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)

The combination of fentanyl citrate (Sublimaze) and diazepam (Valium) was evaluated for efficacy of analgesia, sedation, and safety in 1,008 predominately outpatient urologic procedures. These procedures included prostate biopsies, basket extractions of ureteral calculi, internal urethrotomies, and cystourethroscopies. Ninety-two per cent were judged to be successful with regard to adequate tranquilization and relief of pain. No detrimental effects were seen with the recommmended method and dosage. This drug combination provides the clinician with an effective and safe alternative to local, general, or spinal anesthesia for many routine urologic procedures and allows them to becom true office procedures.
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PMID:Ataralgesia in outpatient urology. Clinical evaluation. 84 78

A special technique of neurolept analgesia for electrocoagulation of the gasserian ganglion is described which has been used since 1974. Induction is by means of Fentanyl and Valium. The dosis is sufficiently low for the patient to remain responsive and co-operative but practically painfree. The actual thermocoagulation is performed in intravenous methohexital sodium anaesthesia. The dosis is kept so low that the patient wakes up within 2--3 minutes and is able to inform the surgeon of the success or failure of the operation. If no relief from pain has been obtained a further 20 mg of methohexital are injected and the operation is repeated.
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PMID:[A special technique of neurolept analgesia for thermocoagulation of the gasserian ganglion (author's transl)]. 88 55

Thirty-four patients with gallbladder disease, but otherwise healthy, were studied in connection with cholecystectomy. For postoperative analgesia, 22 patients were given a posterior splanchnic blockade with 0.5% plain lidocaine, and 12 were injected intramuscularly with fentanyl in a dose of 3.5 mug/kg b.w. Postoperatively, before administration of the analgesic agent, the cardiac output, mean arterial blood pressure, heart work and estimated hepatic blood flow were increased and the total peripheral resistance, splanchnic vascular resistance, arterial oxygen tension and base excess values were decreased. Fentanyl, in addition to its analgesic effect, also decreased the arterial oxygen tension and pH and increased the arterial carbon dioxide tension. There was little change in cardiac output, mean arterial blood pressure and estimated hepatic blood flow. Following splanchnic blockade, on the other hand, pain relief was accompanied by a decrease in cardiac output, mean arterial blood pressure and heart work to about the preoperative level, while the estimated hepatic blood flow remained unchanged and the splanchnic vascular resistance decreased rapidly. Neither total peripheral resistance nor blood gases altered as a result of splanchnic blockade.
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PMID:Postoperative hepatic blood flow and its relation to systemic circulation and blood gases during splanchnic blockade and fentanyl analgesia. 105 22

The safety and efficacy of patient-controlled analgesia used for postoperative pain relief were evaluated. Cumulative 24-hour requirements were analyzed for possible correlation with patient characteristics. All patients who used a patient-controlled analgesia device for postoperative pain relief were reviewed from June to October 1991. The device Baxter's basal/bolus infusor with patient control module, was used to deliver fentanyl in 379 patients. The fentanyl requirement, verbal analog pain score, first passage of flatus, side effects, sedative score, and degree of satisfaction were examined. The fentanyl requirement during the first 24 hours after operation was analyzed with regard to age, body weight, and sex. The daily fentanyl consumption in the first three postoperative days was 928 +/- 352 micrograms (n = 338), 553 +/- 259 micrograms (n = 220), and 490 +/- 222 micrograms (n = 71), respectively. The requirement for fentanyl during the first 24 hours after surgery was significantly higher than for the next two days (p-value < 0.001). Fentanyl consumption correlated well with body weight, and inversely with age. No difference was found between fentanyl consumption and sex (p-value = 0.4687). The mean time to the first passage of flatus in patients with abdominal surgery was 54.6 +/- 26.4 hours. The incidence of nausea, vomiting, and dizziness was similar, about 20% of patients. Itching was noted in 7% of patients. Oversedation (class 4) was found in three patients during the first operative day, the sedative score for other patients were around class 1-3. No patient exhibited signs of respiratory depression or withdrawal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The efficacy of intravenous fentanyl patient-controlled analgesia for postoperative pain relief]. 134 40

The author studied the use of intravenous Propofol for the relief of pain. He demonstrated that Propofol and 10 mg of Lidocaine intravenously decreased moderate or severe pain from 31.6% to 9% and that increasing the dose of Lidocaine did not significantly decrease the pain further. Fentanyl did not produce a statistically significant further diminution of the pain from the level of relief obtained with Propofol.
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PMID:[Changes in the pain produced by the peripheral venous injection of propofol when it is combined with lidocaine or fentanyl]. 143 6

The association of extremely diluted concentrations of opioids and local anesthetics appears to be highly promising for pain control during labour. This study examined the efficacy of the association of Fentanyl 100 mcg and Bupivacaine 10 mg in second-stage labour pain and perineal pain. The study which was carried out in 20 patients confirmed the lack of collateral effects on the fetus, mother (except for slight itching in 25% of cases) and the progress of labour. A virtually total elimination of pain was obtained in all cases during the dilatation and expulsion stages. During the second stage of labour pain was completely abolished in 50% of cases, whereas in the remaining 50% it lasted on average for 13 minutes. Perineal analgesia was sufficient to allow episiorrhaphy in 50% of patients without resorting to the use of local anesthetic.
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PMID:[Pain control during the expulsion period in labor using bupivacaine and fentanyl]. 146 54

The administration of epidural and intrathecal opioids for the management of postoperative pain is well established. Fentanyl, because of its greater lipophilicity, offers a number of advantages over morphine for epidural analgesia, including a lower incidence of side effects and reduced risk of delayed-onset respiratory depression. The relatively short duration of action of epidural fentanyl makes this agent more ideally suited for continuous infusion or patient-controlled epidural analgesia (PCEA). The effective doses and adverse effects profile of epidural fentanyl are reasonably well understood. Because of the lack of spread through the cerebrospinal fluid (CSF) and hence the segmental nature of the analgesia achieved, location of epidural catheter placement is of paramount importance when this agent is used. Prolonged epidural infusion of fentanyl may result in high systemic concentrations not dissimilar to IV infusion, and, therefore, the greatest efficacy of epidural fentanyl administration may be in combination with low concentrations of bupivacaine, an approach that achieves a synergistic effect. 2-Chloroprocaine has been shown to antagonize epidural fentanyl analgesia. Intrathecal fentanyl for postoperative analgesia is limited by its short duration of action with single-bolus administration. The widespread international increase in the use of epidural fentanyl for postoperative analgesia promises further improvements and refinement in techniques.
J Pain Symptom Manage 1992 Oct
PMID:Fentanyl: clinical use as postoperative analgesic--epidural/intrathecal route. 148 96

Fentanyl and morphine were administered epidurally to the patients after upper abdominal surgery for postoperative pain management. One hundred and ninety patients were divided into 3 groups; F group: bolus and continuous administration of fentanyl, M group: bolus and continuous administration of morphine, FM group: bolus of fentanyl and morphine and continuous administration of morphine. Pain scores of 1, 2, 3, 4, 8, 12 hours after administration and of the next morning were examined and side effects were recorded. Pain scores at 1 and 2 hours in F and FM group were significantly lower than those in M group. There were no significant differences in the scores among 3 groups from 3 hours to the next morning. The incidence of itching in F group was significantly less than in other groups. Respiratory depression (less than respiratory rate 8.min-1) occurred in 2 cases in M and FM group, but no case in F group. FM group had no advantage compared with F group. We conclude that continuous epidural infusion of fentanyl is more useful than morphine for postoperative pain management after upper abdominal surgery.
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PMID:[Comparison of continuous epidural fentanyl and morphine for postoperative pain management after upper abdominal surgery]. 149 76

Fentanyl is an opioid traditionally administered by infusion or injection and more recently in a rate-controlled transdermal dosage form. This system is a four-layer laminate on a protective liner. A backing layer seals and protects the drug reservoir, the source for continuous delivery of fentanyl. A membrane controls the release rate of fentanyl from the system. An adhesive layer attaches the system to skin and releases an initial loading dose of fentanyl. The rate of fentanyl delivery through skin is determined by the system and the skin at the application site. The release rate from the system is approximated by Fick's first law of diffusion and is controlled by the rate-controlling membrane. A complete simulation model that combines both in vitro release data and the pharmacokinetic model has been developed and used to show the influence of various physiologic and system variables on serum fentanyl concentrations.
J Pain Symptom Manage 1992 Apr
PMID:System functionality and physicochemical model of fentanyl transdermal system. 151 27

The transdermal therapeutic system (TTS) is a novel technique of drug administration that can mimic long-term continuous intravenous infusions in maintaining stable drug plasma concentrations. Fentanyl, a potent lipid-soluble synthetic opioid, has been incorporated into such a system and has undergone preliminary clinical trials in postoperative patient populations to assess analgesic efficacy and incidence of undesirable side effects (pruritus, nausea and vomiting, urinary retention, respiratory depression). In general, when applied 2 hr preoperatively, a TTS (fentanyl) patch (in different doses) provides moderate-to-good analgesia for a variety of surgical procedures for periods of up to 3 days. Most patients will require small amounts of systemically administered opioids for supplementary analgesia, especially in the first 24 postoperative hr. The incidence of side effects such as nausea and vomiting varies between studies but can be as high as 70%. Clinically significant respiratory depression is rare but was reported in several of the studies. TTS (fentanyl) is a simple and useful technique for the control of postoperative pain.
J Pain Symptom Manage 1992 Apr
PMID:Transdermal fentanyl: acute analgesic clinical studies. 151 28


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