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 material of 100 patients aged 18-70 years, ASA groups 1-2, who were otherwise healthy with slight generalized sequelae of their illness but without limitations in their usual habits, who were admitted for gastroscopy were randomized to sedation with either diazepam or propofol. Prior to the examination, 0.2 mg/kg diazepam or 1 mg/kg propofol was administered. If necessary, this was supplemented with half of the initial dosage. No difference were found in the sedation. Patients in the propofol group remembered the surgeon's information significantly better and woke significantly more rapidly. Propofol caused significantly more pain on injection. We consider that propofol can be employed for outpatient gastroscopy.
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PMID:[A comparative study of propofol and diazepam used as sedatives in gastroscopy]. 195 9

We have studied 40 ASA I/II patients aged from 18 to 65 years undergoing otorhinolaryngologic surgery of 40-100 minutes of duration. Patients were randomly assigned to two groups. Anesthesia in group I was induced with thiopental, 4 mg/kg and maintained with N2O at 66% and a variable perfusion of fentanyl. In group II, anesthesia was induced with propofol, 2.5 mg/kg and maintained with a perfusion of 6-12 mg/kg/hour and an initial perfusion of fentanyl, 4 micrograms/kg/hour. Loss of consciousness occurred in 37.49 +/- 9.78 seconds in group I and in 46.25 +/- 12.62 seconds in group II, with no significant differences. Two minutes after induction, propofol group presented a significant decrease in systolic blood pressure of - 12 mm Hg and both groups presented comparable increases in systolic blood pressure and heart rate during intubation. Five minutes later, systolic blood pressure regained normal values. Maintenance in group II was achieved in a proper fashion with a mean propofol consumption of 9.5 +/- 2.6 mg/kg/hour and fentanyl consumption of 4.94 +/- 2.22 micrograms/kg/hour whereas in group II, with N2O at 66%, the amount of fentanyl required was 6.85 +/- 2.95 micrograms/kg/hour, which was significantly higher. Eye opening from the time of interruption of anesthetics was achieved at 6.6 +/- 3.2 minutes in group I and 12.44 +/- 6.34 in group II. Consciousness was regained at 11.25 +/- 3.96 and 16.87 +/- 6.95 minutes, respectively. Pain on injection occurred in 15% with propofol and in 10% with thiopental. No patient presented major complications nor phlebitis after administration of the anesthetic.
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PMID:[Comparative study of the efficacy and tolerance of propofol and thiopental in induction and in continuous perfusion with neuroleptanesthesia]. 196 55

This randomized, double-blind study evaluated the antiemetic efficacy and the side-effects of promethazine pretreatment (0.5 mg.kg-1 IV + 0.5 mg.kg-1 IM) versus droperidol + placebo pretreatment (droperidol, 0.075 mg.kg-1 IV + physiological saline, 0.02 ml.kg-1 IM). One hundred unpremedicated ASA physical status I children ranging from two to ten years, and undergoing outpatient strabismus surgery were studied. All children received inhalational anaesthesia with halothane, nitrous oxide and oxygen. Neither opioids nor muscle relaxants were used. The incidence of vomiting and/or retching and the incidence of side-effects were determined in the post-anaesthesia recovery room (PARR), in the short-stay surgical unit (SSSU), and after discharge from the hospital (including the journey and the stay at home during the first postoperative day). Promethazine and droperidol were equally effective in reducing the incidence of vomiting before discharge to two and eight per cent respectively. On the contrary, the incidence of vomiting after discharge and overall were significantly less with promethazine (ten and ten per cent) than with droperidol pretreatment (54 and 56 per cent) (P less than 0.0001). Promethazine permitted the time to discharge from the hospital to be reduced to an average of three hours, without increasing the incidence of vomiting postdischarge. Promethazine pretreatment is much less expensive than droperidol pretreatment. The incidence of restlessness was significantly less with droperidol (eight per cent) than with promethazine (36 per cent) (P less than 0.001). Promethazine pretreatment demands the use of an analgesic like acetaminophen in order to reduce the incidence of postoperative pain and restlessness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antiemetic prophylaxis with promethazine or droperidol in paediatric outpatient strabismus surgery. 198 40

Indobufen--an inhibitor of platelets aggregation--has been used in 306 patients with intermittent claudication due to peripheral vascular disease. Patients were treated and followed up for one year. One patient of every 3 treated with indobufen was treated with ASA, and a control group of patients receiving no treatment was also followed up. The authors studied by means of a treadmill exercise test the pain-free walking distance (PFWD), the global walking distance (GWD), and the recovery time after exercise. The treatment period was completed by 290 patients: 204 claudicants, 51 claudicants with diabetes, and 35 with a short PFWD and GWD (greater than 150 m). Indobufen was more effective than ASA in improving the PFWD and GWD in all groups. There were also fewer side effects with indobufen, and cardiac morbidity and mortality was also reduced. In conclusion indobufen showed its activity and safety in chronic treatment of patients with peripheral disease, and we suggest that it may be used for long periods without side effects.
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PMID:Long-term evaluation of indobufen in peripheral vascular disease. 199 62

A pilot study of continuous postoperative regional analgesia by nerve sheath block for lower limb amputation is presented. At the time of exposure of sciatic or posterior tibial nerve trunks during above- or below-knee amputations in 11 patients with ASA physical status III or IV, a catheter was introduced directly into the transected nerve sheath for continuous infusion of 0.25% bupivacaine at a rate of 10 mL/h for 72 h. Effective amputation stump analgesia was obtained, significantly reducing the need for on-demand narcotic analgesics during this time to a mean dose equivalent of 1.4 mg of morphine compared with a retrospective control group who received the equivalent of a mean dose of 18.4 mg of morphine (P less than 0.0001). No complications related to the technique were observed. A follow-up of the group receiving continuous postoperative regional analgesia for up to 12 mo showed a total absence of phantom pain despite the presence of preoperative limb pain.
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PMID:Continuous postoperative regional analgesia by nerve sheath block for amputation surgery--a pilot study. 199 57

In a prospective randomized clinical investigation, we examined the influence of continuous thoracic epidural analgesia (TEA) on pulmonary function and pathologic chest X-ray findings. METHODS. One hundred sixteen patients having resection and/or anastomosis of the colon participated in this study; 57 were randomly assigned to the epidural group, whereas 59 were given systemic analgesia. Both groups were comparable with regard to ASA classification and pre-existing disease, as well as operative procedures and surgeons. Bupivacaine 0.75% was given to the TEA patients pre- and intraoperatively (epidural catheter T8/9), and postoperatively they received bupivacaine 0.25% continuously by motor pump for 3 days. We aimed to reach an analgesic spread from T5 to L2. In order to maintain sufficient analgesia, we had to increase the dosage from 19.2 mg/h on the evening of the operative day to 22.2 mg on the 3rd postoperative day. However, under these conditions the number of blocked segments decreased from 9.3 postoperatively to 6.6 on the 3rd postoperative day. Balanced anesthesia (isoflurane plus fentanyl) was given to the control group. Postoperatively, these patients received systemic analgesia on request (piritramide i.m., tramadol, or a simple analgesic). Vital capacity and pain score (10-point nominal analog score) were evaluated at 1, 8, 24, 36, 48, 60 and 72 h postoperatively. Blood gas analyses were taken at 1, 8, 24, 48 and 72 h, and chest X-rays were performed on the 1st, 3rd, and 8th postoperative days. Statistically significant results are indicated by "*" (P less than 0.05) and "*" (P less than 0.005) and "***" (P less than 0.001). The standard deviations were shown in cases of statistical significance. RESULTS. There were significantly lower pain scores by 1.0-2.2 points at 1, 8, 24 and 36 h postoperatively in the TEA group. Fourteen patients in group I required adjustments of the postoperative pain treatment regime: 6 had a unilateral epidural block; in 4 the catheter was withdrawn involuntarily. Up to the 2nd postoperative day, patients in the control group received systemic analgesics significantly more often. The vital capacity (percentage of preoperative value) was significantly higher in the TEA group than in the control group after 1 h (58.5% vs 51.7%) and 8 h (63.9% vs 56.7%). From the 1st postoperative day on there was no difference between both groups with regard to arterial blood gases, there was no difference in pCO2 between both groups 1 h postoperatively; it was, however, significantly lower in patients receiving bupivacaine at 8, 24, 48 and 72 h. There was no difference in pO2 at any time. The number of pathologic chest X-ray findings showed no difference between both groups. Looking especially for infiltrates, dystelectasis, atelectasis, and congestion, we also could not demonstrate any difference between the groups. (ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The effect of continuous thoracic peridural anesthesia on the pulmonary function of patients undergoing colon surgery. Results of a randomized study of 116 patients]. 200 46

In a double-blind study, propofol (P) 2-2.5 mg.kg-1 preceded by saline (Sal) or alfentanil (A) 20-30 micrograms.kg-1 was used for anaesthetic induction in 59 young patients of ASA physical class I or II, premedicated with oxycodone 0.1 mg.kg-1 and atropine 0.01 mg.kg-1 i.m. The patients were randomly allocated to one of the four groups: Group 1 Sal + P2.5, Group 2 A20 + P2.5, Group 3 A30 + P2.5 and Group 4 A30 + P2. Pain on injection of propofol occurred in 67, 36 and 7% of the patients in the Sal + P2.5, A20 + P2.5 and A30 + P2 groups, respectively, but not at all in the A30 + P2.5 group. Intubating conditions were assessed as good, moderate, poor or impossible on the basis of jaw relaxation, ease of insertion of the tube and coughing on intubation, each on a three-point scale. In impossible cases, suxamethonium was used. In the Sal + P2.5 group, the frequencies of good, moderate, poor and impossible intubating conditions were 0, 38, 8 and 54%, respectively. The corresponding figures in the A30 + P2.5 group were 43, 46, 7 and 14% (P less than 0.05 between the groups). The other groups did not differ significantly from the Sal + P2.5 group. After injection of propofol, both systolic and diastolic arterial pressures decreased significantly in all other groups, with the exception of diastolic pressure in the Sal + P2.5 group, whereas heart rate did not differ from the control level. After intubation, systolic arterial pressure increased statistically significantly in the Sal + P2.5 and A30 + P2 groups and diastolic arterial pressure in all other groups with the exception of the A30 + P2.5 group when compared with the corresponding preceding values.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Injection pain, intubating conditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with alfentanil. 200 94

Forty ASA physical status I or II patients scheduled for elective Caesarean delivery were studied to determine the effect of epidural fentanyl on post-Caesarean delivery analgesic requirements as administered by intravenous patient-controlled analgesia (PCA). Following delivery of the infant, under epidural anaesthesia with lidocaine 2% with 1/200,000 epinephrine, patients were randomly assigned to receive either 10 ml of preservative-free normal saline via the epidural catheter or 100 micrograms of fentanyl with 8 ml preservative-free normal saline in a double-blinded fashion. On arrival in the post-anesthesia recovery room (PAR), patients were provided with intravenous PCA meperidine 12.5 mg every eight minutes as needed. Patients were visited at intervals over the next 24 hr to determine if any differences in narcotic requirements, demands for narcotics, or severity of pain were noted. No differences were observed in any values between the groups. It is concluded that a single bolus of epidural fentanyl does not provide an advantage for postoperative pain relief in this patient population.
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PMID:Epidural fentanyl does not influence intravenous PCA requirements in the post-caesarean patient. 206 12

Propofol (Diprivan), a modern intravenous hypnotic, produces a reduction in both cardiac index (CI) and mean arterial pressure (MAP). Ketamine (Ketanest), a potent analgesic, in contrast, causes an increase in MAP and CI. The aim of the present study was to investigate whether the combination of propofol and ketamine can give better hemodynamic stability during the induction and maintenance of general anesthesia than propofol used with fentanyl, whose cardiodepressant actions may cumulate. METHODS. For induction of general anesthesia 10 patients (ASA I and II) each received 3-5 boluses of propofol (0.5 mg.kg-1 during 35 s until predetermined level of anesthesia was reached (stage D2/E0 according to [20]) followed by a continuous propofol infusion (0.120 mg.kg-1.min). Fentanyl 0.1 mg was administered to each patient in group A for induction of anesthesia and again if evident pain was present. In group B ketamine was given following a pharmacokinetic model based on computer-simulated calculation. After an initial bolus of 38 mg injected within 2 min further doses of 42 mg, 35 mg, 32 mg and 28 mg ketamine were administered over 30 min at a time. Signs of evident pain were treated by means of supplementary doses of 0.5 mg.kg-1. RESULTS. In both groups a moderate drop of MAP was observed after the induction of general anesthesia. Two patients in each group showed a distinct decrease in MAP (-32%). The heart rate dropped slightly (-9%) in group A, but did not change in group B. Following intubation the MAP rose by less in group A (+8%) than in group B (+21%). After the beginning of the operation the group treated with propofol/fentanyl showed major hemodynamic changes; in particular, bradycardia with less than 40 bpm was observed in more patients than in the propofol/ketamine group. Postoperatively, fewer patients in group B required rescue doses of analgesics (1 of 10) than these in group A (7 of 10), though vigilance was better in group B. DISCUSSION. The dose of ketamine administered during the induction of general anesthesia may have been not high enough to neutralize the cardiodepressant effect of propofol. But during the maintenance of anesthesia there was in fact better hemodynamic stability in group B than in group A as a result of the neutralization of opposing actions. Fentanyl even intensified the fall in MAP after propofol. Patients in group B showed better vigilance as well as better pain relief postoperatively. The population of the fentanyl group was obviously more deeply sedated and analgesia was still inadequate. In our study general intravenous anesthesia with propofol and ketamine offered the advantages of better analgesia, a higher state of vigilance and the absence of respiratory depression during the postoperative phase compared with the combination of propofol and fentanyl.
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PMID:[The effect of propofol-ketamine anesthesia on hemodynamics and analgesia in comparison with propofol-fentanyl]. 207 45

A study of 60 pediatric patients (ASA I), aged 2-13 years, was carried out. They had been operated for circumcision under general anesthesia. A penile blockade was carried out in all with a puncture in the middle line, following Bacon's technique, to control postoperative pain. They were divided in three groups of 20 patients each, depending on the drug that was used: group I (control), 4.5 ml of saline; group II, 0.5% bupivacaine, 20-25 mg, and group III, 2% mepivacaine, 80-100 mg. For the analgesic evaluation, Broadman's scale of pain/discomfort was used. The results showed that the procedure is effective, pain free, easy to perform and free from secondary effects. Therefore, it is beneficial for the postoperative period and convenient in this type of surgery.
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PMID:[Usefulness of penile blockade in postoperative analgesia of circumcision procedures]. 207 99


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