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)

Patients requiring root canal treatment were randomly assigned to one of three groups. The first group received Ketorolac oral 10 mg at six hour intervals for 24 hours, the second group received Ketorolac (Toradol) injectable 10 mg at the height/depth of the buccal vestibule of the tooth to be treated, and the third group received no assigned medication. Significantly better pain relief was achieved when Ketorolac injectable or oral was used then when no drug was administered. Some of the patients in the Ketorolac injectable group felt that an additional dose of medication would have been helpful at the six- to eight-hour postoperative period. However, there was no significant difference in pain relief between the two groups treated with different drug regimens.
 ...
PMID:Efficacy of ketorolac in the management of pain associated with root canal treatment. 867 37

Topically administered ketorolac (Acular), a cyclooxygenase inhibitor, has recently been reported as clinically beneficial for treating allergic conjunctivitis. The ability of ketorolac to relieve the itching associated with allergic conjunctivitis is intriguing because cyclooxygenase inhibitors are not regarded as useful in treating allergic dermatoses and prostaglandins (PG) do not elicit an itch response in human skin. To gain further insight into the mechanisms involved in the antipruritic activity of ketorolac, we used a method of reproducibly assessing ocular surface itch responses in the guinea pig. The measurement of conjunctival pruritus involved a recently developed behavioral model whereby hind limb scratching episodes directed toward the afflicted area were quantified. Itch-scratch episodes have previously been delineated from foreign body and pain sensations, which do not evoke such a behavioral response. Ketorolac significantly inhibited the itching associated with experimental allergic conjunctivitis. The basis of this antipruritic activity may be ascribed to preventing the biosynthesis of itch-producing PGs because ketorolac inhibited arachidonic acid-induced pruritus. In contrast to skin studies, PGE2 and PGI2 were found to be potent pruritogens at the guinea pig ocular surface. PGD2 was a weak pruritogen, and PGF2 alpha and the thromboxane-mimetic U-46619 produced no meaningful response. Further studies involving selective agonists and antagonists suggested that EP1 receptors, IP receptors and PGD2-sensitive receptors may mediate prostanoid-induced conjunctival itching. No evidence for the involvement of other prostanoid receptor subtypes was obtained. Although the EP1 receptor antagonist AH 6809 and the DP receptor antagonist BW A868C inhibited PGE2- and PGD2-induced itching, respectively, neither antagonist alone significantly affected the itching associated with experimental allergic conjunctivitis. A combination of AH 6809 and BW A868C, however, did exhibit antipruritic activity. It appears that for effective relief of itching in allergic conjunctivitis, it is not sufficient to block the effects of a single pruritogenic PG. It is preferable to reduce the participation of all pruritogenic PGs by either using combined receptor antagonists or by using a cyclooxygenase inhibitor such as ketorolac to block their biosynthesis.
 ...
PMID:Characterization of receptor subtypes involved in prostanoid-induced conjunctival pruritus and their role in mediating allergic conjunctival itching. 885 86

Ketorolac tromethamine, a nonsteroidal anti-inflammatory analgesic, was compared with flunixin and butorphanol for its analgesic efficacy and potential side effects after laparotomy or shoulder arthrotomy in dogs. Sixty-four dogs were randomly assigned to receive butorphanol 0.4 mg/kg body weight (BW) (n = 21), flunixin 1.0 mg/kg BW (n = 21), or ketorolac 0.5 mg/kg BW (n = 22), in a double blind fashion. The analgesic efficacy was rated from 1 to 4 (1 = inadequate, 4 = excellent) for each dog. The average scores after laparotomy were ketorolac, 3.4; flunixin, 2.7; and butorphanol, 1.6. After shoulder arthrotomy, the average scores were ketorolac, 3.5; flunixin, 3.0; and butorphanol, 1.4 (5/11 dogs). As butorphanol was unable to control pain after shoulder arthrotomy, oxymorphone, 0.05 mg/kg BW, replaced butorphanol in a subsequent group of dogs and had a score of 2.0 (6/11 dogs). Serum alanine aminotransferase and creatinine were significantly elevated above baseline at 24 hours postoperatively in dogs receiving flunixin. One dog in each group developed melena or hematochezia. One dog receiving ketorolac had histological evidence of gastric ulceration. We concluded that ketorolac is a good analgesic for postoperative pain in dogs.
 ...
PMID:A comparison of ketorolac with flunixin, butorphanol, and oxymorphone in controlling postoperative pain in dogs. 887 43

Effective pain management of the endodontic emergency patient is often a problem. Ketorolac tromethamine is the first nonsteroidal anti-inflammatory drug available for intramuscular injection in the United States. Although its analgesic efficacy is comparable with opiates after intramuscular injection, to date no study has evaluated its efficacy after intraoral periapical injection. Fifty-two endodontic emergency patients were injected (injection routes = intraoral infiltration/intramuscular deltoid) on a double-blind basis with either: (i) placebo/placebo, (ii) 30 mg ketorolac/placebo, (iii) placebo/30 mg ketorolac, or (iv) 2% mepivicaine with 1:20 K levonordefrin/placebo. Infiltration injection of ketorolac at on oral site produced significant analgesic effects, particularly in treating pain of mandibular origin. These results suggest that intraoral injection of ketorolac may prove to be a useful adjunct in the management of endodontic pain patients. Further studies are required to replicate these findings and to develop optimal treatment combinations.
 ...
PMID:Evaluation of periapical injection of Ketorolac for management of endodontic pain. 893 18

One hundred and three patients ASA grades I-II, 16-80 years of age scheduled for arthroscopic meniscectomy were prospectively studied, and randomly allocated to one of four groups: group 1 (n = 25): 0.25% bupivacaine (50 mg) intra-articular (IA), group 2 (n = 27): 1 mg of 0.1% preservative free morphine chloride in saline, group 3 (n = 26): 1 mg of 0.1% preservative free morphine chloride in 0.25% bupivacaine and group 4 (n = 25): normal saline (0.9%). The volume given was always 20 mL. Ketorolac [Toradol, 30 mg intramuscularly (i.m.)] was used as rescue medication; analgesia was assessed using a visual analogue scale (VAS), a verbal rating scale (VRS), supplemental analgesic consumption post-operatively (SAC) and the presence of side effects. Verbal rating scale and visual analogue scale scores showed better pain control in group 1, 20 min after surgery, and in groups 1 and 2 at 4 h and 10 h as well as in the global VAS. In multifactorial analysis no significant differences among groups or side effects was found, pH analysis of the substances used showed no alterations in the basal pH range. The analgesic efficacy of 20 mL of bupivacaine 0.25% is similar to that of 1 mg of morphine in 20 mL of saline 0.9%. The morphine-bupivacaine mixture was no more efficacious than bupivacaine or morphine alone.
 ...
PMID:Intra-articular analgesia after arthroscopic knee surgery: comparison of three different regimens. 952 34

The less invasive procedures described herein are suitable for use in the office setting. Improvement in symptoms and quality of life are similar to that achieved with TURP. With the exception of TUIP, flow rate improvement is less than with TURP. TURP, however, tends to produce a "super normal" flow rate, which may be unnecessary. Patients are concerned regarding symptoms and quality of life and the avoidance of complications. In regard to decreased complications, less invasive procedures have an advantage. The main concern with these new treatments, with the exception of TUIP, is durability. Treatment failure may lead to other treatments, thereby increasing overall management costs. In this regard, it must be remembered that there is a significant treatment failure rate with TURP. Although patients failing less invasive treatments are likely to be offered other treatments, this is less likely after an adequate TURP. Therefore, when results are compared, it may be more appropriate to evaluate failure rates based on symptoms and quality of life rather than on the use of additional treatments. More patient follow-up for a longer period of time will be required before a definite answer is available on durability. All of the procedures described herein can be performed to a variable extent using topical anesthesia. TUNA has been performed using topical lidocaine alone but frequently requires intravenous sedation/analgesia and, in some instances, a regional block. If the patient can tolerate rigid cystoscopy fairly well, topical anesthesia alone may suffice. Similar requirements for anesthesia apply to ILC with the Nd:YAG or indigo systems. Using the Targis (T3) microwave device, Peterson and co-workers reported that 60% of patients were treated with topical urethral lidocaine alone, whereas 40% also received oral Toradol. Djavan (personal communication) using the Targis (T3) device randomized patients to topical urethral anesthesia alone or combined with intravenous sedoanalgesia. Pain was evaluated using a 0 to 10 visual analog scale score. At the commencement of treatment, the mean score was 1.4 in the topical anesthesia alone group and 1.3 in the sedoanalgesia group. During therapy, the score increased to a peak at 30 minutes of 2.2 and 2.0 in the topical and sedoanalgesia groups, respectively. After this, the visual analog score declined, falling to 0.2 and 0.1, respectively, by 1 hour following treatment. This study shows that microwave treatment with the Targis (T3) system is well-tolerated using topical urethral anesthesia alone. No difference was observed between outcomes in the two groups. Capital and operating costs as well as reimbursement issues are important in the introduction of these treatments into the office; however, until more information is available on the durability of results, the cost-effectiveness of these newer treatments remains unclear.
 ...
PMID:Office treatment of benign prostatic hyperplasia. 1002 66

The postoperative analgesic effects of intra-articular injections of bupivacaine and/or morphine were examined prospectively in 437 patients who had total knee replacement for osteoarthritis. They were divided randomly into four groups. Group I received 10 mg of morphine (1 ml) and 9 ml of saline, group II received 10 ml of bupivacaine (2.5 mg/ml), group III received 10 ml of saline, and group IV received 10 mg of morphine (1 ml) and 9 ml of bupivacaine (2.5 mg/ml). All analgesics administered in the first 24 hours after operation were recorded. The patients rated their pain on the McGill-Melzack scale at 1, 6, 12 and 24 hours. No significant differences were found between any of the groups in the use of Demoral and/or Toradol in 24 hours, the length of stay in hospital or the pain rating at 1, 6, 12 or 24 hours. Patients in groups I and IV, whose injections included morphine, used significantly more morphine in the first 24 postoperative hours than did groups II or III.
 ...
PMID:Intra-articular morphine and/or bupivacaine after total knee replacement. 1020 38

Effective management of severe endodontic pain is often a major problem. The analgesic effect of ketorolac tromethamine (Toradol, 10 mg p.o.) was compared with acetaminophen codeine (325 mg/15 mg p.o.) in patients with severe pain due to acute apical periodontitis in a double-blind clinical study. A total of 66 patients presenting with severe pain (defined as 7 cm and more using a visual analog scale) were randomly assigned to receive either ketorolac tromethamine or acetaminophen codeine (33 patients in each group), and recorded their pain score once every 10 min for 90 min after administration. Results indicate that patients in the ketorolac group had significantly less pain than those who received acetaminophen codeine (p = 0.005).
 ...
PMID:A comparison of ketorolac tromethamine and acetaminophen codeine in the management of acute apical periodontitis. 1042 51

Ketorolac tromethamine is a potent non-narcotic analgesic with moderate anti-inflammatory activity. Clinical studies indicate that ketorolac has a single dose efficacy greater than morphine for postoperative pain and has excellent applicability in the emergency treatment of pain. Due to incomplete oral absorption of ketorolac, several approaches have been tried to develop a nonoral formulation in addition to injections, especially for the treatment of migraine headache. The aim of our study was to develop a nasal formulation of ketorolac with a dose equivalent to the oral formulation. A series of spray and lyophilized powder formulations of ketorolac were administered into the nasal cavity of rabbits, and their pharmacokinetics profiles were assessed. The spray and powder formulations were compared through their pharmacokinetics parameters and absolute bioavailability. Drug plasma concentration was determined using solid phase extraction, followed by an HPLC analysis. Nasal spray formulations were significantly better absorbed than powder formulations. A nasal spray formulation of ketorolac tromethamine showed the highest absorption with an absolute bioavailability of 91%. Within 30 min of administration, the plasma concentration was comparable to that resulting from an intravenous injection. The absolute bioavailability of a solution of ketorolac acid was 70%. Apparently, the dissolution of ketorolac acid into the mucous layer limits its absorption. There were no significant differences in absorption between different powder formulations. Even the reduction of particle size from 123 microm to 63 microm did not indicate better absorption of ketorolac tromethamine from powder formulations. Interestingly, the absolute bioavailability of ketorolac tromethamine from a powder formulation is only 38%, indicating that the drug may not be totally released from the polymer matrix before it is removed from nasal epithelium by mucociliary clearance.
 ...
PMID:Development and evaluation of nasal formulations of ketorolac. 1119 29

To compare the analgesic efficacy and tolerability of intravenous (IV) ketorolac tromethamine with IV meperidine in the treatment of biliary colic, a prospective, randomized, double blind study was carried out upon a convenience sample of patients at a large inner city facility. Patients between the ages of 18 and 65 years of age with a history and physical examination consistent with biliary colic were enrolled over a 2-year period. Patients were randomly assigned to receive ketorolac 30 mg IV or meperidine 50 mg IV. Pain was quantified using a 4-point verbal rating system (VRS) as well as a visual analog scale (VAS). Patients were queried about their pain at times 0, 12 h, 1 h, and 2 h after administration of the study medication. Adverse effects were also recorded. A total of 324 patients completed the study protocol with 175 patients receiving ketorolac and 149 receiving meperidine. Patient demographics were similar for both groups with mean age for the ketorolac group of 36.1 years and for the meperidine group of 34.6 years. Both groups were predominantly Latino and over 80% of patients in both groups were female. No significant difference in pain control was found between ketorolac and meperidine in either the VAS or VRS for any time interval studied. The mean change in the VAS at time 2 h was 6.2 cm +/- 3.6 cm for the ketorolac group, compared with 6.7 cm +/- 3.6 cm for the meperidine group (p = 0.25). Although no significant difference was found in overall drug tolerability, patients receiving meperidine reported higher incidences of nausea and of dizziness than those receiving ketorolac (p = 0.009 and 0.003, respectively). Ketorolac tromethamine is a well-tolerated, effective medication in the treatment of acute biliary colic. It showed similar efficacy to meperidine with a decreased number of adverse effects.
 ...
PMID:Comparison of intravenous ketorolac and meperidine in the treatment of biliary colic. 1242 13


<< Previous 1 2 3 4 5 6 Next >>