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)

At Helsinki University Central Hospital in Finland, clinical researchers divided 169 women into two groups (group 1: diagnostic laparoscopies; group 2: laparoscopic sterilizations) as part of a study to evaluate the effect of intravenous diclofenac on postoperative pain, nausea, and recovery after outpatient gynecological laparoscopy. After induction of anesthesia (propofol infusion, total dose = about 370 mg), the patients randomly received, in a double-blind approach, either 100 mg diclofenac sodium (Voltaren, Ciba-Geigy) diluted in 10 ml saline or 10 ml saline alone. Patients in the saline group needed much more fentanyl and paracetamol for pain relief than those in the diclofenac group (47 vs. 25 mcg and 0.69 vs. 0.23 g, respectively; p 0.05). Even though a higher proportion of diclofenac patients experienced postoperative nausea and vomiting (17% vs. 6%) and thus were more likely to receive droperidol (9% vs. 2%), the differences were not statistically significant. Laparoscopic sterilization patients experienced more pain and required more pain relievers postoperatively than diagnostic laparoscopy patients. Specifically, sterilization patients receiving saline received 2.8 times more fentanyl and 1.9 times more paracetamol than diagnostic laparoscopy patients. As for diclofenac patients, these figures were 4.9 and 5.5, respectively. Sterilization patients had more nausea and vomiting than diagnostic laparoscopy patients (34% vs. 11%; p 0.001). Diclofenac did not influence the rapidity of recovery or home readiness in either group. These findings show that diclofenac significantly reduced the need for postoperative analgesia in diagnostic laparoscopy patients but not laparoscopic sterilization patients.
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PMID:Effect of intravenous diclofenac on pain and recovery profile after day-case laparoscopy. 846 34

In a double-blind study, diclofenac sodium (Voltaren), 50 mg two or three times a day, was compared with placebo in 32 patients with pain localized to the temporomandibular joint (TMJ). The patients were allocated into two equally large groups. A visual analog scale was used to estimate the pretreatment degree of pain. The treatment effect was assessed as the frequency of joint and muscle pain and by the patients' own evaluation of improvement. The change in the clinical condition was assessed by tenderness to palpation of the TMJ and masticatory muscles and by mandibular mobility. The frequency of TMJ pain showed a greater reduction in the diclofenac group than in the placebo group, and there was a significant reduction of daily TMJ pain in the diclofenac group. The diclofenac group also showed a significant decrease in tenderness to palpation of the masticatory muscles in comparison with the placebo group. The patients with short duration of pain showed the best response to diclofenac. There was no evidence in this study to prove that diclofenac should be used as a primary treatment of TMJ pain, but it could be used as a complement to other treatments of acute TMJ pain.
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PMID:Diclofenac sodium as an alternative treatment of temporomandibular joint pain. 881 Nov 36

Twenty-four surgical patients of both sexes without cardiac, hepatic, renal or endocrine dysfunctions were divided into two groups: 10 cardiac surgical patients submitted to myocardial revascularization and cardiopulmonary bypass (CPB), 3 females and 7 males aged 65 +/- 11 years, 74 +/- 16 kg body weight, 166 +/- 9 cm height and 1.80 +/- 0.21 m2 body surface area (BSA), and control, 14 surgical patients not submitted to CPB, 11 female and 3 males aged 41 +/- 14 years, 66 +/- 14 kg body weight, 159 +/- 9 cm height and 1.65 +/- 0.16 m2 BSA (mean +/- SD). Sodium diclofenac (1 mg/kg, im Voltaren 75 twice a day) was administered to patients in the Recovery Unit 48 h after surgery. Venous blood samples were collected during a period of 0-12 h and analgesia was measured by the visual analogue scale (VAS) during the same period. Plasma diclofenac levels were measured by high performance liquid chromatography. A two-compartment open model was applied to obtain the plasma decay curve and to estimate kinetic parameters. Plasma diclofenac protein binding decreased whereas free plasma diclofenac levels were increased five-fold in CPB patients. Data obtained for analgesia reported as the maximum effect (EMAX) were: 25% VAS (CPB) vs 10% VAS (control), P < 0.05, median measured by the visual analogue scale where 100% is equivalent to the highest level of pain. To correlate the effect versus plasma diclofenac levels, the EMAX sigmoid model was applied. A prolongation of the mean residence time for maximum effect (MRTEMAX) was observed without any change in lag-time in CPB in spite of the reduced analgesia reported for these patients, during the time-dose interval. In conclusion, the extent of plasma diclofenac protein binding was influenced by CPB with clinically relevant kinetic-dynamic consequences.
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PMID:Diclofenac plasma protein binding: PK-PD modelling in cardiac patients submitted to cardiopulmonary bypass. 924 35

Thirty-one patients with acute renal colic were treated with Voltaren (Diclofenac Sodium, Ciba). The drug proved to be suitable for relieving, and stopping pain. Adverse effects were observed but in few cases. For this reason authors suggest a more extensive use of the drug.
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PMID:The use of Voltaren (diclofenac sodium, Ciba) in acute renal colic. 926 25

A 29-year-old Hispanic man who had bilateral radial keratotomy (RK) and astigmatic keratotomy (AK) in his right eye 1 year previously went swimming in a lake. He subsequently developed foreign-body sensation and pain with a gradual decrease in vision over the following 5 weeks, despite treatment with ciprofloxacin hydrochloride (Ciloxan) and diclofenac sodium (Voltaren). The patient sought a second opinion. On examination, best corrected visual acuity was 20/40 in the right eye and 20/20 in the left. Slitlamp examination revealed mild conjunctival and scleral injection and a 3.5 mm diameter stromal infiltrate densest at the edges (Figure 1). The infiltrate involved one RK and one AK incision with gaping of both, approximately 90% depth incisions (Figure 2). The anterior chamber was deep and quiet. Examination was otherwise unremarkable. The cornea was scraped, but the smears were negative. The Ciloxan and Voltaren were stopped, and scopolamine four times a day was started. Cultures for aerobic, anaerobic, fungal, acid-fast bacilli, and Acanthamoeba were performed but showed no growth in the following week. Except for vascular ingrowth, there was no change in the appearance of the microbial keratitis during this week. An incisional biopsy and rescraping were performed, but there was again no growth of micro-organisms and no change in the microbial keratitis in the following 4 days. How would you manage this patient at this time?
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PMID:Consultation section. Refractive surgical problem. 929 62

An AIDS physician at New York's St. Vincent's Hospital reports considerable success with a topical formulation of the prescription drug Voltaren (a non-steroidal anti-inflammatory in the same class as Advil or Aleve). Dr. David Kaufman found the drug reduces pain and has essentially no side effects. The topical formulation, called Emulgel, is not sold in the United States. Information is requested about results using Emulgel and other brands of topical diclofenac sodium for treating neuropathy. Readers are also asked to share experiences with topical use of other anti-inflammatory drugs for relieving neuropathy. Contact information is provided.
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PMID:Neuropathy: call for info. on Voltaren Emulgel (topical diclofenac sodium). 1136 14

Non-steroidal anti-inflammatory drugs (NSAID) are potent analgesic agents. They are indicated for rheumatoid arthritis, osteoarthritis, severe acute and prolonged chronic pain. A wide range of analgesic agents are available. The objective of this study was to assess the patient's knowledge of his illness, his knowledge familiarity with NSAID medications and their side effects and thereupon, to evaluate the awareness, utilization, satisfaction and expectations associated with current available treatment. During the year 2000, a randomized telephone screening questionnaire, was completed over a 2 month period for a sample group of the general Israeli population over 50 years of age. Of the 3179 persons contacted, 2028 responded and 292 persons were treated with NSAIDs and further investigated. Fifty percent suffered from chronic musculoskeletal pain, 22% had osteoarthritis, 10% had rheumatoid arthritis, and 18% had undefined chronic pain. The average age of the respondent was 65 years old. The average duration of treatment was 11 years. The most common drugs used by the 292 respondents that were taking NSAIDs were diclofenac (Voltaren)--51% and naproxen (Naxyn)--21%. Only 4% were treated with COX-2 specific inhibitors. Twenty percent of the respondents utilized more than one NSAID simultaneously. Forty seven percent of the patients had peptic ulcer disease but only 39% of them were simultaneously treated with an NSAID and a gastroprotective agent. Sixty eight percent of patients expected amelioration of symptoms while taking NSAIDs. Seventy seven percent of respondents were dissatisfied with treatment. The patients expressed that they did not have a reliable easily accessible source of information on their disorder or on available treatment options. Many respondents were not aware of their medical diagnosis. In general, patients were not aware of all the available NSAIDs or the side effects of gastrointestinal complications. Enhancement of information available to the patient is warranted to improve the provision of efficient therapy, reduce side effects and increase patient satisfaction from therapy.
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PMID:[The lack of awareness of the Israeli population regarding gastrointestinal complications from non-steroidal anti-inflammatory drugs]. 1142 Aug 44

The aim of this study is to compare the effectiveness of the 5-HT3 antagonist, ondansetron and a non-steroidal anti-inflammatory agent, diclofenac sodium, as a pain reliever in the treatment of acute ureteral colic. Sixty four patients with severe or moderate pain who were clinically diagnosed as having ureteral colic associated with microscopic or gross hematuria were included in the study. Thirty three patients were administered ondansetron and 31 patients were administered diclofenac sodium. Exclusion critera were known kidney or liver disease causing dysfunction, known hypersensitivity to ondansetron or diclofenac sodium, pregnancy, lactation, duodenal ulcer or bleeding. After pain assessment with a verbal scale and a visual analog scale (VAS), we randomized patients and administered 8 mg ondansetron intravenously to 33 patients and 75 mg diclofenac sodium intramuscularly to 31 patients and pain scores were recorded every 15 minutes. If significant pain relief was not achieved within 60 minutes, i.v. meperidine was given as rescue pain medication. Ondansetron was effective as a primary pain reliever in 14 (42.4%) patients, whereas 19 patients required additional medication. Diclofenac sodium was effective as a primary pain reliever in 24 (77.4%) patients, whereas 7 patients required additional medication. Ondansetron was not superior to diclofenac sodium in relieving pain in patients with acute ureteral colic.
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PMID:Ondansetron versus diclofenac sodium in the treatment of acute ureteral colic: a double blind controlled trial. 1209 46

To reasons not yet completely understood, the pharmaceutical trademark Voltaren or Voltarol refers to the Italian scientist Alessandro Volta (1745-1827) who played an important role in the history of electricity. It is shown that electrotherapy has been used for the treatment of pain, gout and rheumatic disorders from ancient times to the present day. This therapeutic attempt was also discussed in scientific literature in the late 1960s, the time Voltaren was under development. Therefore, it is suggested that the electrotherapy of pain in history is a background for chosing this trademark.
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PMID:The history of electrotherapy of pain--or: what Voltaren has to do with voltage. 1264 36

In this study, we examined whether several types of non-opioid agents would inhibit the pain-related responses of melanoma-bearing mice. Orthotopic inoculation with melanoma into the hind paw induced marked tactile allodynia and mechanical hyperalgesia. A peroral injection (p.o.) of gabapentin (100-300 mg/kg) inhibited the allodynia and hyperalgesia, without effects on gross behaviors. An intraperitoneal injection (i.p.) of ketamine hydrochloride (30 mg/kg) produced partial inhibition in allodynia and hyperalgesia and prostate posture at 15 min after injection. Diclofenac sodium (10 and 30 mg/kg, i.p), mexiletine hydrochloride (20 mg/kg, i.p.), clonidine hydrochloride (0.1 mg/kg, i.p.) and suramin (100 mg/kg, i.p.) were without effects on allodynia and hyperalgesia. Subcutaneous injections of baclofen (3 mg/kg) and N(G)-nitro-L-arginine methyl ester (100 mg/kg) were also without effects. Repeated administration of gabapentin (150 mg/kg, p.o.) produced constant inhibitions, suggesting no analgesic tolerance. Gabapentin may be useful for the management of cancer pain.
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PMID:Suppression by gabapentin of pain-related mechano-responses in mice given orthotopic tumor inoculation. 1267 42


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