative pain control and controlling the postoperative response to surgical stress.
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PMID:Alfentanil infusion for postoperative pain: a comparison of epidural and intravenous routes. 173 10

A randomized, double-blind crossover study was performed with three different acute oral dosages of CM 40907 (3-(4-hydroxypiperidyl)-6-(2'-chlorophenyl)-pyridazine) (600, 900 and 1200 mg), a newly developed anticonvulsant drug, vs acetylsalicylic acid (ASA, 1000 mg) and placebo in 12 male healthy volunteers to check analgesic potency. Objective algesimetry was done by Laser Somatosensory Evoked Potentials (LSEP). Subjective pain intensities were measured by retrospective visual analog scale ratings (VAS). Effects on objective vigilance were checked by Auditory Evoked Potentials (AEP). For both types of evoked potentials there was a simultaneous control of alterations in vigilance by means of the adaptive pursuit tracking task (APTT). A vigilance-controlled EEG (V-EEG) and a resting (R-EEG), visual analog scales (VAS) on sedation, excitation and anxiety as well as vital parameters (blood pressure and heart rate under supine and upright conditions) and adverse event scales were included in this trial as well. CM 40907 showed distinct analgesic effects on objective and subjective algesimetric parameters, which for the highest dosage (1200 mg) were superior in ("central") P2-amplitude suppression of LSEPs to those of ASA in ("peripheral") N1-amplitudes suppression and ongoing for more than 6 h. Subjective sedation was decreased, however, AEP-findings indicated a decreased vigilance after CM 40907. Some EEG-patterns, specifically related with CM 40907--although being ambiguous in classification terms--resembled features of benzodiazepines. Blood pressure and heart rate were raised in a clinically irrelevant manner.
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PMID:Analgesic potency of a new anticonvulsant drug versus acetylsalicylic acid via laser somatosensory evoked potentials. Randomized placebo-controlled double-blind (5-way) crossover study. 185 18

Twenty ASA 1 volunteers were each injected intradermally with four solutions containing 0.2 ml of 0.5%, 1%, and 2% lignocaine and 0.9% saline to determine whether the pain experienced on injection was related to the concentration of local anaesthetic. A 10 cm linear analogue pain scoring system was used, and the solutions were ranked from most painful to least painful. There were no differences between the different concentrations of lignocaine and 0.9% saline in the severity of pain experienced. We conclude that any concentration of lignocaine may be used intradermally before inserting intravenous catheters without affecting the degree of pain experienced by that injection.
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PMID:Pain on intradermal injection with lignocaine. The effect of concentration. 843 65

Twenty-five ASA 1 or 2 patients undergoing thoracotomy were entered into a prospective, randomised, double-blind study comparing thoracic epidural fentanyl alone and thoracic epidural fentanyl combined with 0.2% bupivacaine. Pain relief, pulmonary function and cardiovascular stability were assessed. Pain relief was superior in the bupivacaine series (p less than 0.05) during the first day after operation and this was accompanied by better oxygenation (p less than 0.05); the difference did not persist into the second day. Forced expiratory variables were reduced in both series to 50-60% of the values before operation throughout the study (p less than 0.05) and differences did not occur between the groups. The incidence of side effects attributable to epidural fentanyl was high, but hypotension did not occur. Small doses of bupivacaine administered together with fentanyl into the thoracic epidural space improve analgesia without causing hypotension.
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PMID:Continuous thoracic epidural fentanyl for post-thoracotomy pain relief: with or without bupivacaine? 192 72

The haemodynamic effects of induction of anaesthesia with propofol in children were studied. Two hundred and sixteen children (ASA 1) were randomly allocated to receive one of six different doses of propofol, from 1.6 mg/kg to 2.6 mg/kg, in 0.2 mg/kg increments. Noninvasive measurement of blood pressure showed that mean arterial pressure was reduced by approximately 15% after 1 minute, and by 30% after 5 minutes. The reduction in pulse rate over a 5-minute period was approximately 17%. These changes were similar in each group, regardless of the dose administered. The propofol was mixed with lignocaine, 0.5 mg/ml, and the incidence of pain on injection into a vein on the dorsum of the hand was 24%. We conclude that, within the dose range of our study, the haemodynamic disturbance after induction of anaesthesia with propofol in children is not dose related.
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PMID:Haemodynamic effects of propofol in children. 192 86

Clonidine, an alpha 2 adrenoreceptor agonist, has nonopiate antinociceptive properties, which might be an alternative for postoperative analgesia free of opioid-induced side effects. To document the analgesic properties of intravenous clonidine during the postoperative period, 50 ASA physical status 1 patients, immediately after spinal fusion, were randomly assigned to two groups, blindly administered either clonidine (5 micrograms/kg infused the 1st h and then 0.3 microgram-1.kg-1.h-1 during 11 h) or a placebo. A visual analog scale graded from 0 (no pain) to 100 mm was used to assess pain before clonidine or placebo administration (T0), at the end of the loading dose (T1) and then every 2 h (T3, T5, T7, T9, and T11). Morphine (0.1 mg/kg) was administered intramuscularly after each pain measurement if the score was greater than 50 mm. No morphine was given at T0. Hemodynamics, blood gases and plasma clonidine concentrations were measured each time the pain score was measured. The pain score decreased from 42 +/- 5 to 26 +/- 3 mm (mean +/- standard error) in the clonidine group whereas it was unchanged in the placebo group despite a greater morphine requirement (dose for each patient: 3.8 +/- 1 vs. 10.8 +/- 1.2 mg). Clonidine delayed the onset of pain and the first request for morphine injection. Mean arterial pressure decreased to 74 +/- 2 mmHg in the clonidine group (-26 +/- 2 vs. -15 +/- 2% in the placebo group at T11) despite a significant increase in the cumulative fluid volume.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postoperative analgesia by intravenous clonidine. 192 67


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