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

The potential benefits of a nonsteroidal antiinflammatory drug to 67 patients undergoing knee arthroscopy were evaluated in a prospective, randomized, placebo-controlled, double-blinded study. Group A received the drug (diclofenac, 75 mg twice daily) for 3 to 5 days before and for 7 days after surgery. Group B received a placebo preoperatively and the drug postoperatively. Group C received a placebo at both times. Codeine was available postoperatively for all patients if needed. Outcomes reported by the subjects included pain, crutch use, and return to activities. Outcomes assessed by physicians included knee effusion, range of motion, and gait. Knee flexion and extension strengths were measured isokinetically pre- and postoperatively. Pain scores on the 1st postoperative day were higher in Group C than in Group A. Pain scores at all other time points were not significantly different in the three treatment groups. Groups A and B required less codeine during the first 72 hours after surgery than Group C (mean, 2.9 +/- 1.0 versus 6.8 +/- 1.0 pills). Recovery of function, recovery of strength, and physical examination parameters were not significantly different in the three treatment groups. Diclofenac was an effective analgesic in the immediate postoperative period. Recovery from arthroscopy, however, was not enhanced by taking the drug.
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PMID:An evaluation of pre- and postoperative nonsteroidal antiinflammatory drugs in patients undergoing knee arthroscopy. A prospective, randomized, double-blinded study. 836 10

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

The aim of the present study was to assess the efficacy and tolerability of single oral doses of 50 mg and 100 mg of diclofenac-K compared to placebo in migraine sufferers during three attacks. The study was conducted in a double-blind, randomized, placebo-controlled, three-period, within-patient comparative trial; 72 migraine patients were treated with diclofenac-K (50 mg or 100 mg) or placebo at six centres (1 in Sweden and 5 in Finland). The primary efficacy end-point was the change in pain intensity assessed on a 100 mm Visual Analogue Scale (VAS) at 120 min after taking the study medication. We found that 50 mg and 100 mg of diclofenac-K reduced the pain intensity significantly better than placebo (p = 0.003 and p = 0.001, respectively), without difference between the doses; 100 mg diclofenac-K was significantly better than placebo in improving phonophobia, photophobia, working ability and need for rescue medication. Diclofenac-K 50 mg or 100 mg is an effective and well-tolerated acute treatment for migraine headache and its associated symptoms. The higher dose of diclofenac-K was only marginally more effective than the lower dose.
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PMID:Diclofenac-K (50 and 100 mg) and placebo in the acute treatment of migraine. 849 53

Post-laparoscopy pain can increase recovery time and delay patient discharge. While previous studies have focused on the problems of nausea and vomiting, the purpose of this study was to assess the effect of diclofenac (a non-steroidal antiinflammatory drug) in the treatment of post-laparoscopy pain. Diclofenac (50 mg) or placebo was administered pr randomly and double-blind, prior to induction of anaesthesia, to 46 women. Pain intensity was assessed by the patient using a visual analogue scale 1, 12 and 24 hr after surgery. Postoperative analgesic requirements and side effects were also studied. Diclofenac resulted in better pain relief at 24 hr (1.0 vs 2.5, P < 0.05) and reduced the number of patients who needed additional postoperative analgesics (7 vs 15, P < 0.05). There was no difference in the incidence of side effects. These data suggest that diclofenac reduces post-laparoscopy pain and postoperative analgesic requirements.
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PMID:Preoperative diclofenac sodium reduces post-laparoscopy pain. 851 18

In a randomized, double-blind, placebo-controlled study designed to assess the post-operative analgesic efficacy and cost-effectiveness of ketorolac and diclofenac 60 ASA I and II patients undergoing laparoscopic cholecystectomy were studied. Prior to concluding the operative procedure, an injection (i.m.) of an equal volume of either saline 3 mL, ketorolac 60 mg, or diclofenac 75 mg was administered. All patients received intravenous morphine via a patient-controlled analgesia device (PCA). Post-operative pain intensity was assessed hourly for 4 h, by recording visual analogue score (VAS) for pain, PCA demands and actual morphine administered. PCA demands (mean +/- SD) were greater in the saline treatment group (115 +/- 90) when compared with both the ketorolac (42 +/- 44) and diclofenac groups (74 +/- 77). Furthermore, the saline treatment group received significantly (P < 0.05) more PCA morphine compared with both the ketorolac and diclofenac groups (12.2 mg +/- 5.0 vs. 8.6 mg +/- 5.2 vs. 8.9 mg +/- 4.8). Improved pain scores were demonstrated in both the ketorolac and diclofenac groups compared with the saline group. PCA demands and post-operative morphine requirements were similar in the ketorolac and diclofenac groups. Diclofenac has the added advantage, in our institution, of being 60% less expensive than ketorolac. We conclude that both ketorolac and diclofenac are effective post-operative analgesic drugs. However, economic considerations may favour diclofenac administration.
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PMID:A comparative study of ketorolac and diclofenac on post-laparoscopic cholecystectomy pain. 854 59

This is a prospective randomized double-blind trial conducted to determine whether preoperative orally administered clonidine causes or potentiates postoperative vomiting in 140 children (3-12 yr) undergoing strabismus surgery. They were all inpatients and classified randomly into four groups (n = 35 each); placebo (control), diazepam 0.4 mg.kg-1, clonidine 2 micrograms.kg-1, and clonidine 4 micrograms.kg-1. These agents were administered 93-112 min (mean; 100 min) before the anticipated time of induction of anaesthesia. All children received inhalational anaesthesia with halothane and nitrous oxide in oxygen. Muscle relaxation in all patients was obtained with vecuronium and residual neuromuscular blockade was antagonized with neostigmine and atropine before tracheal extubation. Diclofenac suppository was prescribed to prevent postoperative pain. No opioids or postoperative antiemetics were administered. All children remained in hospital for two days postoperatively. The incidence and frequency of vomiting were compared in the groups with Kruskall-Wallis Rank test. Clonidine 4 micrograms.kg-1 caused a lower incidence and frequency of vomiting than did placebo and diazepam (incidence and frequency: 11% and 1.37% and 3, and 34% and 2 in clonidine 4 micrograms.kg-1, placebo, and diazepam, respectively; P < 0.05 for clonidine 4 micrograms.kg-1 vs placebo and diazepam). However, low-dose clonidine was ineffective. These data suggest that preanaesthetic medication with clonidine 4 micrograms.kg-1 may be useful for preventing emesis following strabismus surgery. This property of clonidine indicates that it may be superior to other sedative premedicants such as diazepam and midazolam.
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PMID:Oral clonidine premedication reduces vomiting in children after strabismus surgery. 859 May 7

The purpose of this study is to determine the effect of postoperative analgesia on the amount of breast feeding and infant weight gain. Thirty parturients undergoing elective cesarean section under spinal anesthesia were randomly allocated to receive postoperative pain management with (S-E group, n = 15) or without epidural bupivacaine (S group, n = 15). Epidural analgesia was performed for 3 days with a continuous epidural infusion (0.7 mL/h) of 0.25% bupivacaine. Diclofenac was available on demand in all patients. The weight of milk fed by breast and the infant weight were measured for 11 days after cesarean section. In the S-E group, the visual analog pain score after surgery was significantly lower and both the weight of milk fed by breast and the infant weight during the study were significantly more than the respective values in the S group. The S group required a larger dose of diclofenac after the operation than did the S-E group. We suggest that satisfactory postoperative pain relief with continuous epidural bupivacaine for 3 days after cesarean section improved the amount of breast feeding and the gain of infant weight.
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PMID:The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. 863 85

Paravertebral analgesia is highly effective in blocking unilateral afferent input from the trunk, but its bilateral use does not appear to have been described. Eight patients undergoing major abdominal vascular surgery had pre-operative bilateral paravertebral catheters inserted. A dose of 25 ml of bupivacaine 0.5% divided between the two catheters provided the basis of an effective intra-operative analgesic regimen which was continued postoperatively by infusion of bupivacaine for 4 days. Diclofenac and morphine completed a balanced analgesic regimen which was started pre-operatively and continued for 5 and 3 days respectively. Cardiovascular stability was notable throughout surgery, even with aortic clamping and all patients were extubated at the end of surgery. Good quality analgesia was obtained as assessed by low postoperative pain scores at rest and on movement. Three patients were not admitted to the intensive care unit, where mean stays for the group was 10 h (range 0-24 h) and mean hospital stay was 10 days (range 7-14). There were no additional demands made on the nursing staff and no postoperative pain-related complications occurred. We conclude that bilateral paravertebral analgesia, as part of a balanced analgesic technique, is an alternative method of providing effective afferent blockage for major abdominal surgery.
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PMID:Bilateral paravertebral analgesia for major abdominal vascular surgery: a preliminary report. 867 63

A Case of drug-induced immune hemolytic anemia during alpha-interferon (alpha-IFN) therapy for renal cell carcinoma is reported. A 61-year-old woman was admitted to Tochigi cancer center for the treatment of left renal cell carcinoma. She underwent left radical nephrectomy. From 7th post operative day, alpha-IFN (6 x 10(6) IU) was administered every other day. Diclofenac and indomethacin were administered for pain and high fever induced by alpha-IFN. Hemoglobinuria was first noted on 20th post operative day. Immune hemolytic anemia was suspected by blood examinations including Coombs' test, serum haptoglobin, serum LDH and serum GOT. alpha-IFN therapy and administration of diclofenac and indomethacin were discontinued and prednisolone therapy (50 mg daily) was begun. Hemoglobinuria disappeared by 5 days and laboratory data became in normal range by 3 weeks. Drug-induced immune hemolytic anemia was diagnosed by the process of laboratory data, especially of direct Coombs' test. Though drug-induced immune hemolytic anemia is a rare adverse side effect during alpha-INF therapy for renal cell carcinoma, it seemed an important complication.
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PMID:[A case of drug-induced immune hemolytic anemia during alpha-interferon therapy for renal cell carcinoma]. 870 50

Clinical efficacy of the antiphlogistic potency of enzymes (Wobenzym, 4 x 7 capsules/day) vs. Diclofenac-Na (2 x 50 mg capsules/day) on patients (n = 80) suffering from osteoarthritis of the knee in an acute phase was evaluated. The study design was double blind according to the GCP-guidelines. The treatment period lasted 28 days and was followed by a treatment-free controll-period of another 28 days. There was equal status of age, sex, duration and impact of osteoarthritis in both groups. The clinical parameters as pain at rest, on motion, on walking, at night and pain tenderness showed a significant improvement (p < 0.05) after the treatment period, with tendency to relapse in the following observation period. No significant difference between both treatment-groups could be seen. No changes in laboratory findings were observed. The global-assessment (physician's and patient's score) of efficacy and tolerability in both groups were mostly stated as "very good" and "good". Adverse events were reported as: Wobenzym: total 14 patients: gastrointestinal complaints (obstipation, vomiting, meteorism), allergic rash once and dizziness twice, 6 of these patients discontinued by that reasons. Diclofenac: total 11 patients: gastrointestinal complaints (epigastrical pain, upset stomach, meteorism), dizziness, 3 of these discontinued. All of these vanished after intake was stopped. Summarizing up it could be demonstrated that both evaluated drugs showed equal clinical potency. So it might be assumed that Wobenzym can be used as an alternative substance in treatment of acute painful osteoarthritis.
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PMID:[Drug therapy of activated arthrosis. On the effectiveness of an enzyme mixture versus diclofenac]. 886 74


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