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

Forty-five patients undergoing total abdominal hysterectomy were randomly divided into three groups. An epidural tube was inserted into one of the following three sites, Th11-12, L2-3, and caudal region. General anesthesia was then maintained with nitrous oxide-oxygen-enflurane, and pancuronium bromide. Morphine hydrochloride 2 mg in 8 ml of normal saline was administered into one of the designated epidural spaces one to two hours before the assumed end of surgery. Postoperative pain was assessed every four hours after the end of the operation until the next morning. Morphine exerted a relatively profound and prolonged analgesic effect in 40% of the Th11-12 group of patients, as well as in 6.7% of the L2-3 and caudal groups. But, supplementary analgesics were necessary in the other patients. No significant differences were found in the degree and extension of postoperative pain, as well as the doses of supplementary analgesics among the three groups. Adverse effects, such as nausea, vomiting and itching, occurred in 30 to 40% of each of the morphine administered groups. Though morphine was applied into different spinal levels, this clinical study did not show any difference in extension of analgesia. The epidurally applied morphine may be distributed widely in the spinal arachnoid space after some time, and may exert an effect on the brain as well as on the spinal nerves. When morphine is administered epidurally one to two hours before the end of a surgical operation, selection of an injection site according to the dermatome level of the skin incision may be unnecessary.
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PMID:[Degree and extension of analgesic effect of morphine applied at three different spinal levels of epidural space]. 227 45

Pressure algometry is a method to estimate pressure pain sensitivity in tissues. The aim of the present study was to evaluate the reproducibility of pressure pain thresholds (PPT) in the abdominal integument and to evaluate the use of pressure algometry as a measure of wound tenderness following surgery. PPT was determined in 20 healthy volunteers on two separate examinations, and in 14 patients at the incisional site before and following inguinal herniotomy. In volunteers, PPT was higher for men than for women, and no difference was observed between the first and second day of examination. In surgical patients a significant decrease in PPT was observed following operation. Morphine 0.07 mg/kg caused a slight but significant increase in PPT. Pressure algometry may be useful to study nociceptive mechanisms and the dynamics of wound pain in surgical patients.
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PMID:Pressure pain thresholds in volunteers and herniorrhaphy patients. 227 31

Morphine (8 micrograms/microliter) was injected into the head of the caudate nucleus (CN). The pain-discharges of the pain-excitation neurons (PEN) in the parafascicular nucleus (Pf) were inhibited, ie, decreasing in frequency of pain-discharges and lengthening in latent period of pain-discharges. The inhibitory effect of the pain-inhibition neurons (PIN) in the Pf induced by noxious peripheral stimulation were relieved, ie, increasing the firing rate and shortening the inhibitory duration. The opiate receptor antagonist naloxone (0.75 mg/kg, ip) blocked the above effects of morphine. These results suggest that the intracaudate opioid peptide system play an important role in the modulation of pain information in the Pf of thalamus.
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PMID:Influence of morphine microinjected into head of caudate nucleus on electric activities of nociceptive neurons in parafascicular nucleus of rat thalamus. 227 81

This study determined whether opiates alter vascular components of inflammation (hyperthermia, edema and plasma extravasation) in addition to the suppression of hyperalgesia. Rats were administered carrageenan into one hind paw and saline into the other hind paw, followed by i.p. injection of morphine (0.2-5.0 mg/kg) or saline at 60 min, and testing at 90 min after hind paw injections. Morphine produced a dose-dependent reduction in carrageenan-induced hyperalgesia (17-53%), hyperthermia (39-53%) and edema (24-36%). Morphine treatment did not alter the temperatures of the contralateral saline-injected paws, indicating that opiate suppression of hyperthermia was not confounded by alterations in systemic body temperature or blood flow. The opiate effects on inflammation were stereospecific since levorphanol (1 mg/kg), but not dextrorphan (1 mg/kg), suppressed carrageenan-evoked hyperalgesia, hyperthermia and edema. Pre-treatment with naltrexone (1.5 mg/kg) blocked the effects of a 5 mg/kg dose of morphine sulfate on hyperalgesia, hyperthermia and edema. In a separate study, i.v. injection of morphine sulfate (2 mg/kg) reduced plasma extravasation by 41% (P less than 0.01). Morphine administration resulted in significantly greater increases in paw withdrawal latencies in the inflamed (38-139%) than the contralateral, saline-treated paws (4-19%). The results indicate that opiates exert a moderate, though significant, reduction in the vascular signs of inflammation in addition to their reduction of hyperalgesia. The mechanisms for this vascular effect involve inhibition of both vasodilation (as indicated by a decrease in hyperthermia) and inhibition of vascular permeability. In addition, opiates exhibit enhanced antinociceptive effects in inflamed paws, even when compared to uninjured paws in the same animal.
Pain 1990 Oct
PMID:Opiates suppress carrageenan-induced edema and hyperthermia at doses that inhibit hyperalgesia. 227 20

We report our experience in introducing patient-controlled analgesia at the Royal Hospital for Sick Children, Glasgow. Twenty-five children used the technique after orthopaedic or general surgery using the Graseby system. The pump was loaded with 1 mg/kg morphine sulphate in 50 ml. A bolus dose of 0.02 mg/kg (1 ml) and a lockout interval of 10 minutes were the initial settings. The dose used, pain and sedation scores, respiratory rate and arterial oxygen saturation were recorded. Ages ranged from 5-15 years (mean 9.6) and the method was used for a mean of 48 hours after operation. Morphine requirements averaged 26 (micrograms/kg)/hour (SD 10.6). Pain control was good and sedation minimal. Adverse effects were few and minor. Education of patients, parents and nurses is essential for its success and safety. The technique is an effective and safe means of providing good quality analgesia in school age children.
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PMID:Patient-controlled analgesia in children. 227 35

Sympathetic skin response and plethysomography were used to assess the sympatholytic effect of the stellate ganglion block with morphine and bupivacaine in patients affected by a sympathetic algodystrophy of the upper limb. Morphine did not show any analgesic or sympatholytic effect. The distribution of the sympatholytic effect and the clinical findings of pain relief without somatic sensory-motor impairments obtained with the local anaesthetic, support the presence of a blockade of the sympathetic efferent pathway as well as of an afferent contingent of fibres probably and mainly involved in sympathetic reflexes.
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PMID:Autonomic variations after stellate ganglion block: are they evidence of an autonomic afference? 228 96

We have observed the influences of opioid-like substances in preoptic area (POA) on the electric activities of pain response neurons in parafascicular nucleus of thalamus (Pf). The results were as follows: 1. Morphine 10 micrograms/microliters or 1 micrograms/microliters microinjected into POA could remarkably inhibit the pain discharges of most (20/26, 19/23 respectively) pain excitatory neurons (PEN) in Pf. The frequency of evoked discharges was decreased nd the duration was shortened. After injecting 10 micrograms/microliters morphine, three neurons showed inhibitory responses to noxious stimuli. 2. Morphine of the two doses could shorten the complete inhibitory period of pain inhibitory neurons (PIN, 23/33). These results suggest that the opioid-like substances in POA might have an inhibitory effects on pain response neurons in Pf.
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PMID:[The influences of morphine microinjected into preoptic area on electric activities of pain response neurons in parafascicular nucleus of thalamus in rat]. 229 71

Postoperative pain relief with epidural morphine and buprenorphine was studied in 33 patients following hepatectomy. Morphine 2mg or buprenorphine 0.06mg in 10ml of normal saline was administered through an epidural catheter inserted at the Th10-11 or L3-4 interspace. Morphine injected at the lumbar level, as well as that injected at the thoracic level produced excellent and long-lasting (20.8 +/- 8.6 hours) pain relief. Respiratory rate decreased significantly following epidural morphine at the L3-4, but PaCO2 did not change. Buprenorphine injected at the thoracic level produced good and long-lasting (22.6 +/- 9.9 hours) pain relief, although buprenorphine injected at the lumbar level produced incomplete analgesia. The epidural administration of morphine 2mg at L3-4 or buprenorphine 0.06mg at Th10-11 may be recommended for postoperative analgesia following hepatectomy.
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PMID:[Epidural morphine and buprenorphine for postoperative pain relief after hepatectomy]. 230 47

The aim of the study was to assess the relative morphine-sparing effects of nefopam and diclofenac when used singly or in combination after upper abdominal surgery. Eighty-four patients of ASA grade 1 or 2 were allocated randomly to one of three groups. Group A received nefopam 20 mg by intramuscular injection 6 hourly after surgery for the 24-hour study period. Group B received diclofenac 75 mg 12-hourly and placebo injections at 6 and 18 hours after surgery. Group C received both 6-hourly nefopam and 12-hourly diclofenac. Supplemental analgesia was given on demand via a patient-controlled analgesia system which delivered intravenous morphine. Morphine requirements in the diclofenac group were significantly lower than in either of the other groups (p less than 0.01). Patients who received the combination of nefopam and diclofenac required significantly less morphine than those who received nefopam alone (p less than 0.01). Pain scores assessed 6 hours after surgery were significantly lower in the diclofenac and combination groups compared with the nefopam group (p less than 0.01).
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PMID:Postoperative nefopam and diclofenac. Evaluation of their morphine-sparing effect after upper abdominal surgery. 233 15

Morphine sulphate was used for the control of pain following major abdominal surgery for a period of three days either as patient-controlled or continuous infusion. The two groups of patients were comparable with regard to patient and operation details, duration of infusion, pain scores and complications. The only significant difference was a reduced dose requirement of morphine in the patient-controlled analgesia group (P less than 0.005). Some possible explanations for this finding are given. It is suggested that a properly supervised continuous infusion of morphine is as good as patient-controlled administration. There was a negative correlation between the age of the patient and the dose of morphine used.
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PMID:Comparison of two methods of intravenous administration of morphine for postoperative pain relief. 226 47


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