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

Fifty-four consecutive cases of single injection peribulbar anaesthesia performed by the same ophthalmologist were evaluated concerning clinical effect on motility/akinesia and pain. The patients were randomly selected to one of two different mixtures of anaesthetics, one containing lidocaine, bupivacaine, adrenaline and hyaluronidase. The other lidocaine and bupivacaine. The mixture with adrenalin and hyaluronidase was significantly more effective than the other (success rates of 77.8% and 25.9%, p < 0.005).
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PMID:Peribulbar anaesthesia. A clinical evaluation of two different anaesthetic mixtures. 774 81

We describe a 31-year-old male with a rebound radicular syndrome due to post-laminectomy scarring in the intervertebral foramen and epidural space. Repeated injection of hyaluronidase through the intervertebral foramen into the scar tissue resulted in periods of appreciably reduced pain and increasing duration. No untoward effects were seen.
Pain 1994 Aug
PMID:Hyaluronidase in the management of pain due to post-laminectomy scar tissue. 865 40

The object of this study was to determine the correlation between clinical symptoms and the activity of enzymes such as collagenase, chondroitinase, and hyaluronidase produced by bacteria isolated from infected root canals. The materials examined consisted of 28 teeth with apical periodontitis from 25 patients. Bacteria producing collagenase or chondroitinase and hyaluronidase were found to be significantly related to subacute clinical symptoms involving percussion pain. The frequency of bacteria producing collagenase was higher in isolates from root canals with a radiolucent area over 5 mm in diameter than in those from canals having a radiolucent area less than 5 mm in diameter.
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PMID:Relationship between clinical symptoms and enzyme-producing bacteria isolated from infected root canals. 800 69

Alkalinized bupivacaine 0.75% (pH 6.8) and a mixture (1:1) of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, were compared in regional ophthalmic anesthesia for day-case cataract surgery. Eighty-two patients were randomized into two groups (n = 39 and 43) to receive one of the two solutions in a double-blind manner. Two intraorbital injections were administered initially: an inferolateral intraconal injection (3 mL) and a medial extraconal injection (3.5 mL). The progress of lid and globe akinesia was examined every 2.5 min up to 25 min and postoperatively. The block was supplemented at 10 and 20 min, if needed. Significantly better globe akinesia was achieved with the bupivacaine-lidocaine mixture; the patients who had received alkalinized bupivacaine needed additional injections significantly more often at 10 and 20 min. In lid akinesia, the onset time and recovery were similar in the two groups. One patient in the alkalinized bupivacaine group felt intraoperative pain, and eight patients in the bupivacaine-lidocaine group and seven in the alkalinized bupivacaine group sensed pain postoperatively from corticosteroid and antibiotic injections. Seventy percent of the pH-adjusted bupivacaine group and 8% of the lidocaine-bupivacaine group had diplopia the day after surgery. Of the two local anesthetic mixtures studied, lidocaine (2%) with bupivacaine (0.75%) provided regional ophthalmic anesthesia of better quality.
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PMID:Comparison of pH-adjusted bupivacaine 0.75% and a mixture of bupivacaine 0.75% and lidocaine 2%, both with hyaluronidase, in day-case cataract surgery under regional anesthesia. 801 Apr 50

The ability of intracanal use of two nonsteroidal anti-inflammatory agents--diclofenac and ketoprofen--with and without hyaluronidase to control posttreatment pain was compared with that of a placebo control in a double-blind study of 760 subjects. The study was carried out on originally asymptomatic and symptomatic teeth that required endodontic therapy. Endodontic treatment was completed in three visits during which medications were placed into the canal either at the end of the first visit (postextirpation) or the second visit (postinstrumentation). Patients subjectively rated their pain on a scale of 1 to 4 as none, mild, moderate, and severe. The ratings were done preoperatively and at 2, 4, 8, and 12 hours postoperatively on the first day as well as on the second and third days. Statistical analysis of the data revealed that both diclofenac and ketoprofen significantly reduced the mean pain score in originally asymptomatic and symptomatic cases and were significantly superior to the placebo until the end of the study. Postendodontic pain occurred with less frequency when the teeth were treated with diclofenac, but diclofenac-treated and ketoprofen-treated cases were not significantly different at controlling postendodontic pain. An increase in the number of patients who reported complete absence of pain was recorded when hyaluronidase was added to the study medications. However, the difference between the medications and medications-hyaluronidase was not of statistical significance.
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PMID:Effect of intracanal use of nonsteroidal anti-inflammatory agents on posttreatment endodontic pain. 802 74

Prilocaine (Citanest) has been shown to be a satisfactory alternative to lignocaine, with certain important advantages, including superior diffusion. The latter may be especially important in peribulbar anesthesia, where the level of diffusion is a critical factor in providing a timely, high-quality block. In a prospective randomized study, we compared the effectiveness of peribulbar vs retrobulbar administration of prilocaine. Eighty-seven patients undergoing elective intraocular surgery were randomized to receive either retrobulbar or peribulbar anesthesia with prilocaine 3% with felypressin and hyaluronidase. Pain of injection, akinesia, and anesthesia were evaluated at predetermined intervals after injection. Except for the fact that lid akinesia occurred earlier in the peribulbar group, there was no difference in the quality or rate of onset of overall akinesia in the two groups. Nor were there any differences in the pain associated with injection. Both groups had excellent operative anesthesia and akinesia.
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PMID:Peribulbar and retrobulbar anesthesia with prilocaine: a comparison of two methods of local ocular anesthesia. 811 1

One-hundred and thirty-nine consecutive cases of retrobulbar blocks were evaluated concerning clinical effect on motility and pain. The patients were randomly selected to one of four different mixtures of anaesthetics. A mixture containing lidocaine w/adrenaline, bupivacaine w/adrenaline and hyaluronidase was shown to be significantly more effective than any of the other tested mixtures concerning analgesia and significantly better than mixtures without hyaluronidase concerning motility/akinesia.
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PMID:Retrobulbar anaesthesia. A clinical evaluation of four different anaesthetic mixtures. 815 54

To determine the most effective local anaesthetic for ingrown toenail surgery, 100 procedures were performed after patients had been randomized to receive lignocaine, bupivacaine or hyaluronidase and bupivacaine. The effect of each anaesthetic was monitored and 80 patients returned a follow-up questionnaire. There was no significant difference in the time for the local anaesthetic to take effect, or in the pain caused by its injection or the procedure. Significant differences were found between treatments with respect to pain at discharge from hospital and significantly fewer patients who received bupivacaine experienced pain 24 h after surgery (P = 0.002). Bupivacaine provides quick-acting and long-lasting anaesthesia and should be used in preference to lignocaine.
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PMID:Local anaesthetic agents in surgery for ingrown toenail. 817 19

The recognition and alleviation of animal pain is a growing veterinary and public concern. Pain can be of an acute or chronic nature with different behavioral manifestations. Physiologically, pain is a dynamic and complex phenomenon that produces changes in the central and autonomic nervous systems as well as in the endocrine system. Horses and other animals appear to possess an endogenous pain-suppressing system involving the brainstem and spinal cord. This system can modulate pain perception and the responses to it. The recently discovered endogenous opioid peptides (endorphins and enkephalins) appear to play a role in this system, which is activated by stress. Opioids (narcotic analgesics) act to selectively depress pain-sensitive cells. Opioid analgesics may act via multiple opioid receptors. Each subclass of opioid receptor has a different pharmacologic profile. Classical opioids that act at mu (morphine) receptors typically produce analgesia, increased locomotor activity, cardiorespiratory stimulation, and a decrease in intestinal peristalsis in the horse. Opioids that act at kappa receptors produce analgesia, sedation, ataxia, and minimal autonomic effects in the horse. Owing to their lack of excitatory actions, the kappa opioids represent a potentially useful class of analgesics for use in equine species. Local anesthetics depress all excitable cells and can diminish sensory, motor, and muscular function. They do not act selectively on pain fibers, although pain is among the first sensations lost following a nerve block. Local anesthetic activity is enhanced by increased extraneuronal pH, nerve cooling, increased nervous activity, coadministration of a vasoconstrictor or hyaluronidase, delayed systemic absorption, prolonged drug metabolism, and by using agents with high lipid solubility. Procaine, lidocaine, and mepivacaine are among the most widely used and studied agents in horses. These agents and/or their metabolites can be readily detected in urine; in some cases, for prolonged periods.
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PMID:Narcotics and local anesthetics. 829 18

Two concentrations of etidocaine (1 and 1.5%) and of pH-adjusted bupivacaine (0.5 and 0.75%, pH 6.8), all fortified with hyaluronidase, were compared as local anesthetics in regional ophthalmic surgery for cataract extraction. The series comprised 160 patients assigned randomly to four groups (n = 40). Each patient received one of the four anesthetics in a double blind manner. The technique used was an inferolateral intraconal injection (3 mL) followed by a medial extraconal injection (3 mL). Supplemental injections were given at 10 and 20 min, if needed. At 10 min, globe akinesia was satisfactory in both etidocaine groups and in the 0.75% bupivacaine group (78-80% of patients), but in only 37% of the 0.5% bupivacaine group. In lid akinesia, the 0.75% bupivacaine group gained the highest scores, but there was no significant difference between the groups. Perioperative analgesia was better in both bupivacaine groups, in which only 3 and 5 patients felt pain compared to 7 and 12 in the etidocaine groups (P < 0.05). Of these local anesthetics, pH-adjusted 0.75% bupivacaine is recommended for regional ophthalmic anesthesia.
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PMID:Comparison of regional ophthalmic anesthesia produced by pH-adjusted 0.75% and 0.5% bupivacaine and 1% and 1.5% etidocaine, all with hyaluronidase. 831 20


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