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

For investigations of CO2-stunning of feeder- and slaughter-pigs parameters of behaviour, blood-gas-analyses and electroencephalograms were chosen. The following results were obtained: 1. Blood-gas-analyses proved that the CO2-stunning does not produce unconsciousness due to a lack of oxygen. 2. The criterias of general anaesthesia: unconsciousness, muscle-relaxation and analgesia with total reversibility could be confirmed. 3. The violent convulsive symptoms were evaluated as reactions identical with the stage II of GUEDEL's scheme of anaesthesia. 4. Muscular agitation, which sometimes appeared a few seconds before the stage of excitation, was judged to belong either to the start of the excitation phase or to the end of Guedel's stage of analgesia, during which the sensitivity is decreased. Neither study of behavior nor objective measurements showed, during the first 10 to 20 seconds of exposure to the CO2, any sign of pain or suffering related to the Act for Prevention of Cruelty to Animals, and accordingly such suffering should not be ascribed to the CO2 stunning method.
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PMID:[CO2-stunning of swine for slaughter from the anesthesiological viewpoint]. 249 19

Acutely ill patients with myocardial infarction may require immediate cardiac catheterization and coronary angioplasty to achieve myocardial reperfusion. To determine the feasibility of using general anesthesia under these circumstances, a randomized clinical trial was performed. Of 50 patients, 25 received anesthesia and 25 receive intravenous sedation. There were transient increases in heart rate and blood pressure after tracheal intubation in the anesthetized patients, followed by significant and sustained decreases below baseline values once steady state anesthesia was attained. Arterial oxygenation was significantly improved in anesthetized patients. There were no serious complications due to anesthesia, but the small sample size limited the power of the study to detect differences in morbidity or mortality. Patients strongly preferred anesthesia. These results show that general anesthesia is feasible in patients undergoing interventional cardiac catheterization during acute myocardial infarction, when pain, anxiety or agitation do not respond adequately to conventional measures.
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PMID:General anesthesia during percutaneous transluminary coronary angioplasty for acute myocardial infarction: results of a randomized controlled clinical trial. 252 88

Intrathecal administration of glycine (strychnine) or GABA (bicuculline) but not opioid (naloxone), adrenergic (phentolamine) or serotonin (methysergide) receptor antagonists resulted in a dose-dependent organized agitation response to light tactile stimulation. This effect was maximally evoked by oscillating but not continuous stimulation applied to a dermatome corresponding to the levels of spinal cord acted upon by the intrathecal antagonist. Similar results were observed in chloralose-urethane anesthetized rats in which tactile stimulation evoked hypertensive responses following local tactile stimuli. The effects were only mildly depressed by even high doses of spinal morphine or DADL and not at all by ST-91 or baclofen. In contrast, intrathecal injections of glutamate receptor antagonists resulted in a dose-dependent depression of the strychnine evoked hyperesthesia with the ordering of activity being MK-801, AP-5, kynurenic acid, SKF10047 and ketamine. At doses below those which produced motor dysfunction, however, these agents had no effects on the hot-plate response latency. These data emphasize that low threshold afferent input is likely subject to an ongoing modulation, the loss of which results in a miscoding of the afferent stimulus yielding a pain relevant message. The lack of effect of agents having a powerful effect on somatic pain stimuli and the converse effects of glutamate receptor antagonists on the strychnine hyperesthesia at doses which do not affect the somatic pain response indicate discriminable processing systems, the characteristics of which resemble the clinical phenomenon observed in patients suffering from sensory dysesthesia following central and peripheral horn injury.
Pain 1989 Apr
PMID:Behavioral and autonomic correlates of the tactile evoked allodynia produced by spinal glycine inhibition: effects of modulatory receptor systems and excitatory amino acid antagonists. 254 67

The incidence of postoperative effects of droperidol, in the hospital and at home the following night, after general anesthesia for minor outpatient procedures was evaluated in two groups of 50 patients each. Anesthetic techniques were identical except for the presence or absence of 1.25 mg of IV droperidol. There were no differences between the groups with regard to postoperative nausea, vomiting, pain, or time to discharge. In 23% of patients given droperidol, anxiety or restlessness developed after discharge from the ambulatory care unit. No patient not receiving droperidol had these reactions. It is suggested that the routine use of droperidol in all outpatients receiving general anesthesia may not be appropriate.
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PMID:Delayed side effects of droperidol after ambulatory general anesthesia. 236 26

The analgesic efficiency of morphine and propacetamol for postoperative pain, in the recovery room, was studied in two groups of children, who had undergone either orthopedic or visceral surgery. An injection of 50 mcg/kg of morphine chlorhydrate was given to the first group of 239 children ASA I, who were admitted to the recovery room and who presented signs of severe pain (agitation, crying, complaining). The analgesic efficiency of morphine was judged on physiological criteria (blood pressure, heart rate) and on behavioral criteria (calming of the child). No incidents were noticed. A second study was then performed on a second group of 100 children ASA I, who received 15 mg.kg-1 of propacetamol as an intravenous perfusion for 15 minutes. The analgesic efficiency of propacetamol was judged on behavioral criteria alone. In the morphine group, 67% of the children was calmed following one injection (94% after a second injection given 15 minutes after the first). In the propacetamol group, 77% of the children were calmed. Propacetamol was insufficient for the pain in 23% of the cases but one subsequent injection of morphine was always sufficient to calm the child. These two successive studies show the need for an analgesic protocol for children in the recovery room. Propacetamol should be administered first and then, if insufficient, followed by only one injection of morphine. This protocol of propacetamol and morphine seems to be satisfactory and thus avoids all pernicious side effects.
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PMID:[Treatment of postoperative pain in children in the recovery room. Use of morphine and propacetamol by the intravenous route]. 263 68

1. Assessment of older adults with behavior problems considers factors contributing to the behavior; potential psychosocial interventions; patient characteristics influencing medication action; and medication characteristics influencing therapeutic and adverse effects. 2. Anxiety, agitation, and other behavioral problems in demented patients might arise from their inability to verbally express complaints such as pain and discomfort. 3. Although constant blood levels of medication are most effective for ongoing management of behavior problems, as needed doses can be used to establish the optimal dosing schedule. 4. Medications in low doses can be used to improve the patient's response to psychosocial interventions for behaviors such as anxiety, agitation, depression, and sleep disorders; but they should not be used as the only intervention.
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PMID:Geropharmacology treatment: behavioral problems extend nursing responsibility. 272 43

Clonazepam is a high-potency benzodiazepine labeled for use as an anticonvulsant. Increasingly, clonazepam has been used in the treatment of a variety of psychiatric disorders. The authors discuss its potential clinical applications, including (1) use as an adjunct to neuroleptics for treating psychosis, (2) management of specific psychotropic side effects, (3) alternative treatment for certain pain syndromes, and (4) a primary treatment for severe agitation, atypical psychosis, and anxiety disorders. Apparent treatment-emergent side effects including depression, disinhibition, and sexual dysfunction are also discussed.
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PMID:Clonazepam: new uses and potential problems. 288 24

In rats with chronically implanted intrathecal catheters, high concentrations of morphine (3 microliters of 50 mg/ml: 150 micrograms) yielded a reliable and striking syndrome of pain behavior that involved intermittent bouts of biting and scratching at the dermatomes innervated by levels of the spinal cord proximal to the catheter tip. In addition, during intervals between bouts of agitation, the animals displayed a clear, marked hyperesthesia where an otherwise innocuous stimuli (brush stroke) evoked significant signs of discomfort and consequent aggressive behavior. These effects were exaggerated rather than reversed by high doses of naltrexone. The effect, perfectly mimicked by a considerably lower dose of morphine-3-glucuronide (15 micrograms) or the glycine antagonist strychnine (30 micrograms), was not produced by equimolar concentrations of sodium sulfate, glucuronide, methadone, or sufentanil. In halothane-anesthetized cats, light brushing of the hindpaw and tail or low-intensity stimulation of the sciatic nerves resulted in prominent elevations in blood pressure and pupil diameter following the intrathecal administration of high concentrations (50 mg/ml; 0.1 ml) of morphine sulfate. This effect, exaggerated by naloxone, was produced by a lower concentration of intrathecal morphine-3-glucuronide (5 mg/ml; 0.1 ml) but not by intrathecal saline. These results suggest the possibility that the effects of high doses of morphine may be characterized by a nonopiate receptor-mediated effect that alters the coding of sensory information in the spinal cord. The authors speculate that high concentrations of spinal opiates, as may be employed in tolerant terminal-cancer patients, could exert an action that physiologically antagonizes the analgesic effects otherwise mediated by the action of morphine on the spinal opiate receptor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High dose of spinal morphine produce a nonopiate receptor-mediated hyperesthesia: clinical and theoretic implications. 293 24

Sixty-eight medical, social, and occupational history variables were analyzed in a general population of 442 men and 478 women, aged 30, 40, 50, and 60 years to identify possible indicators for first-time experience and recurrence or persistence of low-back trouble (LBT) during a 1-year follow-up. Variables that in univariate analyses showed statistically significant indications for future LBT were subjected to stepwise logistic regression analyses. The most important indicators for recurrence or persistence of LBT thus identified were, for men, intermittent claudication, restlessness, or other discomfort in the lower limbs, frequent headache, and living alone. For women, the corresponding indicators were rumbling of "the stomach" and feeling of fatigue. For first-time experience of LBT, the indicators identified by the regression analyses were frequent pain in the top of the stomach, previous hospitalizations and operations, daily smoking, and a long distance from home to work. The result suggests that the population likely to experience future LBT does not enjoy good general health even prior to its first LBT episode, and this, in turn, may be due to greater psychosocial pressure.
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PMID:Medical, social and occupational history as risk indicators for low-back trouble in a general population. 294 36

Nitrous oxide/oxygen has long been the mixture of gases used in dental practice to produce light sedation. The main indication for use of nitrous oxide/oxygen sedation is fear-anxiety. The equipment used is a continuous flow machine with a fail safe system set at a minimum of 30 or 40 per cent oxygen. A standardized sedation technique starting with administration of 100 per cent oxygen, is recommended. The concentration of nitrous oxide is then slowly increased and individually set, mostly between 30 and 50 per cent. In most cases the analgesia produced by nitrous oxide is not sufficient to ensure pain-free dental treatment. The sedation must therefore be supplemented by local anaesthesia. Side effects, e.g. restlessness, vomiting, and nausea are infrequent. About 90 per cent patients, who have difficulty in co-operating during dental treatment, mainly because of anxiety, show excellent or fair co-operation during nitrous oxide/oxygen sedation. Occupational exposure to nitrous oxide can be minimized by the use of scavenging systems, local exhaust systems, careful sedation technique, and equipment management.
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PMID:Sedation by the use of inhalation agents in dental care. 305 46


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