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)

Twelve patients with systemic sclerosis (SS) and severe Raynaud's phenomenon received infusions of prostaglandin E1 (PGE1) at a dose of 6-10 ng/kg/min, with either saline or 5% dextrose, for 72 hours in a single-blind cross-over study. The infusions were administered intravenously by centrally positioned catheters. Infusions were well tolerated with only mild side effects. Following the PGE1 infusion cold tolerance improved and attacks of Raynaud's phenomenon were less frequent, less severe, and shorter in duration. This subjective improvement was maintained for several weeks in most patients, and 2 noted healing of ischaemic ulcers. There was no significant change in objective measurements of hand function after either infusion. However, pain measured on a 10 cm visual analogue scale improved 2.19 cm with PGE1 and only 0.91 cm with normal saline (P less than 0.05). Temperature of the fingers and hands recorded by thermography did not change significantly with saline infusions, but did rise during PGE1 infusions (mean rise 2.0 degrees C at 48 hours, p less than 0.001), and was maintained when measured again 2 weeks later (mean rise 1.56 degrees C, p less 0.001). PGE1 may therefore be suitable treatment for Raynaud's phenomenon and the vascular insufficiency of systemic sclerosis and other connective tissue diseases.
 ...
PMID:Prostaglandin E1 infusions for vascular insufficiency in progressive systemic sclerosis. 725 26

We report the extradural administration of low-dose morphine in 10 ml of 10% dextrose (2-3 mg) to 98 adult patients with various types of acute and chronic pain. Extradural morphine injections were given either via a Tuohy needle (single or repeat injection) or via an extradural catheter. Pain relief was evaluated by subjective scoring and by the subsequent need for systemic analgesics. In 56% of patients, pain relief was considered good or excellent, in 24% it was fair, and in 20%, poor. The best results were after surgery and trauma and in patients with advanced peripheral vascular disease. The analgesia of each dose of extradural morphine lasted for 8 h (mean range 4-36 h). There was no motor, sensory or sympathetic blockade and no respiratory or haemodynamic complications. Dizziness and vomiting occurred in two patients, and urinary retention for about 12 h in three.
 ...
PMID:Observations on extradural morphine analgesia in various pain conditions. 737 Jan 40

Acute exposure to severe stressors induce profound analgesia as well as depleting catecholamine levels. The present study examined whether d-amphetamine and apomorphine, agents which increase catecholamine availability, would alter the analgesic effectiveness of cold-water swims (CWS) and 2-deoxy-D-glucose (2-DG) as measured by an operant liminal escape procedure. Two groups of 10 rats each were tested to determine alterations in liminal escape threshold functions following amphetamine at doses of 0.25, 0.5, 1, 2 mg/kg and following apomorphine at doses of 0.025, 0.05, 0.1, 0.2 mg/kg. Half of the amphetamine and half of the apomorphine groups were tested across their respective dose ranges for the drug effects upon CWS analgesia. The remaining animals in each group received 2-DG (600 mg/kg IP) alone followed by 2-DG paired with each stimulant dose. No dose of amphetamine or apomorphine alone altered escape thresholds. While amphetamine produced slight potentiations of 2-DG analgesia at the two low doses, apomorphine at the 0.05 and 0.1 mg/kg doses returned CWS and 2-DG analgesia to within normal placebo values. These results provide indirect evidence for a role for brain norepinephrine and dopamine in stress-induced analgesia, and these data are discussed with respect to catecholamine involvement in pain-inhibitory processes.
 ...
PMID:Reversal of stress-induced analgesia by apomorphine, but not by amphetamine. 741 86

Vaginocervical stimulation affects progesterone secretion, sperm transport, sexual receptivity, locomotion, and perception of pain in female rats. In this experiment, vaginocervical stimulation produced statistically significant increases in the metabolic uptake of carbon-14-labeled 2-deoxy-D-glucose in the following brain areas (ordered by magnitude of uptake): medial preoptic, mesencephalic reticular formation, bed nucleus of stria terminalis, dorsal raphe, and globus pallidus. The results provide information about the concurrent processing of sensory stimulation by several neural areas and indicate that the medial preoptic area is a receiving area for copulatory stimulation.
 ...
PMID:Vaginocervical stimulation selectively increases metabolic activity in the rat brain. 746 82

The use of lidocaine in concentrations less than 5% for spinal anesthesia may be advantageous but has not been carefully studied. Lidocaine 50 mg (1.5% with dextrose and 1.5% dextrose-free) was administered to eight volunteers in a randomized, double blind, cross-over fashion. All of these subjects had previously received 5% lidocaine with dextrose using the same experimental protocol. Sensory analgesia was assessed with pinprick, transcutaneous electrical stimulation (TES) equivalent to surgical incision, and duration of tolerance of pneumatic thigh tourniquet. Motor block was assessed with isometric force dynamometry. Peak dermatomal level was the highest and duration until regression of pinprick the longest with the 5% solution (P < 0.05). Duration of tolerance to TES was increased (33 +/- 10 min) with the 5% solution (P < 0.04). Duration of tolerance to tourniquet pain was increased (11 +/- 3 min) with the 5% solution (P < 0.02). Duration of motor block was increased (45 +/- 9 min) with the 5% and the 1.5% without dextrose solutions (P < 0.04). Time to void was increased (33 +/- 5 min) with the 5% solution (P < 0.03). In conclusion, the use of different solutions of lidocaine for spinal anesthesia results in significant differences in sensory and motor block and time until recovery of micturition.
 ...
PMID:Comparison of 5% with dextrose, 1.5% with dextrose, and 1.5% dextrose-free lidocaine solutions for spinal anesthesia in human volunteers. 757 96

This study examined the effects of hyperglycemia and treatment with the aldose reductase inhibitor, Tolrestat, on the pain behavior evoked by injection of formalin into the dorsum of a single hind paw. In control rats, injection of formalin (50 microliters of a 5% solution) evoked two phases of flinching of the injected paw (phases 1 and 2), separated by a quiescent period. Four weeks of streptozotocin-induced diabetes or galactose intoxication did not alter the frequency of flinching during either of the active phases but significantly (P < 0.001 and P < 0.05, respectively) enhanced flinch frequency during the quiescent period. Concurrent treatment with Tolrestat (50 mg/kg/day by gavage) during hyperglycemia prevented the accumulation of the polyol pathway metabolites sorbitol and fructose in the nerve and spinal cord of streptozotocin-diabetic rats and also significantly (P < 0.05) reduced the enhanced flinching of diabetic rats during the quiescent period. These data demonstrate that hyperglycemia induces a period of Tolrestate-preventable hyperalgesia in a paradigm that is used to model persistent pain and suggest that exaggerated flux through aldose reductase may initiate changes in nociceptive pathways that could contribute to some of the pain states experienced by patients with diabetic neuropathy.
Pain 1994 Sep
PMID:Tolrestat treatment prevents modification of the formalin test model of prolonged pain in hyperglycemic rats. 783 91

Lidocaine spinal anesthesia is a popular anesthetic for short procedures due to its brief duration. The addition of fentanyl may improve the quality and duration of lidocaine spinal anesthesia. Eight volunteers received plain lidocaine 5% in dextrose (50 mg) both with and without 20 micrograms of fentanyl in a randomized, double-blind, cross-over fashion. Sensory analgesia was assessed with pinprick, cold, touch, transcutaneous electrical stimulation equivalent to surgical incision, and duration of tolerance of pneumatic thigh tourniquet. Motor block was assessed with isometric force dynamometry. Regression of pinprick, touch, and cold was prolonged with fentanyl. Duration of tolerance of electrical stimulation at the umbilicus, hip, knee, and ankle was increased with fentanyl (181% increase from plain lidocaine on average; P < 0.01). Duration of tolerance of tourniquet-induced pain was increased by an average of 48% with addition of fentanyl (P = 0.02). Neither motor block nor time to void was prolonged with fentanyl. Pruritus occurred in all subjects receiving fentanyl but was treated easily and were well tolerated. We recommend the addition of 20 micrograms of fentanyl to lidocaine spinal anesthesia as a means to improve duration of sensory anesthesia without prolonging recovery of motor function or time to micturition.
 ...
PMID:Fentanyl prolongs lidocaine spinal anesthesia without prolonging recovery. 789 26

A sick premature baby who requires intensive care will undergo many uncomfortable procedures. It is now accepted that such babies perceive pain and need adequate analgesia, but little is known about the effects of sedation in these patients. We investigated the use of morphine to provide analgesia and sedation for ventilated preterm babies in a randomised, double-blind, placebo-controlled trial. 41 mechanically ventilated babies who had been treated with surfactant (Curosurf) for hyaline membrane disease were randomly assigned morphine in 5% dextrose (100 micrograms/kg per h for 2 h followed by 25 micrograms/kg per h continuous infusion) or 5% dextrose (placebo). Plasma catecholamine concentrations were measured 1 h after the first dose of surfactant and 24 h later. Blood pressure was measured at study entry and after 6 h. The morphine and placebo groups showed no differences in method of delivery, Apgar scores, birthweight, gestation, or catecholamine concentrations at baseline. Morphine-treated babies showed a significant reduction in adrenaline concentrations during the first 24 h (median change -0.4 [95% CI -1.1 to -0.3] nmol/L p < 0.001), which was not seen in the placebo group (median change 0.2 [-0.6 to 0.6] nmol/L, p = 0.79). There was a non-significant reduction in noradrenaline concentration in the morphine group. Blood pressure showed a slight but non-significant fall (median -4 mm Hg) in morphine-treated babies. The incidence of intraventricular haemorrhage, patent ductus arteriosus, and pneumothorax, the number of ventilator days, and the numbers of deaths did not differ significantly between the groups. Morphine, in the dose regimen we used, is safe and effective in reducing adrenaline concentrations in preterm ventilated babies.
 ...
PMID:Randomised double-blind controlled trial of effect of morphine on catecholamine concentrations in ventilated pre-term babies. 810 52

Because of its slow onset of action, intrathecal morphine may not be the optimal drug for intraoperative analgesia during short cases, such as cesarean sections. It is not known whether adding fentanyl to a morphine-lidocaine spinal solution would provide any benefits to patients undergoing cesarean sections. Sixty-two women scheduled for elective cesarean section received intrathecal 5% lidocaine with dextrose (50-70 mg), epinephrine 200 micrograms, preservative-free morphine 0.2 mg, and either 10 micrograms of fentanyl (study group) or preservative-free normal saline (placebo group) in a 0.2-mL volume. Patients were asked to rate their severity of pain on a visual analog scale (VAS) intraoperatively as the uterus was exteriorized and again when the dermatomal level had receded to L1. Intravenous fentanyl was administered if the patient experienced intraoperative discomfort. The VAS scores were 0.8 +/- 1.5 and 2.3 +/- 1.6 (mean +/- SD) in the placebo group at the time of uterine extrusion and in the post-anesthesia care unit (PACU). The corresponding scores in the fentanyl group were 0.4 +/- 1.1 and 2.7 +/- 2.2. There was a significant difference between the two groups in the VAS scores intraoperatively (P < 0.014) but not in the PACU (P not significant). There was also a significant difference (P < 0.015) in the need for supplementation with intravenous (i.v.) fentanyl. Six patients in the placebo group received i.v. fentanyl as compared with none of the patients in the fentanyl group.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The use of fentanyl added to morphine-lidocaine-epinephrine spinal solution in patients undergoing cesarean section. 816 Sep 90

In many institutions, spinal anesthesia is used for surgery involving ultrasonically guided transvaginal oocyte retrieval. Because this relatively short procedure is performed on an outpatient basis, the optimal spinal technique would allow good surgical anesthesia with a short recovery time. The relative regression of equal doses of different concentrations of hyperbaric spinal lidocaine is presented. We compared 1.5% and 5% hyperbaric lidocaine (7.5% dextrose) as spinal drugs for use in this procedure. Fifty-six patients were randomized to receive 60 mg of hyperbaric solutions of either 1.5% or 5% lidocaine in combination with 10 micrograms of spinally administered fentanyl. Visual analog scale pain scores were zero throughout the procedures for all patients. There were no significant differences between the groups with regard to sensory level, maximum motor block, intravenous sedation requirements, time to two-segment regression, and time to full sensory recovery. The group receiving 1.5% lidocaine had significantly shorter times to ambulation (141 +/- 21 min vs 162 +/- 29 min; P < 0.05), voiding (147 +/- 21 min vs 174 +/- 28 min; P < 0.05), full motor recovery (86 +/- 21 min vs 111 +/- 22 min; P < 0.0001), and discharge (170 +/- 38 min vs 201 +/- 41 min; P < 0.05). The use of 1.5% hyperbaric lidocaine for transvaginal oocyte retrieval provides a significantly shorter recovery time when compared to 5% hyperbaric lidocaine and is a good choice for spinal anesthesia for this procedure.
 ...
PMID:Anesthesia for in vitro fertilization: a comparison of 1.5% and 5% spinal lidocaine for ultrasonically guided oocyte retrieval. 836 44


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>