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

Double-blind clinical trials involving the use of phenothiazines as analgesics or potentiators of analgesics (aspirin, meperidine, morphine sulfate) and adverse effects of phenothiazines are reviewed and evaluated. Promethazine, promazine and propiomazine were not found to possess analgesic or potentiating properties. One chlorpromazine study contained important design and reporting deficiencies which precluded a recommendation for use of chlorpromazine in the treatment of pain. Methotrimeprazine was determined by numerous authors to have analgesic properties; however, most of the studies also were deficient in design or data presented, or both. Adverse reactions to phenothiazines, including hypotension, sedation, drowsiness, extrapyramidal symptoms, tardive dyskinesia, cardiac toxicity and agranulocytosis, are often more common and severe than those attributed to narcotic analgesics. Because of the lack of data supportive of analgesic activity and the adverse reactions associated with phenothiazines, use of these agents in the management of pain should be discouraged. The prophylactic use of phenothiazine for narcotic analgesic-induced emesis also is, in most cases, a questionable practice.
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PMID:Phenothiazine analgesia--fact or fantasy? 3 54

The separate and combined analgesic effects of 10 mg of oral amphetamine sulfate and 25 mg of oral anileridine dihydrochloride were studied in 24 healthy, adult, male volunteers. Tolerance of progressively increasing pain produced by the Submaximum Effort Tourniquet Technique was tested four times in each subject: after amphetamine, after anileridine, after the combination, and after a matching placebo. Treatments were administered double blind and in counterbalanced order. Elapsed time to report of slight, moderately distressing, very distressing, and unbearable pain was recorded on each trial. The four oral treatments differed significantly for very distressing and for unbearable pain. At each of the three upper pain levels, the mean tolerance times for anileridine and amphetamine were similar; each was longer than placebo but shorter than the combination; and the effect of the combination was approximately the sum of the effects of the two components.
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PMID:Toward the development of a potent, nonsedating, oral analgesic. 10 42

The results of this study in postoperative patients have, thus far, revealed little that was not expected from a review of the literature. Heroin hydrochloride appears to be about two to three times more potent than morphine sulfate as an analgesic, to act more promptly and to have a slightly shorter duration of action. There is a suggestion that heroin may have a somewhat different spectrum of side effects and mood effects compared to morphine, but the effects of both drugs on mood were inversely correlated with the patients' feelings at the time of drug administration. Regardless, as a group, patients responded to both drugs with significantly improved moods. A lag time between the peak intensity of analgesic and mood effects of both heroin and morphine suggest a dissociation between these effects. Whether or not these early impressions will be reinforced as this study proceeds, and whether or not the effects of the drugs in patients with chronic pain due to advanced cancer will be any different than in these patients with postoperative pain, remains to be seen.
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PMID:Relative analgesic potency of intramuscular heroin and morphine in cancer patients with postoperative pain: a preliminary report. 12 41

The pharmacokinetics and the hormonal, analgesic, and behavioral effects of several doses of human beta-endorphin were evaluated after intravenous administration to three patients and intracerebroventricular administration to one patient with pain caused by cancer. These effects were compared to the hormonal effects of intravenously administered morphine sulfate in two patients and an enkephalin analog in two baboons. The mean terminal half-life after intravenous administration of 5 or 10 mg of human beta-endorphin to three patients was 37 min; the mean volume of distribution was 178 ml/kg, and the metabolic clearance rate was 3.2 (ml/min)/kg. The half-life of beta-endorphin in cerebrospinal fluid after intracerebroventricular administration was 93 min, and the volume of distribution was 0.74 ml/kg. A rapid rise in plasma prolactin followed both intravenous and intracerebroventricular beta-endorphin. Intravenous administration did not affect plasma growth hormone, but intracerebroventricular administration suppressed plasma growth hormone. No significant change in plasma growth hormone was noted after intravenous administration of morphine to humans, but plasma growth hormone decreased in one baboon after administration of the enkephalin analog. beta-Endorphin-stimulated release of prolactin occurred at doses lower than those required to produce analgesic and other behavioral effects. When both hormonal and analgesic effects were observed (after 7.5 mg were given intracerebroventricularly), the onset of the hormonal response slightly preceded the analgesic and behavioral responses. These studies suggest that the hormonal effects of beta-endorphin are species dependent and are similar to those of morphine. Hormonal and analgesic effects of beta-endorphin appear to result from the activation of opiate receptors that differ in their locations and characteristics.
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PMID:beta-Endorphin: analgesic and hormonal effects in humans. 29 54

In a double-blind, single-dose study, dextroamphetamine combined with morphine was compared with morphine alone to determine the relative efficacy of the combination given intramuscularly for postoperative pain. Each of 450 patients received one treatment of morphine sulfate (3, 6 or 12 mg) with dextroamphetamine (0, 5 or 10 mg). Analgesia, as measured by the patients' subjective responses to questions about relief of pain, was augmented when dextroamphetamine was given with morphine; the combination of dextroamphetamine, 10 mg, with morphine was twice as potent as morphine alone, and the combination with 5 mg was 1 1/2 times as potent as morphine. In simple performance tests, and in measures of side effects, dextroamphetamine generally offset undesirable effects of morphine (sedation and loss of alertness) while increasing analgesia. Effects on blood pressure, pulse and respiratory rate were minimal.
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PMID:Dextroamphetamine with morphine for the treatment of postoperative pain. 32 Apr 78

In a double-blind control study, oral doses of placebo, propoxyphene napsylate (50 or 100 mg), or codeine sulfate (30 or 60 mg) were administered to 46 postepisiotomy patients, grouped by severity of pain reported at first-dose drug administration. Eight hourly observations by a trained observer provided estimates of analgesia. The analgesia scores for placebo treatments were significantly lower than for the lesser doses of either drug (P less than .05) as well as for the greater doses (P less than .01). At both dose levels, the analgesia scores for both drugs were almost identical. Analgesia with the higher doses was greater than with the lower, but not to a statistically significant extent. The difference in patient responses increased following the second dose. No serious adverse reactions occurred; the elicited and volunteered reports of minor side effects were similar for all five treatments.
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PMID:Codeine and propoxyphene in postepisiotomy pain. A two-dose evaluation. 32 38

In a double-blind, 5-way crossover designed study, single doses of placebo, 2 doses of codeine sulfate (60 and 120 mg), and 2 doses of benzopyranoperidine (2 and 4 mg) were administered orally to 35 patients who required analgesics for chronic pain due to malignancies. Benzopyranopyridine is an analogue of delta-9-tetrahydrocannabinol and was chosen on the basis of its sedative, hypnotic, and analgesic properties in animals. Pain relief scores indicated a degree of relief of clinical significance with 120 mg of codeine but no consistent difference between placebo and any other active agent. On the basis of the data, bezopyranoperidine (2 or 4 mg) is not as effective as codeine (120 mg or 60 mg) and not more effective than placebo in relieving pain due to cancer; indeed, pain perception appeared to be augmented by both doses.
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PMID:Effect of benzopyranoperidine, a delta-9-THC congener, on pain. 35 40

Previous studies have suggested that in rats probing against the vaginal cervix with a glass of is analgesic, for this stimulus elevates the threshold for eliciting vocalization in response to tail shock. In the present studies pretreatment with naloxone HCl (1 or 10 mg/kg), a potent narcotic antagonist did not antagonize this vaginal stimulation-induced analgesia. Furthermore, vaginal stimulation was found to exert its analgesic effect even in rats made tolerant to, and dependent upon, morphine sulfate. These results suggest that the analgesic effect of vaginal stimulation is not necessarily mediated by an opiate-sensitive neural system. However, we hypothesize that even though vaginal stimulation and other analgesic manipulations may act via different neural substrates, they may nevertheless converge onto a final common mechanism for pain suppression.
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PMID:Analgesia induced by vaginal stimulation in rats is apparently independent of a morphine-sensitive process. 41 36

Severe hip pain developed in a patient who was receiving anticoagulation therapy of heparin sodium and warfarin sodium (Coumadin) for femoral vein phlebitis. The patient had exquisite tenderness but no ecchymoses along the sciatic nerve. A drop in the hemoglobin level showed a large volume loss of blood. Retroperitoneal hematoma with lumbar plexopathy was suspected, but a computerized tomographic scan revealed instead hemorrhage into the gluteal muscles. The anticoagulation therapy was corrected with the addition of protamine sulfate and vitamin K; the patient's pain lessened and the hemoglobin level stabilized. Computerized tomography allowed clear visualization of the hematomas in the buttock, and invasive studies were avoided. Hip pain and a falling hemoglobin level in a patient receiving anticoagulation therapy should alert one to the possibility of bleeding into the retroperitoneal space, thigh, or buttock.
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PMID:Sciatic nerve compression during anticoagulation therapy. Computerized tomography aids in diagnosis. 45 53

Several animal irritancy test methods whose criteria include sensory response, pain/discomfort or tissue damage were evaluated as to their ability to assess relative irritancy potential of the following surfactants: sodium lauryl polyether (12) sulfate (SLES), Miranol C2M (MC2M), Miranol MHT (MMHT), sodium coco methyl tauride (SCMT), triethanolamine lauryl sulfate (TEALS), ammonium lauryl sulfate (ALS) and sodium lauryl sulfate (SLS). Data from the mouse upper respiratory tract and mouse writhing tests indicated that SLES, MC2M and MMHT were the least irritating and SLS, ALS and TEALS were the most irritating. The blepharospasm test did not lend itself to this type of evaluation because sequential instillation of the surfactants produced eye anesthesia. Data from the Draize eye test indicated that SLES was the least irritating while MC2M was slightly more irritating. All other surfactants were equally irritating. The Draize skin test results showed that SLES again was the least irritating at all concentrations tested and that SLS and ALS along with TEALS and SCMT were the most irritating.
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PMID:The determination of the irritancy potential of surfactants using various methods of assessment. 75 72


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