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)

This study investigated the opioid-sparing effect of diclofenac using patient-controlled analgesia with oral methadone. Fifteen patients with advanced cancer participated. After achieving adequate analgesia with regular dosing of oral methadone (T1), patient-controlled analgesia with methadone was administered for 3 days (T2). Intramuscular diclofenac 75 mg twice daily was then added to this regimen for 3 days (T3). Compared to T2 values, methadone dose was significantly reduced at T2 and T2, and pain report (recorded on a visual analogue scale) was significantly reduced at T3. A reduction in methadone plasma concentration was also observed at T2 and T3, although it did not attain statistical significance. Significant decreases in the intensity of several symptoms other than pain were also found at T2 and T3. Diclofenac appears to have a relevant opioid-sparing effect when using patient-controlled analgesia with oral methadone.
J Pain Symptom Manage 1997 Jul
PMID:Opioid-sparing effect of diclofenac in cancer pain. 922 38

Diclofenac is a non-steroidal anti-inflammatory drug available in an ophthalmic preparation. We present a prospective randomised double-masked placebo-controlled trial involving 40 patients that assessed the effectiveness of topical diclofenac in relieving pain from traumatic corneal abrasions. Statistical analysis of visual analogue and categorical pain scores revealed a significant reduction in pain experienced by subjects in the diclofenac group (p < 0.02).
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PMID:The effectiveness of topical diclofenac in relieving discomfort following traumatic corneal abrasions. 924 81

The relationship between the pharmacokinetics and the antinociceptive effect of diclofenac was evaluated using the pain-induced functional impairment model in the rat. Male Wistar rats were injected with uric acid in the knee joint of the right hind limb, which induced its dysfunction. Once the dysfunction was complete, animals received a p.o. dose of 0.56, 1, 1.8, 3.2, 5.6 or 10 mg/kg of sodium diclofenac, and the antinociceptive effect and drug blood concentration were simultaneously evaluated at selected times for a period of 6 h. Diclofenac produced a dose-dependent antinociceptive effect, measured as a recovery of the functionality of the injured limb. However, the onset of the antinociceptive effect was delayed with respect to blood concentrations. Moreover, the effect lasted longer than expected from pharmacokinetic data. Therefore, when functionality index was plotted against diclofenac blood concentration, an anticlockwise hysteresis loop was observed for all doses. Hysteresis collapse was achieved using the effect-compartment model, and the plot of functionality index against diclofenac concentration in the effect-compartment data was well fitted by the sigmoidal Emax model. Our data suggest slow equilibrium kinetics between diclofenac concentration in blood and at its site of action, which leads to a delayed onset of the antinociceptive effect as well as a longer duration of the response resulting from drug accumulation in synovial fluid.
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PMID:Pharmacokinetic-pharmacodynamic modeling of the antinociceptive effect of diclofenac in the rat. 926 31

Efficacy of diclofenac in pain relief after hip alloplasty was investigated in 35 patients aged 61-73 (mean 66). We compared "diclofenac group" to similar group of patients treated with i.m. morphine Complications and side effects of both therapies have been analyzed. Diclofenac therapy decreased opioids demand thus reduced its side effects. Patient's comfort has been improved also at non-operated sites.
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PMID:[Diclofenac for treatment of postoperative pain after hip arthroplasty in older patients]. 949 Feb 56

The postoperative pain and stress experienced by tonsillectomy patients are often underestimated. For this reason traditional methods of analgesia are frequently used but with an ineffective result. Our study involved an analysis of pain sensation with regard to postoperative analgesia after adult tonsillectomies. In all, 150 patients following tonsillectomy were treated with different methods of analgesia, which included Diclofenac monotherapy and combined treatment with Tramadol-retard and Naproxen. Postoperative sensations of pain were realized in a visual analogous pain score, with consideration given to individual experiences of subjective pain. In addition, circulatory and hemopoiesis parameters were controlled. Results showed that the postoperative analgesic effect of Diclofenac was significantly less than that of Tramadol-retard and Naproxen. Diclofenac monotherapy after tonsillectomy was only sufficient in cases involving an individual's low pain sensation. In cases with moderate or stronger pain the tonsillectomy patient requires an effective postoperative analgesia, as achieved with combined therapy using Tramadol retard and Naproxen. Aggravating side effects were not found in both schemes of analgesia.
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PMID:[Pain therapy after tonsillectomy in adults]. 953 56

The analgesic efficacy and tolerability of diclofenac-potassium 50 mg were compared with those of glafenine 200 mg in 109 outpatients suffering from moderate to severe dental pain. Throughout the four-day trial period, patients (Diclofenac-potassium: n = 58, mean age = 32.84 +/- 12.0 yrs. Glafenine n = 51, mean age = 34.12 +/- 14.0 yrs.) were randomised, in a double-blind fashion, to receive one tablet of either medications three times daily, together with an antibiotic, ampicillin, 500 mg, 8 hourly. Half an hour following the administration of the first analgesic dose, both treatment groups showed highly statistically significant (P < 0.001) reductions in the mean pain level when compared with their baseline values. The mean decrease of pain level in diclofenac-potassium group after 1/2 hour was significantly (P < 0.01) greater than that in the glafenine group. Moreover, the percent of pain free patients after 1/2 hour in the diclofenac-potassium group was significantly higher (P = 0.05) compared with those in the glafenine group. The mean decreases in pain and tenderness on the second and fourth days, in relation to their initial values, were greater in the diclofenac-potassium treated patients than the glafenine treated ones. The overall evaluation of therapeutic effect was considered excellent in 72% of the diclofenac- potassium patients compared with 57% of the glafenine patients. Furthermore, 95% of the diclofenac-potassium patients, compared with 90% of the glafenine ones, expressed their willingness to use the trial medication again in similar conditions. None of the patients in both treatment groups discontinued the trial due to unwanted effects. Both therapies were well tolerated. Only one patient (1.72%) in the diclofenac-potassium treatment group experienced slight diarrhoea. It can be concluded from this study that both medications are effective and well tolerated in the management of dental pain. However, diclofenac-potassium with its fast onset of effect is particularly suitable in the management of acute painful conditions.
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PMID:Diclofenac potassium in the management of dental pain: a multicenter double-blind comparison with glafenine. 959 Sep 71

We evaluated the efficacy and safety of 0.1% indomethacin and 0.1% diclofenac solutions, in controlling pain post excimer laser photorefractive keratectomy (PRK). After written consent, 61 informed patients (23 males, 38 females; mean age = 33.5 +/- 8.4 yrs) were enrolled in a double-masked, randomized, comparative study and assigned to either indomethacin or diclofenac treatment. Subjective preoperative evaluation of individual susceptibility to pain evoked by topical application of 1% tetracaine vs saline served as reference for further post-operative pain measurement using a visual analog rating scale. Ocular and cephalic pain, itching, foreign body sensation, insomnia, photophobia, blepharospasm as well as systemic analgesic medication and alcohol intake were monitored for 3 days following photoablation as well as the re-epithelialization process. Both solutions significantly reduced pain on the first day following excimer laser PRK, and this activity was maintained until the end of the observation period. At Day 0 the first measure of pain level was slightly higher in the indomethacin group (p < 0.05) and could be related to a possible anaesthetic effect of Diclofenac. During the follow-up the oral intake of analgesics was higher in the diclofenac group, however this difference was not significant. Wound healing rate was not affected by indomethacin or diclofenac administration. These data suggest that both 0.1% indomethacin and 0.1% diclofenac ophthalmic solutions may help to control the pain induced by excimer laser PRK without any deleterious effect on corneal wound healing.
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PMID:Comparative study of two non-steroidal anti-inflammatory eyedrops, 0.1% indomethacin versus 0.1% diclofenac in pain control post photorefractive keratectomy. 974 9

Diclofenac (a non-steroidal anti-inflammatory drug) and pethidine (a synthetic opiate) are the two analgesics most commonly used to relieve the pain of ureteric colic. Fast frame renography is a non-invasive means of imaging ureteric peristalsis and renal drainage. The aim of this study was to determine the effects of each of these drugs on the drainage pattern of the upper tracts. Twelve normal male volunteers were studied. All underwent a standard fast frame renogram using 75 MBq of technetium-99m-mercaptoacetyltriglycine, and were then administered either 100 mg pethidine or 75 mg diclofenac by intramuscular injection. Fast frame renography was then repeated. Peristalsis was determined from the condensed image of each ureter and the renogram curves were analysed to obtain standard parameters and deconvolution analysis. Diclofenac caused a profound disruption to both ureteric peristalsis and the renogram curve. This effect was not seen after the administration of pethidine. Deconvolution analysis suggests the effects of diclofenac are mediated via a direct effect on drainage rather than by any alteration of blood flow to the kidney. This study suggests that pethidine is the analgesic of choice prior to renography and that inferences about alterations of drainage in the presence of diclofenac should be interpreted with care.
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PMID:The effect of diclofenac (voltarol) and pethidine on ureteric peristalsis and the isotope renogram. 979 48

The aim was to evaluate the effect of diclofenac on uterine artery blood flow resistance during the first day of menstruation. A total of 28 regularly menstruating women were examined longitudinally with and without a copper intrauterine contraceptive device (IUD) by transvaginal colour Doppler ultrasonography. The uterine artery pulsatility index (PI) was first measured, after which 50 mg of diclofenac was infused i.v. After 15 min the PI was measured again. The patients evaluated their menstrual pain with a scoring system before and after the diclofenac infusion. The mean PI (SD) during menstruation was significantly lower with the IUD [2.13 (0.43)] than without [2.39 (0.62)], P = 0.05. The mean PI in nine patients who experienced advanced menstrual pain was also lower in the presence of the IUD [2.16 (0.42)] than without it [2.83 (0.78); P < 0.05]. Diclofenac was effective in revealing menstrual pain both with and without the IUD, and reduced the PI in the absence of an IUD [pre-treatment 2.39 (0.62) versus post-treatment 2.12 (0.45); P < 0.001], but had no effect when the IUD was present [pre-treatment 2.13 (0.43) versus post-treatment 2.10 (0.41)]. The results indicate that by inhibiting prostaglandin synthesis one can reduce the resistance to blood flow in the uterine arteries during menstruation. This does not hold true when an IUD is present, however, suggesting that the device might induce the production of vasoactive agents other than prostaglandins in the surrounding tissue.
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PMID:The effect of diclofenac on uterine artery blood flow resistance during menstruation in patients with and without a copper intrauterine device. 980 71

We studied intensity of pain, cumulative morphine consumption, ventilatory and renal function, and haemostasis in patients undergoing video-assisted thoracoscopic surgery and receiving a 2-day i.v. infusion of diclofenac, ketorolac or saline. Plasma concentrations of the two NSAID were also measured. The study was randomized, double-blind and placebo-controlled, with 10 patients in each group. Patients experienced mainly moderate pain. Mean consumption of i.v. morphine during the first day after operation was 57 (SEM 11) mg in the placebo group. Diclofenac and ketorolac were equally effective in reducing total morphine consumption (61% and 52%, respectively). Adverse events were similar and minor. Greater variability in plasma concentrations of ketorolac were detected compared with diclofenac.
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PMID:I.v. diclofenac and ketorolac for pain after thoracoscopic surgery. 1036 98


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