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

The evaluation of central opiate activity could be of clinical value in the diagnosis and treatment of pain syndromes. The current approach via direct measurement of endogenous opioid peptides in cerebrospinal fluid (CSF) is not devoid of side effects and cannot be used in every-day practice. As an alternative to this method, we have studied the neuroendocrine response of plasma LH to an i.v. naloxone injection in 39 headache sufferers from different diagnostic subgroups, and in 12 age- and sex-matched healthy volunteers. Patients (19 females and 20 males) were affected by common migraine (CM, 11 cases), migraine with interparoxysmal headache (MIH, 9), classical migraine (CIM, 9), and chronic cluster headache (CH, 10). Headache lasted 3-36 years. Prior to naloxone challenge (4 mg i.v.), LH pulsatility was evaluated for 1 h. The next morning, the pituitary response to LH-RH (10 micrograms i.v.) was tested in 20 patients. Plasma LH was measured by RIA in every sample. The response to the tests was evaluated as secretion area of plasma LH minus the mean basal value. Controls (497.5 +/- 85.5 mIU/ml x 120 min), ClM (357.8 +/- 78.9) and CH (450.5 +/- 70.4) patients showed similar results, while in cases of CM (155.3 +/- 71.7, P less than 0.05) and MIH (104.1 +/- 53.7, P less than 0.01) the LH secretion after naloxone injection was significantly blunted. On the contrary, the response of LH to LH-RH was similar in controls and patient groups, thus excluding pituitary dysfunctions in this response.(ABSTRACT TRUNCATED AT 250 WORDS)
Pain 1988 Jul
PMID:Neuroendocrine evaluation of central opiate activity in primary headache disorders. 304 18

Analyses of fetal heart rate (FHR) variability, visual evaluation of FHR decelerations, and respiratory gas analyses of the umbilical vein were performed in 27 labors, where one dose (50 or 75 mg) of intramuscular pethidine was used for pain relief, in 47 labors with one paracervical blockade (6 ml 0.5% marcaine) and in a control group of 135 labors without any pain relief. Umbilical vein pH, standard bicarbonate and base excess were lowest in the pethidine group and highest in the PCB group. The duration of labor was shortest in the control group, but there was no difference in the duration of labor of the two anesthesized groups. Intramuscular pethidine seems to associate with umbilical metabolic acidosis and PCB should be preferred to it, when an obstetrician is available.
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PMID:Intramuscular pethidine (meperidine) during labor associated with metabolic acidosis in the newborn. 373 46

A comparative study of analgesic and endocrinologic effects of obstetrical epidural anesthesia (EA, n = 23) and paracervical block (PCB, n = 39) was performed. Pain intensity was assessed on a horizontal linear scale. Simultaneously, blood samples for the determination of concentrations of norepinephrine (NE), epinephrine (E) and arginine vasopressin (AVP) were obtained. NE and AVP levels did not bear any relationship to pain scores. Instead, the average plasma E profile during labor was practically identical with the profile of pain scores. Plasma levels of E decreased significantly after EA. A similar but short-lived effect was observed also after PCB. When comparable doses of bupivacaine were used (30 mg in the EA group and 25 mg in the PCB group); initial pain relief after EA and PCB was similar, though after 30 min the pain score increased for patients who received the PCB, while patients who received EA had continued pain relief. Faster absorption of bupivacaine was observed after paracervical than epidural injection. Decreased variability was seen in the fetal cardiograms in 25% after EA and in 33% after PCB. Transient bradycardia was observed in 2 cases after paracervical injection.
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PMID:Epidural and paracervical blockades in obstetrics. Catecholamines, arginine vasopressin and analgesic effect. 381 42

In a prospective, randomized study the duration and effectiveness of four different regimens of PCB were studied: Bupivacaine both with and without adrenaline, and chloroprocaine with and without adrenaline. The pain relief was immediate and almost complete in most patients in all four treatment groups. The duration of the effect of bupivacaine was the same whether adrenaline was added or not. The labors were significantly prolonged with adrenaline, however. The duration of the effect of chloroprocaine was substantially shorter than bupivacaine, but with this short-lasting anesthetic the duration was prolonged by the addition of adrenaline. It is concluded that bupivacaine without the addition of adrenaline is the drug of choice for PCB.
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PMID:Which local anesthetic is best suited for paracervical blocks? 635 40

2-Chloroprocaine (CP) has recently been recommended as a less toxic alternative to amide-type local anesthetics due to its rapid metabolism. A double-blind, randomized study comparing CP to lidocaine when used for paracervical block was carried out. Twenty-nine patients received CP, while 31 received lidocaine. None of the 60 mothers developed adverse side effects. Adequate pain relief was achieved in 28 cases in each group, with a mean duration of 40 min regardless of the anesthetic. No change in uterine activity was observed. In the CP group one fetus had mild bradycardia, while two in the lidocaine group had severe, and three mild bradycardia within 5-7 min after the block. Low concentrations of CP were detected in the venous blood of 2 of 29 mothers and in the umbilical venous blood of their babies. Measurable amounts of its metabolite, 2-chloro-4-aminobenzoic acid (CABA), were found in all 13 samples of maternal blood 5 min after PCB and in 6 of 27 maternal samples at birth. Traces of CABA were found in umbilical venous blood in three neonates; in a fourth, a level of 1,000 ng/ml was found. In contrast, unmetabolized lidocaine was found in all maternal samples and in all but one of the cord samples at birth. Concentration of lidocaine in cord blood at delivery ranged from less than 100 to 4,000 ng/ml and were similar for both arterial and venous samples. No correlation could be demonstrated between levels of local anesthetics in the cord samples and the frequency or severity of fetal bradycardia regardless of the anesthetic.
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PMID:Comparison of lidocaine and 2-chloroprocaine in paracervical block: clinical effects and drug concentrations in mother and child. 682 19

Somatostatin 1-14, a natural occurring neuropeptide (Somiaton), has been reported to have analgesic effects in humans in different painful conditions. The aim of the present study was to investigate if epidural somatostatin produced clinical analgesia to postoperative pain after upper abdominal surgery. In a randomized double-blind controlled study, 40 patients received either 125 micrograms of epidural somatostatin infusions every hour (using a continuous infusion pump: CADD-PCA model 5200 PCX, Pharmacia) or placebo: mannitol (somatostatin inactif ingredient) 2.5 mg during the first 3 postoperative days (plus additional pulses of either substance, 250 micrograms or 5 mg, respectively, according to the level of analgesia needed by the patient). Additional subcutaneous analgesic treatment with 1 mg/kg pethidine chlorhydrate was administered at the patient's request. The degree of pain was quantified with visual analogue scale at baseline, 1 h after the operation and at every 4 h for the next 3 days. Arterial blood gases and spirometry values were determined at different intervals throughout the study period. Somatostatin was significantly better than placebo for pain relief (P < 0.01) and respiratory function preservation (P < 0.05). The total consumption (and ranges) of somatostatin at 24, 48 and 72 h were: 5.2 +/- 1.4 mg (4.0-6.25 mg), 4.2 +/- 0.8 mg (2.2-5.0 mg) and 3.7 +/- 0.4 mg (2.2-4.7 mg) respectively. During the whole study the need for complementary analgesia (pethidine chlorhydrate) was significantly higher in the placebo group: 5.4 +/- 3.5 vs. 2.7 +/- 1.9 (mean +/- SD) P < 0.01, dose/72 h. Side effects were irrelevant and scarce in both groups. The sustained pain relief combined with the respiratory function preservation in the somatostatin group suggests an important role of this drug in postoperative analgesia.
Pain 1994 Oct
PMID:Epidural somatostatin as an analgesic in upper abdominal surgery: a double-blind study. 865 41

With the purpose of increase of efficiency of postoperative pain relief in maxillofacial surgery it is offered and for 20 years was used a method of prolonged conductor blockade PCB) of the second and the third branches of the trigeminal nerve by means of a catheter. The comparative analysis with traditional at 86 patients anesthesia of narcotic analgesics was performed. Questioning, measurement of a blood pressure, oxigemometry, spirography were used, pneumotachometry, parameters of the acid-basic condition of blood, the maintenance of glucose in blood, temperature of a skin in the field of a chin, small es, Cyrillicomplications on the part of easy and other parameters were used. We also determined need for the medicines appointed for anesthesia in the postoperative period. Results of the study and experience of successful application of the method on 576 patients have shown, that efficiency of the was 91.3%, PCB of branches of a trigeminal nerve was worthy alternative to opioid analgesics.
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PMID:[Prolonged conductor blocking of the trigeminal nerve branches for anesthesia in postoperative period]. 1900 28

An epidemiologic examination was carried out to reveal the prevalence of the periodontal diseases and oral pigmentation in patients with Yusho in 2008. The results obtained were as follows. 1) Yusho patients complained of tooth pain and periodontal diseases such as gingival swelling, gingival bleeding, but not of oral pigmentation. 2) 116 patients out of 148 patients with Yusho, who were measured periodontal pocket depth according to Ramfjord' methods, had at least one tooth with periodontal pocket deeper than 3 mm. Similarly, 399 teeth out of a total 710 examined teeth showed a periodontal pocket with more than 3 mm in depth. However, it was determined that 74 teeth had a periodontal pocket deeper than 4 mm. 3) Oral pigmentation was observed in 91 patients out of 155 patients with Yusho. In this study, gingival pigmentation was most predominant among oral pigmentation. The prevalence of oral pigmentation in male patients seemed to be somewhat higher than that in female patients. In addition, the prevalence of oral pigmentation tended to be higher in younger patients than in elder patients. Pigmentation of the buccal mucosa, lip or palate, however, was observed only in patients beyond the age of fifty. These results indicated that PCB-related compounds may be responsible for the higher prevalence of both periodontal diseases and oral pigmentation.
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PMID:[An epidemiologic examination on the prevalence of the periodontal diseases and oral pigmentation in Yusho patients in 2008]. 1958 37

Because of their physical and general health problems, people with a combination of profound intellectual and severe or profound motor disabilities (PIMD) are at risk of pain-related medical conditions. They are fully dependent on support professionals for the detection and accurate interpretation of nonverbal pain behaviour. These professionals can use a recently developed instrument, the Pain Behaviour Checklist (PBC), to assess pain in post-operative situations for children with PIMD. It is not yet known whether this instrument can also be used to identify pain in both children and adults in daily care situations. The aim of this pilot study was therefore threefold: to establish (1) whether the PBC can be used to identify pain in day-to-day situations in people with PIMD, (2) which behaviours are most frequently identified as indices of pain behaviour, and (3) whether there is a difference in pain-related behaviour between children and adults. In total, 32 people with PIMD participated in the study (16 children with a mean age of 10.4 years and 16 adults with a mean age of 46.7 years). Each participant was videotaped twice during a planned care moment in which we assumed that pain was prevalent. During each observation, pain was scored by the direct support professional using the Visual Analogue Scale (VAS) and by two trained independent observers using the PBC. The reliability (both intrarater and interrater) of the PBC was analysed by calculating Spearman's rho. Validity was analysed by correlating the PBC with the VAS scores; Phi was calculated for both children and adults. Finally, positive scores on each separate item of the PBC were analysed in adults and children in order to discover possible differences between pain behaviour in each group. The interrater reliability of the PBC is .63 (p<.05) and the intrarater reliability was .88 (p<.05). Phi, as a measure of the agreement on pain/no pain between the VAS and the PBC, is .75 (p<.05) in children and .28 (p<.05) in adults. Adults were more likely to exhibit the pain-related behaviours of 'tense face', 'deeper naso-labial furrow' and 'moaning and groaning', whereas children made more 'penetrating sounds of restlessness'. Based on this pilot study, we conclude that the PCB's reliability when used in daily practice with people with PIMD is satisfactory. However, although the validity is good for children, it appears insufficient for adults. It seems that children display different pain-related behaviours than adults. More research is needed into the proper assessment of pain in people with PIMD, especially adults, by health care professionals in daily practice. We also need a better understanding of the extent to which the knowledge and experience of care professionals play a role in detecting (chronic) pain behaviour in both children and adults and of how people with PIMD cope with pain.
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PMID:Pain assessment in people with profound intellectual and multiple disabilities; a pilot study into the use of the Pain Behaviour Checklist in everyday practice. 2144 Apr 13

An epidemiologic examination was carried out to reveal the prevalence of the periodontal diseases and oral pigmentation in patients with Yusho in 2010. The results obtained were as follows. 1) Yusho patients complained of tooth pain and periodontal diseases such as gingival swelling, but not of oral pigmentation. 2) 104 patients out of 117 patients with Yusho, who were measured periodontal pocket depth according to Ramfjord' methods, had at least one tooth with periodontal pocket deeper than 3 mm. Similarly, 314 teeth out of a total 551 examined teeth showed a periodontal pocket with more than 3 mm in depth. However, it was determined that 57 teeth had a periodontal pocket deeper than 4 mm. 3) Oral pigmentation was observed in 63 patients out of 122 patients with Yusho. In this study, gingival pigmentation was most predominant among oral pigmentation. The prevalence of oral pigmentation in male patients seemed to be somewhat higher than that in female patients. In addition, the prevalence of oral pigmentation tended to be higher in patients under seventy years old than patients beyond the age of seventy. These results indicated that PCB-related compounds may be responsible for the higher prevalence of both periodontal diseases and oral pigmentation.
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PMID:[An epidemiologic examination on the prevalence of the periodontal diseases and oral pigmentation in Yusho patients in 2010]. 2170 83


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