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

A comparison was made of the effects of continuous epidural analgesia with bupivacaine and intermittent epidural morphine on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. An "epidural morphine" group received general anesthesia and epidural morphine for postoperative pain relief, and an "epidural bupivacaine" group was given combined general anesthesia and epidural anesthesia with 0.5% bupivacaine intraoperatively and epidural analgesia with 0.25% bupivacaine postoperatively. Epidural morphine or bupivacaine was given for 42 h postoperatively. Pain intensity (visual analog scale) was low in both groups, but lower (P less than 0.05) in the epidural bupivacaine group. The time to first passage of flatus was 22 +/- 16 h in the epidural bupivacaine group and 56 +/- 22 h in the epidural morphine group (P less than 0.001). The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the epidural bupivacaine group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the epidural morphine group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when epidural bupivacaine is given for postoperative pain relief than when this is achieved by epidural morphine.
 ...
PMID:Effects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomy. 292 85

Comparison of the visceral analgesic effects of xylazine, morphine, butorphanol, pentazocine, meperidine, dipyrone, and flunixin in a cecal distention model of colic pain indicated that xylazine produces the most relief from abdominal discomfort. Repeated administration of xylazine may reduce visceral pain so effectively that the seriousness of abdominal disease is obscured. Xylazine decreased propulsive motility in the jejunum and pelvic flexure of healthy ponies. Morphine and butorphanol also gave relief from visceral pain in the cecal distention model. Morphine may inhibit colonic, and butophanol jejunal, motility. Whether xylazine or opiate mediated decreases in gut motility cause clinically important slowing of ingesta transit is controversial and requires further investigation. The development of behavioral changes (i.e., apprehension and pawing) in horses given opiate therapy may limit the use of these drugs. Combinations of xylazine and morphine or butorphanol produce excellent, safe, visceral analgesia and sedation without untoward behavioral effects. Although flunixin fails to demonstrate good visceral analgesic effects in the cecal distention model, this drug produces analgesia in some cases of colic by blocking prostaglandin mediated induction of pain. Improvement of propulsive gut motility in patients with ileus may follow administration of neostigmine (which is particularly effective when the large bowel is hypomotile), naloxone (which experimentally stimulates propulsive colonic motility), and metoclopramide (which stimulates stomach and proximal small intestinal motility).
 ...
PMID:Selected aspects of the clinical pharmacology of visceral analgesics and gut motility modifying drugs in the horse. 306 95

One hundred consecutive patients undergoing cholecystectomy by the standard operative technique were managed according to five cost-efficiency principles. Ileus did not occur, and patients routinely ate a regular diet on the evening of the first postoperative day. Oral analgesics adequately controlled incision pain. The preoperative day in the hospital was eliminated in the latter part of the study. With careful preoperative and postoperative patient instruction, the majority of patients were satisfied with their stay and no readmissions were necessary. In short, the feasibility and safety of admission 2 hours before and discharge 2 days after elective cholecystectomy have been documented herein.
 ...
PMID:Short surgical stay: two hospital days for cholecystectomy. 311 26

We report a series of patients with severe radiation injury treated with endoscopic laser photocoagulation. Eight patients with recurrent lower gastrointestinal bleeding secondary to procosigmoiditis were treated with endoscopic Nd:YAG laser therapy. Patients were followed for an average of 21.7 months after the first laser treatment. Average transfusion requirements and hospital admissions per patient-month were 0.93 and 0.27, respectively, in the prelaser period and 0.18 and 0.06, respectively, in the entire period following the first laser treatment. A total of 26 laser treatments were performed. There were three major (prolonged ileus) and one minor (pain) complication. We conclude that endoscopic Nd:YAG laser photocoagulation is a safe, effective, and lasting treatment in severe, symptomatic radiation injury of the lower gastrointestinal tract.
 ...
PMID:Endoscopic Nd:YAG laser treatment of severe radiation injury of the lower gastrointestinal tract: long-term follow-up. 191 80

We report on the early diagnosis of gallstone ileus by sonography. The usually principal x-ray sign was missing in the pneumocholangiogram or pneumocholecystogram. The size and position of the stone were easy to determine by ultrasound. While character of pain and x-ray results are often misleading in gallstone ileus sonography offers another way to diagnosis and may so avoid the heavy mortality of the disease.
 ...
PMID:[Sonographic diagnosis of gallstone ileus]. 331 Feb 25

Though patient-controlled analgesia (PCA) has been in use for over a decade, it has been popularized only recently. Conventional techniques of intermittent intramuscular (IM) administration of analgesia have fallen short of meeting the needs of patients following major abdominal surgery. This has prompted a search for methods to improve postoperative pain management. Though PCA has been accepted in many hospitals, few studies comparing conventional IM administration of morphine with PCA have been performed. A prospective randomized study comparing IM- and PCA-administered morphine in 62 patients undergoing colon surgery was performed. A comparison of the efficacy of analgesia and extent of sedation using these approaches shows that PCA allows for analgesia with less sedation and less drug requirement than that of IM administration. No differences were noted in postoperative duration of ileus, duration of hospitalization, and total hospital costs. This study confirms the safety and efficacy of PCA, and should be considered the current optimal method of controlling pain following major colonic surgery.
 ...
PMID:Patient-controlled analgesia vs. conventional intramuscular analgesia following colon surgery. 333 48

The medical records of 20 neonatal foals in which exploratory celiotomies were performed for gastrointestinal disease were reviewed. In all 20 foals, persistent pain and/or progressive abdominal distension were the primary clinical findings influencing the decision to operate. However, ancilliary laboratory data were important to the proper medical management of these foals during anaesthesia and following surgery. Surgical diagnoses of the 20 foals included ileus (nine foals; 45 per cent), small colon obstruction (five foals; 25 per cent), large colon displacement (three foals; 15 per cent), small intestinal displacement (two foals; 10 per cent), and perforated gastric ulcer (one foal; 5 per cent). Seventeen foals were recovered from anaesthesia, 13 of these were discharged from the hospital, seven were alive six months or more following discharge. Sepsis was the cause of death in six of the 10 foals that died following recovery.
 ...
PMID:Exploratory celiotomy for gastrointestinal disease in neonatal foals: a review of 20 cases. 336 15

In the past four years or so splenectomy used in children with hematological defects, who showed hypersplenism has been replaced with partial arterial splenic embolization (Pase), in general, 2/3 of the lower spleen were embolized. Pase was performed after the selective catheterization of the splenic artery up to the hilum with local anesthesia. As an embolizing agent, with the first 2 patients a suspension of Gelaspon microparticles and absolute alcohol (90 degrees) was used, and with the others (7 patients with 9 embolizations) only absolute alcohol. The Pase indication was: congenital hemolytic anemia in 5 cases; thrombocytopenia in 3 cases (5 pase); portal hypertension by extra-hepatic blockage with secondary hypersplenism in one case where the endoscopic sclerosis of the esophageal varices had been done first, followed by Pase after weeks. The evolution after Pase was simple in 6 patients: fever, pain in the left hypochondrium, and moderate ileus for 2-3 days. In 3 cases the evolution was both complicated and difficult excessive Pase in the first 2 patients, that practically resulted in total splenectomy, and, in the other one, the growth of a big subcapsular hematoma with effusion that had to be eliminated through transparietal drainage, under echographic control and operated secondary for peritonitis. Hematologically, in all cases but one (1 failure) hypersplenism remission was obtained and the results are the same 1-3 years after Pase. Partial arterial splenic embolization can very well replace splenectomy in hematological defects manifested as hypersplenism. The use of absolute alcohol (90 degrees) as an excellent embolization agent has not been reported so far in children.
 ...
PMID:[Splenic artery embolization in hematologic diseases in children]. 344 67

The extraperitoneal approach is not usually used for reconstruction of the abdominal aorta; however, herein we have made an attempt to influence vascular surgeons to modify this practice. The results in 200 patients approached extraperitoneally have been compared with those of 70 patients explored by the traditional transperitoneal route. The expeditious technique of extraperitoneal exploration described results in significantly less postoperative morbidity due to the pulmonary complications of atelectasis and pneumonia. Intestinal ileus is uniformly brief, and rarely requires nasogastric suction. Patients explored extraperitoneally have demonstrably less pain and were discharged from the hospital sooner. Furthermore, prosthetic graft patency and mortality were comparable in both groups. Thus, the retroperitoneal approach should be the preferred method of aortoiliac reconstruction since the postoperative convalescence period is smoother and shorter.
 ...
PMID:Extraperitoneal approach for aortoiliac reconstruction of the abdominal aorta. 351 14

Use of the rigid ureterorenoscope has become widely accepted for the diagnosis of ureteral lesions, and for the removal and disintegration of ureteral calculi. Few complications have been reported. During the last 3 years 128 ureteroscopic procedures were performed for a variety of indications (98 for stone disease). There were 26 complications: 22 minor with no morbidity and 4 major that required surgical correction. Minor complications consisted of asymptomatic ureteral perforations in 6 patients, perforations with urinary extravasation, pain, ileus or fever in 4, migration of the stone into the kidney in 10 and migration of the stone outside the ureter with the calculus left in situ in 2. Major complications included ureteral perforation during basket extraction of an upper ureteral stone, urinoma following perforation and requiring drainage, stenosis of the intramural ureter that was corrected by marsupialization and aseptic necrosis of the ureter that was treated by ileal replacement.
 ...
PMID:Complications of ureteral endoscopy. 355 Jan 47


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>