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)

In postoperative patients using patient-controlled analgesia (PCA) to administer i.v. doses of morphine sulfate, respiratory rates and subjective rankings of pain, sedation, and liking for the drug were correlated with plasma morphine concentrations. In 12 patients selected before surgery, the initial morphine sulfate dose of 0.6 mg/sq m was increased or decreased as needed. Every two hours, cumulative morphine sulfate dose, respiratory rate, and sedation were recorded by the nurse, along with the patient's evaluation of pain and liking for the drug. Plasma was collected in the morning and evening during PCA therapy for morphine analysis. Data were analyzed by analysis of covariance. Dosing rates and rankings of pain, sedation, and liking decreased as a function of time postoperatively, but respiratory rates did not. Sedation and respiratory rates were independent of morphine concentration. Liking of the drug increased directly with plasma morphine concentration but decreased with time. A high level of pain was directly related to morphine use. For all significant relationships, there was high interpatient variability, with the exception of changes in pain rankings induced by morphine. Patients defined a minimum effective plasma morphine concentration of 20-40 ng/mL. The maximum plasma morphine concentration achieved by self-administration was 82 ng/mL. These postoperative patients used patient-controlled analgesia to deliver morphine sulfate i.v. for pain relief, not for euphoria, and did not exhibit sedation or respiratory depression. Morphine was consistently effective at plasma concentrations of 40 ng/mL or greater.
 ...
PMID:Relationship between plasma morphine concentrations and pharmacologic effects in postoperative patients using patient-controlled analgesia. 315 20

An open pilot study was undertaken to evaluate the analgesic properties of epidurally administered sufentanil in the early postoperative period. After orthopaedic surgery of the lower extremity, four different groups of five adult patients each received either 15 micrograms (group 1), 30 micrograms (group 2), 50 micrograms (group 3) or 75 micrograms (group 4) sufentanil via an epidural catheter previously used for the surgical procedure. Results were satisfactory in groups 3 and 4 with very good relief of pain and a mean duration of action of 372 and 307 minutes respectively. Dosage above 50 micrograms did not seem to improve the quality or duration of pain relief, although the onset of action was faster with 75 micrograms. Sedation was always present in patients with effective analgesia. In the present study respiratory depression was not evident, but three patients complained of itching and two of urinary retention.
 ...
PMID:Epidural sufentanil for postoperative pain relief. 316 8

In a randomized, double-blind crossover study, 40 patients with postherpetic neuralgia were given single oral doses of clonidine, 0.2 mg, codeine, 120 mg, ibuprofen, 800 mg, or inert placebo. Pain relief and side effects were recorded for 6 hours. Patients reported significantly more relief after clonidine than after the other three treatments. Codeine and ibuprofen were ineffective. Sedation, dizziness, and other side effects were more frequent after clonidine (74%) or codeine (69%) than after placebo (36%) or ibuprofen (28%). Reported pain relief was greater during trials in which side effects were present. A single, mild side effect was associated with as much additional pain relief as multiple, severe side effects. Clonidine's superiority to codeine, which had a similar incidence of side effects, argues for a specific analgesic effect. In addition, side effects may have contributed to clonidine analgesia, perhaps by suggesting to patients that they had received a potent drug.
 ...
PMID:Association of pain relief with drug side effects in postherpetic neuralgia: a single-dose study of clonidine, codeine, ibuprofen, and placebo. 328 74

In a double-blind randomized study of three groups of 18 patients scheduled for major abdominal surgery the efficacy and side effects of sublingual buprenorphine were tested and compared to intramuscular meperidine and buprenorphine. Single doses of either 75 mg of meperidine, 0.4 mg of sublingual buprenorphine, or 0.3 mg of intramuscular buprenorphine were used. Patients given buprenorphine as sublingual tablets were significantly more conscious in the immediate postoperative period (Glasgow Coma Scale) than when given buprenorphine or meperidine intramuscularly. Median pain intensity differences (PID) showed equal pain relief, whereas the summarized pain intensity differences (SPID) were significantly higher in the intramuscular buprenorphine group compared to the meperidine group. Three cases of respiratory acidosis in the meperidine group required IPPV treatment, and one case in the intramuscular buprenorphine group required treatment. Sedation and nausea were the most common side effects in all three groups. We conclude that sublingual buprenorphine is useful for relief of postoperative pain and exhibited administrative advantages, when the patients were able to cooperate.
 ...
PMID:Pain relief after major abdominal surgery: a double-blind controlled comparison of sublingual buprenorphine, intramuscular buprenorphine, and intramuscular meperidine. 354 57

Sixty male and female patients, scheduled for colonoscopy were premedicated with glycopyrrolate 0.4 mg intramuscularly. Anaesthesia was induced with 2 mg/kg propofol ('Diprivan') and maintained with a continuous infusion of propofol at a rate of 3, 6 or 9 mg/kg/h randomly allocated. Patients lost consciousness within 60.6 +/- 18.7 (s.d.) s. Preservation of the hypnotic effect was infusion-rate dependent as 15, 40 and 85% of the patients were unconscious on infusion rates of 3, 6 or 9 mg/kg/h propofol, respectively. A high degree of sedation was observed in the remaining patients with an incidence of 40, 35 and 0% in the different series. Sedation was light in the remainder of the patients. To increase the acceptability of the procedure, a supplemental bolus of propofol and/or an increase in the infusion rate were required in 40, 15 and 10% of the 3, 6 and 9 mg/kg/h infusion rate groups, respectively. The incidence of amnesia was similar in all three groups (80, 90 and 95%, respectively). Recovery was significantly longer with increasing infusion rate, but remained rapid. The longest time was 7.3 +/- 4.0 min to open eyes on command and 10.6 +/- 4.6 min to answer correctly. The most important side effects were pain on injection (50%) and some restlessness during maintenance (25%). Blood pressure decreased, but heart rate was unaffected. Patients breathed room-air spontaneously. Respiratory rate slowed after induction then increased rapidly above baseline values. The incidence of apnoea was 48% with a mean duration of 51 +/- 22s (s.d.). The technique was evaluated as good or adequate in 95% of the cases. We suggest than an analgesic premedication followed by an average of 6 mg/kg/h propofol by infusion might be a simple and convenient method of achieving good conditions for colonoscopy.
 ...
PMID:Infusion of propofol ('Diprivan') as sedative technique for colonoscopies. 387 79

Ciramadol, an agonist-antagonist analgesic (in intramuscular doses of 30 and 60 mg) was compared with 10 mg of morphine and placebo in a double-blind, parallel study in 160 patients with postoperative pain. The patients were assigned randomly to one of the four treatment groups and could receive a dose of the medication every 3 hr as needed for 48 hr; a maximum of six doses was allowed in a 24-hr period. Formal efficacy assessments using standard pain intensity and pain relief scales were restricted to the initial dose period. The three active therapy groups had significantly (P less than 0.05) higher analgesia scores than the placebo group on all efficacy scales. The mean cumulative efficacy scores for the initial dose evaluation were highest for 60 mg of ciramadol; however, patients' overall evaluations of therapy were highest in the morphine group. Nausea and vomiting were the most frequent adverse experiences (15-25% incidence); however, there were no statistically significant differences between groups in their occurrence. A greater percentage (P less than 0.05) of patients reported skin reactions in the 60 mg ciramadol group (15%) than in the 30 mg ciramadol (0%) and placebo (0%) groups. Sedation was slightly higher with the active therapies than with placebo. Changes in vital signs were minimal. It is concluded that 60 mg of ciramadol compares favorably with 10 mg of morphine as a postoperative analgesic.
 ...
PMID:A double-blind comparison of multiple intramuscular doses of ciramadol, morphine, and placebo for the treatment of postoperative pain. 390 21

The influence of diurnal variation and morbid obesity on the morphine requirements of patients using patient-controlled analgesia (PCA) was studied. Forty-six patients undergoing either elective (Group I) or gastric bypass (Group II) surgery composed the study group. Patients were allowed to use the PCA machine for 36 to 72 hours postoperatively to deliver 0.6 mg/sq m doses of morphine sulfate intravenously. Counters on the device indicating the number of doses received were monitored every two hours along with vital signs and a pain and sedation rating. Dosing rates were studied with regard to the time of day. Morbid obesity had no significant effect on dosing rate requirements. Analyses revealed a significant diurnal rhythm in morphine dosing rate requirements despite a 27-fold interpatient variability. Peak analgesic use was at 0900, and the nadir was at 0300. Patient pain rankings did not indicate any changes in pain status, demonstrating PCA's use of analgesia as an endpoint for dosing. Sedation status showed a higher degree of sedation at night when compared with the daytime values, documenting that sedation was not drug-induced. There is a circadian variation in narcotic analgesic need in the postoperative patient that is met appropriately by PCA.
 ...
PMID:Morphine requirements using patient-controlled analgesia: influence of diurnal variation and morbid obesity. 668 12

Nitrous oxide analgesia was used prior to local anesthesia in over 200 outpatient implants and was very effective in reducing anxiety and pain of injections. Sedation by nitrous oxide is characterized by unique absorption, distribution, and elimination, which result in rapid onset and rapid recovery. The drug is widely accepted as a nontoxic conscious sedation modality, and simple machines permit easy and safe administration. The drug is particularly desirable in the elderly who may have respiratory or cardiovascular disease, and seems ideally suited to ambulatory surgicenters.
 ...
PMID:Nitrous oxide analgesia for outpatient surgery. 673 94

Patients with pain after operation received morphine hydrochloride intrathecally in doses of 0.02 mg kg-1 (n = 30) and 0.2 mg kg-1 (n = 30). The high-dose group showed slightly longer-lasting and more potent analgesia than the low-dose group. Sedation, decreases in heart rate and systolic arterial pressure, oliguria, nausea and urinary retention were more frequent in the high-dose group. Two patients of the high-dose group showed evidence of respiratory depression which appeared after a late change in posture (7 and 11 h). We conclude that postoperative analgesia with intrathecal morphine 0.02 mg kg-1 must be followed by a prolonged head-up posture and be performed in hospital units where the treatment of respiratory depression is competent.
 ...
PMID:Postoperative spinal analgesia with morphine. 702 19

This study contrasts the efficacy and side effects of epidural clonidine and sufentanil in the perioperative period. Using a randomized, prospective, double-blind study design, 40 patients undergoing abdominal surgery under propofol/nitrous oxide anesthesia were enrolled. Before anesthesia, an epidural catheter was inserted at the L1-L2 interspace. At induction of anesthesia, the patients received epidurally either clonidine (4 micrograms/kg in 10 mL) infused in 20 min followed by a 2-micrograms.kg-1.h-1 infusion (5 mL/h) during 12 h (Group 1) or sufentanil (0.5 microgram/kg in 10 mL) in 20 min followed by a 0.25-microgram.kg-1.h-1 infusion (5 mL/h) during 12 h (Group 2). Intraoperatively, increases in arterial blood pressure and heart rate not responding to propofol bolus (0.5 mg/kg) were treated with a bolus of intravenous (IV) sufentanil 0.035 microgram/kg. Postoperatively, IV sufentanil boluses (5 micrograms) were given through a patient-controlled analgesia (PCA) device. Postoperative analgesia was assessed by recording the IV PCA sufentanil requirements and the patients' visual analog scale (VAS) at 3, 6, 12, 18, 24, 36, and 48 h. Sedation analog scales and side effects were also recorded. Plasma clonidine and sufentanil concentrations were measured after 20 min and 6, 12, and 24 h. The number of reinjections of propofol (n = 1.6 +/- 1.6 in Group 1 vs 6.5 +/- 4.0 in Group 2) and of IV sufentanil (n = 0.6 +/- 0.8 in Group 1 vs 3.8 +/- 3.7 in Group 2) was significantly reduced (P < 0.001) in the epidural clonidine group. In the early postoperative period, pain scores and rescue analgesic requirements were very low in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Epidural clonidine or sufentanil for intraoperative and postoperative analgesia. 748 97


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