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

In a controlled trial, before having a lower wisdom tooth surgically removed, 190 patients were blindly randomized to 2 parallel groups. One group received 100 mg Voltaren (diclofenac-sodium) before surgery and then 50 mg 3 times a day for 5 days; the other group in Sweden widely used fixed combination tablets (acetylsalicylic acid 500 mg, caffeine 50 mg, aprobarbital 20 mg, codeine phosphate 10 mg) in the highest recommended dose, 2 tablets when needed at most 3 times a day. Twice a day the patients recorded pain and swelling on 100 mm visual analogue scales. Patients treated with Voltaren had significantly less pain and swelling (p less than 0.001). Furthermore, they had significantly fewer days away from work (p less than 0.01). The study indicates that visual analogue scales may also be useful in assessment of swelling and that Voltaren in a fixed dosage offers a promising alternative against postoperative pain and swelling.
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PMID:Voltaren as an analgesic after surgical removal of a lower wisdom tooth. 392 8

Models with experimentally induced pain in healthy man might be useful for the screening for analgesic effects of new drugs. Experimental pain models have been shown to discriminate reliably between the effects of opioid analgesics and placebo but their sensitivity to nonsteroidal anti-inflammatory agents is disputed. This study investigated whether it would be possible by using electrically and thermally induced cutaneous pain to discriminate reliably the effects of single oral doses of 75 and 150 mg diclofenac sodium on the one hand and 60 mg codeine on the other from those of placebo. Forty-eight healthy subjects participated each in four experiments in which they received, in random double-blind fashion, each of the treatments. Every experiment comprised eight series of measurements, two before and six after drug administration, carried out at 30 min intervals. Diclofenac sodium produced significant dose-related increases of threshold and tolerance to electrically and threshold to thermally induced pain. Codeine 60 mg was significantly superior to placebo in all pain measures. Its analgesic effects were stronger than those of diclofenac 75 mg but weaker than those of diclofenac 150 mg. Neither 150 mg nor 75 mg diclofenac caused more side effects than placebo, whereas codeine 60 mg elicited a high frequency of side effects. No severe adverse effects occurred after any one treatment. The results suggest that both electrically and thermally induced cutaneous pain are well suited to evaluate analgesic effects not only of opioids but also of nonsteroidal anti-inflammatory drugs.
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PMID:Experimental pain induced by electrical and thermal stimulation of the skin in healthy man: sensitivity to 75 and 150 mg diclofenac sodium in comparison with 60 mg codeine and placebo. 394 5

A randomized prospective double blind study of the analgesic effect of 75 mg intramuscular diclofenac sodium (Voltaren), a potent prostaglandin synthetase inhibitor, versus placebo (saline solution) was carried out in 131 consecutive patients with acute ureteral colic. Diclofenac provided complete relief of pain 25 minutes after the injection in 59% of the cases, while placebo provided relief in 29% (p less than 0.01). Forty patients in the placebo group and seventeen patients in the diclofenac group needed an open injection of 75 mg diclofenac intramuscularly after 25 minutes due to persistent pain. Fifty-four of the fifty-seven patients treated with an open injection of diclofenac achieved complete relief of pain after 30 minutes. There were no side-effects of the treatment.
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PMID:Diclofenac sodium in ureteral colic: a double-blind comparison trial with placebo. 635 90

Diclofenac sodium, a phenylacetic acid derivative, is a non-steroidal, anti-inflammatory, analgesic agent advocated for use in rheumatoid arthritis, degenerative joint disease, ankylosing spondylitis and allied conditions, and in the treatment of pain resulting from minor surgery, trauma and dysmenorrhoea. Published data indicate that diclofenac 75 to 150mg daily (25 to 50mg 3 times daily) is comparable in efficacy with ordinary aspirin 3 to 5g daily and indomethacin 75 to 150mg daily in rheumatoid arthritis and with indomethacin in osteoarthritis. Available data suggest that in patients with osteoarthritis diclofenac sodium is comparable in efficacy and tolerability with naproxen, ibuprofen, sulindac and diflunisal. As oral diclofenac is generally given in 3 divided daily doses it may be at a disadvantage relative to less frequent administration with naproxen, diflunisal and sulindac in rheumatoid arthritis, although there is some evidence of diclofenac's efficacy when administered twice daily, or once daily as a slow release tablet. The drug is also available as suppositories and ampoules for intramuscular injection. No one of the non-steroidal anti-inflammatory agents is the most suitable drug for all patients requiring such therapy, and diclofenac should be considered along with other drugs of its type in the arthritic patient.
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PMID:Diclofenac sodium: a review of its pharmacological properties and therapeutic use in rheumatic diseases and pain of varying origin. 677 22

Diclofenac sodium (Voltaren) was tested over a period of six months in a double-blind experiment for its antiphlogistic and analgesic effect. A retained or impacted lower third molar was removed from each of the 138 patients studied. The postoperative course was evaluated in terms of the criteria of pain, trismus, swelling, and side effects; and the results were recorded. The swelling was objectified by photographic documentation and planimetric measurements. Our studies indicated that diclofenac sodium can also be recommended for the medicamentous prophylaxis of swelling and pain resulting from dental procedures.
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PMID:[Antiphlogistic and analgesic effect of diclofenac sodium after maxillofacial interventions in a double-blind trial]. 700 45

A double-blind, cross-over trial compared the antiinflammatory and analgesic effects as well as tolerability of diclofenac sodium (Voltaren) and ibuprofen. Twenty-four outpatients with rheumatoid arthritis were included. A single-blind placebo period was inserted between the two active treatments. The daily dose of diclofenac sodium was 50 mg bid and that of ibuprofen 400 mg tid. The duration of each treatment period was 14 days. The efficacy was measured by the following criteria: Articular index (Lansbury), morning stiffness, fatigue, pain (measured on a visual analogue scale), consumption of rescue-analgesics, status of the arthritic condition, and patient preference. No significant differences were found between diclofenac sodium and ibuprofen, but regarding consumption of analgesic, global evaluation, rheumatic activity, and activity index, a slight trend towards a better effect of diclofenac sodium was found. The study had an adequate sensitivity as it could distinguish placebo from the active treatments for all parameters evaluated. No patient was withdrawn for unwanted effects. None of the laboratory data showed abnormalities of clinical relevance.
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PMID:Diclofenac sodium (Voltaren) and ibuprofen in rheumatoid arthritis. A randomized double-blind study. 700 69

Three therapeutic regimens using nonsteroidal antirheumatic drugs in the treatment of rheumatoid arthritis were compared in an open long-term cross-over trials. Voltaren 100 mg suppositories or Naprosyn 500 mg suppositories were introduced every evening at bed-time, and Naprosyn tablets were administered twice in a day, in the morning and at night. Each drug was administered for one month and every patient was treated with all three drugs in succession. The individual sequence was determined by randomization. The assessment included nine objective and subjective criteria and after the termination of the trial each patient named his preferred sequence of drugs. All three drugs proved effective. The results of our investigations showed that nonsteroidal antirheumatic drugs in the form of suppositories were more effective in the treatment of rheumatoid arthritis. They exerted a more beneficial effect on morning stiffness and on pain than tablets of the same drug. The treatment was most effective as late as in the third month of the therapy, regardless of the substance which was administered as the third drug. This confirmed our experience of the advantage of alternate administration of various nonsteroidal antirheumatic drugs. A series of subjective and objective criteria, as well as the preference expressed by the patients spoke in favour of Voltaren suppositories, which was obviously due to the fact that Naprosyn was ineffective in about 20 per cent of the patients.
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PMID:Comparison of three therapeutic regimens using nonsteroidal antirheumatic drugs in patients with rheumatoid arthritis. 729 22

1. This study was undertaken to assess whether the analgesia conferred by Diclofenac sodium in the post operative period following general surgery is enhanced by preoperative administration of the drug. 2. Two groups of patients were studied. Group I patients received narcotic premedication and Group II patients received Diclofenac sodium as premedication. Post operatively both groups were administered intramuscular Diclofenac sodium 8 hourly for 48 hours. 3. Pain scoring using visual analogue scale indicated a better pain relief in Group II patients. In Group I, 75% patients had a pain score less than 3 whereas 85% in Group II had a pain score less than 3 (Figure 1). 4. Pulmonary function tests were done 24 hours after surgery and revealed improved values of all parameters in Group II patients. This indicates a greater degree of analgesia in Group II patients. 5. Preoperative administration of the drug reduces the initiation of pain in the periphery and decreases the inflammatory response after surgery. 6. NSAIDS do not have any central effect or any respiratory depression. Patients in our study were found to be awake, cooperative and pain free. The additional analgesia conferred by preoperative administration in conjunction with adequate postoperative therapy allows us to recommend Diclofenac sodium as a sole analgesic for perioperative pain relief except in those patients with a bleeding diathesis.
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PMID:Evaluation of diclofenac sodium as a perioperative analgesic. 787 49

Diclofenac and nimesulide are non-steroidal antiinflammatory agents advocated for use in painful and inflammatory rheumatic and certain non rheumatic conditions. In Uruguay, these drugs are administered in doses of 100 mg and 200 mg once a day, respectively. Diclofenac is an effective and safe analgesic and antiinflammatory drug. There are scarce data available on the pharmacokinetic profile of nimesulide. These facts encouraged us to undertake the present study on clinical efficacy, tolerance and pharmacokinetics of nimesulide, controlled with sustained release diclofenac. Twenty patients with osteoarthritis, stage II-III, according to a clinical-radiological evaluation, were selected for the study. Patients were assigned at random to treatment A (Voltaren sustained release, 100 mg) or B (Nodo regular formulation, 200 mg) once a day. A double blind study with active drug and controlled parallel groups was designed. After a washout period of one week patients were treated with active medication during 84 days, and clinical controls every 14 days ensued. Experienced rheumatologists assessed pain and other clinical symptoms. Blood samples were drawn on days 7, 49 and 91 of the study, ten hours after the morning dose, and plasma diclofenac and nimesulide concentrations were measured. On day 7 and 91, blood counts and biochemical laboratory studies were performed (namely, hemoglobin, RBC, WBC, leucocyte differential count, platelet count, alkaline phosphatase, ASAT, ALAT, creatinine, etc.) Already two weeks after the study had begun, significant improvements in clinical parameters assessed were seen for both treatments. A trend to accumulation of diclofenac and nimesulide along the three months of treatment was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diclofenac vs nimesulide in arthrosis. Plasma levels and clinical efficacy]. 820 12

In the field of respiratory surgery there is a need for further research and clinical experience with thoracoscopic surgery. It has already proved excellent for pain reduction and mizing of the wound. We describe the method and results of thoracoscopic surgery, which was started in June, 1992. Twelve cases are reported. The procedure consist of : (1) trocar insertion, (2) observation by thoracoscopy, (3) lifting up and cutting off lung tissue, (4) drainage and removal of the trocar. The most important technique needed by the operator is the cooperative motion of both hands which handle forceps, GIA and other instruments. The two indications for thoracoscopic surgery are spontaneous pneumothorax (bullectomy) and diffuse interstitial pulmonary disease (biopsy). Our operation time was 50 to 145 minutes. No complication occurred on the eleven patients. Wound pain was controlled by diclofenac sodium (Voltaren) suppositories on the first day. The wounds (3 spots 2 cm in size) healed well.
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PMID:[Thoracoscopic surgery by use of endo-GIA]. 831 19


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