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)

Epidural administration of an opioid analgesic by means of a patient-controlled analgesia (PCA) system was compared with conventional intravenous PCA for pain relief after cesarean delivery. One hundred seventeen healthy women were randomly assigned to receive hydromorphone either intravenously (IV-PCA) or epidurally (EPI-PCA) after cesarean delivery with epidural bupivacaine for operative anesthesia. The hydromorphone requirements were 3.4 and 4.2 times more in the IV-PCA group on the first (P less than 0.01) and second (P less than 0.01) postoperative days, respectively. The mean number (+/- SD) of PCA demands during the first 24 h after the operation was 105 (+/- 88) for the IV-PCA group and 33 (+/- 48) for the EPI-PCA group (P less than 0.01). This difference was also significant 24-48 h after surgery. Although the EPI-PCA group utilized significantly less opioid medication, pain and sedation scores were similar in the two treatment groups; however, a significantly larger percentage of patients in the IV-PCA group (46% vs 22%) stated that they felt drowsy during the first postoperative day. Pruritus was reported more frequently in the EPI-PCA (67%) than in the IV-PCA (33%) group. Nausea was experienced by only 10% of patients in the IV-PCA and 6% in the EPI-PCA group. There was no evidence of postoperative respiratory depression, with minimal oxygen saturation values of 93% (+/- 3%) and 94% (+/- 1%) in the IV-PCA and EPI-PCA groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. 137 7

In tropical areas measles cases often are under-reported but the authors comment here two epidemics which had at first been considered as outbreaks of measles but were not. The first epidemic resembled a Chikungunya virus outbreak with important rashes, hyperthermia and pain attacks and was due to Igbo-Ora arbovirus. In the second epidemic children were having rashes with hyperthermia and adenopathy evoking rubella. The authors consider the possibility of over-reporting in view of the surveillance of measles, the target-disease in EPI (Expanded Programme on Immunization). This hypothesis is confirmed by the distribution of reported cases at national level with a high rate of out-season cases and among adults.
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PMID:[Difficulties in the epidemiological surveillance of measles in Africa: exemplified by the Ivory Coast]. 165 99

The relationship between personality traits and post-surgical pain was studied in 126 patients submitted to a particular set of procedures. The personality was studied by MMPI, STAI, EPI tests before surgery. After surgery, pain intensity was positively related to duration, and pain latency negatively related to both intensity and duration. According to multiple regression analysis, pain intensity was found to be predictable from both the state anxiety and psychoasthenia scales, pain latency from state anxiety and masculinity/femininity, pain duration from aggressivity and hysteria. Results suggest that personality traits constitute strong modulatory factors of the overall pain experience.
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PMID:Intensity, latency and duration of post-thoracotomy pain: relationship to personality traits. 209 50

Endogenous opiates have been implicated in pain and stress experiences. In order to directly assess the relationship between endorphin activity and acute behavioral distress, beta-endorphin immunoreactivity (beta-EPI) was measured by radioimmunoassay in cerebrospinal fluid of 75 children with acute leukemia undergoing routine lumbar puncture. These data were related to four measures of behavioral distress collected during the procedure. For children 4 years of age and above, beta-EPI correlated inversely with age (r = -.31,p less than or equal to .05). All behavioral measures also inversely correlated with age (r = -.26 to -.67,p less than or equal to .05 to .001). Females had a significantly lower mean beta-EPI than males (p less than or equal to .01), and exhibited greater behavioral distress. beta-EPI and behavioral measures interacted with the use of specific antileukemia agents. L-Asparaginase was associated with lower beta-EPI (p less than or equal to .05), while prednisone was associated with lower behavioral distress on three of the four measures (p less than or equal to .05 to .01). After controlling for age, sex, and chemotherapy, beta-EPI and nurse ratings of anxiety were positively correlated (partial correlation coefficient = .31, p less than or equal to .05). Correlations between beta-EPI and other behavioral measures demonstrated positive trends. Results of this study are interpreted as support for the reactive nature of beta-EPI in cerebrospinal fluid to acute distress, and may help explain documented sex differences in distress behavior. Potential clinical implications and directions for further research are discussed.
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PMID:beta-Endorphin immunoreactivity and acute behavioral distress in children with leukemia. 627 5

Treated chronic low back pain patients (N = 102) in a university hospital clinic. Ss were given the EPI, the Recent LIfe Changes Questionnaire, and the Locus of Control Scale in order to isolate the principal dimensions of emotional disturbance in such patients and to see whether derived dimensions were related to response to conservative treatment for back pain. Self-report ratings of current pain intensity were obtained approximately 1 year after the start of treatment. Factor analysis revealed five factors: Distrust and alienation, somatic concern, vulnerability, extraversion, and social desirability; these accounted for 71% of the total variance among patients. Patients with above-average pretreatment distrust and alienation scores more frequently failed to return the follow-up form than patients with below-average scores. Low scores on somatic concern were related to good outcome. Results suggest that patients in alienation and distrust may be prone to be poor compliers. Because only the somatic concern dimension predicted outcome, a single scale that measures this characteristic may be sufficient for effective identification of the potential good vs. poor responders to conservative treatment of low back pain.
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PMID:Emotional disturbance and chronic low back pain. 644 12

Personality factors are known to influence the augmenting/reducing tendency in evoked potentials and also the results obtained from pain-relieving methods in chronic pain conditions. In this study 30 chronic pain patients treated with high frequency transcutaneous electrical nerve stimulation were evaluated by means of personality inventories and visual evoked potentials (VEP). The results indicate that the group for whom the treatment had a positive outcome had an augmenting tendency in VEP and also significantly differed as regards certain factors in the EPI (high values in the L scale) and the CMPS (high values in factors I, II, IX, X and index I, V) personality inventories.
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PMID:Personality factors related to the outcome of treatment with transcutaneous nerve stimulation. 697 68

The behaviour pattern was assessed in two groups of middle aged men, 157 subjects selected randomly from a coronary risk group of 1553 subjects and 83 respondents for physical fitness testing. The number of risk factors i.e. smoking, hypertension, hypercholesterolemia, angina pectoris by chest-pain questionnaire and positive family history was higher in the physical fitness testing respondents than in randomly selected subjects, the difference being highest for A Type men. No correlation between the behaviour pattern and prevalence of RF was found. Subjects with higher score of neuroticism in EPI were the heaviest smokers.
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PMID:A/B behaviour pattern not correlated with other coronary risk factors in industrial plant populations. 718 53

The occlusion rate of peripheral vascular grafts depends on technical as well as endogenous factors. Platelets play an integral part in graft failure and it has been suggested that anaesthesia may influence platelet function. In order to evaluate the influence of anaesthesia on stress response and platelet function in peripheral vascular surgery, patients (n = 18) were allocated to either general anaesthesia (GA; n = 9) followed by alleviation of postoperative pain with intramuscular analgesics or to lumbar epidural anaesthesia (EPI; n = 9) which was continued for 24 hours postoperatively. Before, during, as well as after vascular surgery of the lower extremity plasma levels of cortisol, glucose, serotonin (p-5HT), and urinary 5-hydroxyindole-3-acetic acid (5-HIAA) were analysed and platelet aggregability was determined. In the GA group surgery was accompanied by a significant stress response while in the EPI group this stress response was almost completely abolished. Platelet aggregability was reduced intraoperatively in both groups but in the postoperative period there was a marked hyperaggregability only in the GA group. P-5HT was increased preoperatively in both groups but was not affected by surgery. It is concluded that epidural anaesthesia, due to its effects on platelet aggregability, may be advantageous for peripheral vascular surgery.
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PMID:Epidural anaesthesia prolonged into the postoperative period prevents stress response and platelet hyperaggregability after peripheral vascular surgery. 808 89

The efficacy of wound perfusion (WP) with lidocaine for postoperative pain relief was studied in patients with median incision for cholecystectomy. Twenty four patients were divided into 3 groups according to the method of postoperative pain relief; group C, n = 8: intramuscular injections of penta-zocine 30 mg administered on demand, group WP, n = 8: WP with continuous lidocaine perfusion for 24 hours (plus pentazocine on demand); group EPI, n = 8: buprenorphine administered epidurally for 24 hours (plus pentazocine on demand). Pain scores at 0, 6, 12, 24, 48, hours after operation were examined. Arterial blood gas analysis, FVC and FEV1 were measured preoperatively and on the first postoperative day. Pain scores at 0 and 24 hours in group WP and EPI were significantly lower than those in group C. There were no significant differences in the scores between group WP and EPI at all the points. Analgesic requirement was significantly reduced in group WP and EPI compared with group C. FVC, FEV1 and PaO2 were significantly reduced postoperatively in every group but there were no differences among three groups. PaCO2 significantly increased postoperatively in group C and EPI. We conclude that the technique of wound perfusion with lidocaine is effective and safe for postoperative pain relief.
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PMID:[The effect of wound perfusion on the relief of postoperative pain]. 830 62

This randomized double-blind study compared epidural sufentanil (SEPI) with intravenous sufentanil (SIV) or epidural fentanyl (FEPI) analgesia in 45 patients after major abdominal operations. On first complaint of severe postoperative pain, SIV patients were given a 15-micrograms bolus and then a 5 micrograms/h infusion of sufentanil intravenously. SEPI patients were given the same bolus and infusion, but epidurally. FEPI patients had a 60-micrograms bolus and 20 micrograms/h infusion of fentanyl epidurally. All patients also received a bolus injection and then an infusion of coded saline via the alternate route. Analgesic requirements were tailored continuously to individual needs by patient-controlled supplementary boluses of 3.1 micrograms of sufentanil or 12.5 micrograms of fentanyl, or by 50% reduction in opiate infusion rate at predetermined intervals. Pain scores, circulatory variables, and respiratory rate did not differ between groups. Mean opiate dose requirements (+/- SD) to maintain analgesia for 24 h were 202 +/- 43 micrograms (SIV), 149 +/- 45 micrograms (SEPI), and 627 +/- 226 micrograms (FEPI). The relative analgesic potencies (AP) calculated from the equianalgesic dose requirement ratios were 1.4 for AP-sufentanil IV/EPI and 4.2 for AP-epidural F/S. SIV patients required more supplementary boluses than SEPI patients, were more sedated during the entire treatment, and had higher PaCO2 and higher serum sufentanil concentrations within the first 3 h of treatment. In addition, severe respiratory depression occurred in four SIV patients soon after the start of treatment, despite serum sufentanil concentrations of less than 0.3 ng/mL.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A randomized double-blind comparison of epidural sufentanil versus intravenous sufentanil or epidural fentanyl analgesia after major abdominal surgery. 849 61


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