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

Descriptions of parturition are reviewed for 88 individuals in 29 species of captive and wild non-human primates. Mild or severe discomfort, in the form of straining, stretching, arching, grimacing, writhing, shaking, doubling up, eye closure and restlessness is reported in 69 cases. Silence and utterance of moderate-level vocalizations are reported in 21 and 43 cases, respectively. The overall pattern indicates that parturition in non-human primates is characterized by a significant degree of pain and discomfort, while vocal responses to pain are generally subdued. We suggest that analgesia is the mechanism, and concealment of the parturient female the adaptive significance behind this blocking of vocal pain responses.
Pain 1985 Apr
PMID:Parturition in non-human primates: pain and auditory concealment. 392 17

This retrospective study examines the indications and the effects of 119 doses of succinylcholine or pancuronium given in the emergency department during a 24-month period to patients considered to have immediately life-threatening emergencies. The most common indication for succinylcholine was to accomplish tracheal intubation (20 of 25 patients). Indications for pancuronium included computerized tomography of the head (60 of 94), control of agitation (40 of 94), facilitation of tracheal intubation (20 of 94), control of ventilation (12 of 94), and control of seizure unresponsive to anticonvulsants (4 of 94). Deterioration following succinylcholine occurred in three cases. These included two involving bradycardia and one involving ventricular tachycardia. Major complications following pancuronium included four incidences of ventricular arrhythmias. Intubation failure requiring surgical airway occurred in one patient given succinylcholine, two patients given pancuronium, and one patient who received both succinylcholine and pancuronium. Inadequate documentation of neurological examination prior to blockade was noted in six of 25 succinylcholine and nine of 94 pancuronium cases. Failure to sedate patients who might be aware of paralysis occurred in three of 25 succinylcholine and eight of 94 pancuronium uses. Neuromuscular blocking agents facilitate expeditious management of selected critical patients in the ED. Their prudent use requires anticipation of potential complications, preparation for surgical airway should intubation fail, documentation of physical examination before paralysis, and prior sedation when the patient responds to pain.
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PMID:Neuromuscular blockade for critical patients in the emergency department. 394 57

Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. In the general anaesthesia group, there was a rise in either systolic or diastolic arterial pressure of over 30% of the control value in 8/15 patients. In the spinal anaesthesia patients, there was a transient rise above 30% in only one patient out of 15 and no rise in the 15 epidural group patients. On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated.
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PMID:Effects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients. 397 20

The effect of sublingual buprenorphine (Temgesic) as a premedicant and for postoperative pain relief compared with morphine/pethidine was studied in 50 patients scheduled for elective surgery of the knee joint. Twenty-five patients received buprenorphine 0.4 mg sublingually 1 h before surgery and the same dose on demand postoperatively. Twenty-five patients were given morphine intramuscularly (7.5 mg or 10 mg to females and males respectively) 1 h preoperatively. This group received pethidine (75 mg) intramuscularly on demand postoperatively. All the patients were anaesthetized with halothane N2O/O2 after induction with thiopentone. No significant differences were found with regard to sedation, dizziness, nausea and vomiting during the study period. Emergence shivering, confusion and restlessness just after termination of the operation were equal in the two groups. In the recovery room, however, there was a higher frequency of shivering (P less than 0.05) in the morphine group. During the first 24 h postoperatively the buprenorphine group was given an average of 3.8 doses compared with 2.3 in the pethidine group (P greater than 0.05). It is concluded, that buprenorphine sublingually is as good as morphine intramuscularly for premedication and therefore should be recommended to patients who wish to avoid injections. For postoperative pain relief the initial dose of buprenorphine should be given intravenously. Only minor and unimportant side effects were seen.
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PMID:Sublingual buprenorphine for premedication and postoperative pain relief in orthopaedic surgery. 397 30

This article discusses the causes of sleeplessness and its long-term management. Sleep may be repeatedly disturbed by pain, dyspnoea, micturition, or restlessness. The sleep patterns of the diseases which produce these symptoms are given, with an explanation in physiological terms of why they disturb sleep. A knowledge of these sleep patterns provides a valuable aid to diagnosis. It is concluded that there is only one condition, senility leading to senile dementia, for which long-term night sedation is justified.
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PMID:The clinical significance of disturbed sleep and the use of hypnotics. 437 78

This paper presents the usage of psychotropic drugs by all general inpatients of a Boston teaching and referral hospital on a randomly chosen weekday. Of all surveyed inpatients, 42.8% were receiving at least one psychotropic medication. Sleep medications were the most frequently prescribed class of psychotropic drugs and flurazepam was the most commonly prescribed of all drugs. Phenothiazine and neuroleptics were given to control agitation, pain, or nausea, rather than psychosis. Antidepressants were prescribed without notated justification in the medical record, and if given for depression, were underdosed. Diazepam was the most frequently prescribed antianxiety drug and was the most frequently prescribed psychotropic drug after flurazepam. Psychotropic drug polypharmacy was common, with the average patient receiving seven different drugs. Remedial approaches to this widespread problem are recommended.
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PMID:Psychotropic drug use and polypharmacy in a general hospital. 611 14

Lorazepam 0.05 mg X kg-1 and diazepam 0.1 mg X kg-1 administered intravenously were compared as sedatives for 42 patients undergoing Caesarean Section under epidural anaesthesia. After receiving the drug, 15 per cent of the diazepam patients and 32 per cent of the lorazepam patients were still agitated. Ten per cent of the diazepam patients and 36 per cent of the lorazepam patients had severe symptoms of delirium. These included hallucinations, confusion, agitation, restlessness, inappropriate weeping and repetitive hand movements. Memory impairment was greater with lorazepam. Thirty-five per cent of the diazepam patients had pain at the injection site. None of the lorazepam patients had such pain. Respiratory rate, heart rate and mean blood pressure did not change significantly in either group. Half the patients who had been given lorazepam had side effects that were bothersome enough to cause them to complain the following day. Lorazepam and diazepam were both unsatisfactory as sedatives for patients having Caesarean Section.
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PMID:Lorazepam and diazepam as adjuncts to epidural anaesthesia for caesarean section. 612 34

The analgesic meperidine has been reported to produce signs of central nervous system excitation in human beings. To determine the relationship between signs and symptoms of central nervous system excitation and plasma levels of meperidine and normeperidine, we studied 67 patients receiving meperidine for the relief of postoperative or chronic pain. In 48 patients, excitatory effects ranging from mild nervousness to tremors, twitches, multifocal myoclonus, and seizures were directly correlated with accumulation of normeperidine in plasma. Evidence of compromised renal function occurred in only 14 of the 48 symptomatic patients, suggesting that renal dysfunction may contribute to but is not the sole factor in the accumulation of normeperidine or its relation to adverse neurological signs. In a second study we surveyed mood alterations in 47 patients receiving meperidine and 29 receiving other narcotic analgesics for postoperative pain. The repeated administration of meperidine was associated with adverse alterations in various elements of mood (e.g., apprehension, sadness, restlessness).
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PMID:Central nervous system excitatory effects of meperidine in cancer patients. 618 75

A controlled, double-blind investigation was undertaken to determine whether regional anesthesia by dorsal penile nerve block (DPNB) could effectively minimize the pain and behavioral disruptions usually associated with newborn circumcision. Fifteen infants had DPNB with lidocaine, eight control infants had DPNB with saline, and eight additional control infants were circumcised without undergoing DPNB. Newborn distress was gauged by subjective observation, measurement of heart rate, and the percent of time spent crying in six sequential timed intervals during circumcision. Ninety-three percent of subjects who received lidocaine were observed to have a decrease in agitation after anesthetic administration. The mean increase in heart rate during circumcision was at least 50 percent less in the lidocaine injected group than in either control group (p less than 0.01). Infants who had DPNB with lidocaine cried 50 percent less during circumcision compared to combined controls (p less than 0.01). DPNB was easily administered, and there were no significant complications. Physicians who circumcise newborns have good reason to employ the technique of dorsal penile nerve block with lidocaine to minimize infant pain and distress.
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PMID:Regional anesthesia during newborn circumcision. Effect on infant pain response. 635 52

In a Finnish general practice 120 patients with psychosomatic disorders, manifest as syndromes of tension headache, cardiac neurosis, dizziness or muscular tension, were randomly allocated to treatment over a 4-week period with either flupenthixol (1 to 2 mg per day) or diazepam (5 to 10 mg mg per day). The 4 syndromes and 12 associated symptoms (anxiety, fatigue, depression, pain, asthenia, muscle fatiguability, tension, dyspnoea, restlessness, palpitations, sleep disorders, and vertigo) were rated on a 4-point scale on entry, at 2 weeks and at 4 weeks. Both drugs reduced significantly the average total scores for syndromes and single symptoms after 2-weeks' treatment. Flupenthixol was the more effective in relieving fatigue and vertigo; diazepam in relieving headache, anxiety, tension, restlessness and sleep disturbance. Cardiac neurosis, palpitations and general muscular tension responded poorly to both drugs. After 4 weeks, relief of vertigo, pain and fatigue was more evident in the flupenthixol group, and of anxiety, tension and restlessness in the diazepam group. Side-effects were complained of at some stage by 17 patients in the flupenthixol group (9 of fatigue, 5 of sleep disturbance, 1 of constipation, 1 of extrapyramidal symptoms, and 1 of weight gain) and by 16 patients in the diazepam group (10 of fatigue, 4 of sleep problems and 2 of diarrhoea).
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PMID:Flupenthixol versus diazepam in the treatment of psychosomatic disorders: a double-blind, multi-centre trial in general practice. 637 78


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