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)

Moderate levels of dioctyl phthalate, hydrogen chloride and carbon monoxide are features of ambient air in production of linoleum, polyvinylchloride decorative filv and in other modern plastic materials production shops. The workers were diagnosed as having latent signs of neurotoxicity--vegetative dysfunction with prevalent parasympathetic tone and inactive polyneuropathy shown by electroneuromyography (higher thresholds of pain sensation and muscular excitability, altered morphology of motor response, trend to longer final latency.
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PMID:[State of the nervous system in workers engaged in the production of plastic materials: data of screening and electrophysiologic studies]. 919 Feb 68

Local anesthetic drugs with prolonged nerve-block effect would have clinical application for postoperative or neuromatous pain relief. This study evaluated the possibility of peripheral nerve neurotoxicity by injection of 10 percent ammonium sulfate. Both intrafascicular and extrafascicular injection of 10 percent ammonium sulfate were tested in the rat sciatic nerve model. One percent lidocaine HCl, 5 percent phenol, and normal saline were similarly injected for comparison. Using histologic studies and motor function evaluation with walking-track analysis, 10 percent ammonium sulfate was found to be neurotoxic when it is injected intrafascicularly; however, extrafascicular injection of this drug did not cause significant nerve injury. The neurotoxicity of the 10 percent ammonium sulfate solution was intermediate between the neurotoxicity of 0.1 percent lidocaine hydrochloride and the marked neurotoxicity of 5 percent phenol solution.
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PMID:The effect of ammonium sulfate injection on peripheral nerve. 927

This study evaluates the use of local anaesthesia in a subset of patients undergoing uterine thermal balloon endometrial ablation for the treatment of menorrhagia. Out of 51 patients with dysfunctional uterine bleeding, 18 were included for uterine balloon therapy under local anaesthesia. Inclusion criteria were dysfunctional bleeding with absence of organic lesions in the uterine cavity, adequate relaxation and pain control during physical examination and diagnostic hysteroscopy, and patient desire to avoid a general anaesthetic. Paracervical block was performed with 20 ml of dilute 1% lignocaine HCl with epinephrine 1:200,000. Success of the procedure was defined as amenorrhoea, hypomenorrhoea, or eumenorrhoea. The median follow-up period was 13.9 +/- 5 months and 11 patients (61%) had follow-up of >1 year. Treatment led to a significant decrease in menstrual flow, duration, and pad count in all patients (P < 0.0001). No intra-operative complications occurred. A pain scale (level 1-10) was used to evaluate the patients' tolerance of the procedure (mean 3.8 +/- 1.3). In light of these successful and well tolerated procedures, thermal balloon endometrial ablation, utilizing local anaesthesia, appears practical as an office-based therapy.
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PMID:Uterine thermal balloon therapy under local anaesthesia for the treatment of menorrhagia: a pilot study. 943 96

The amygdala, periaqueductal gray (PAG), and rostral ventromedial medulla (RVM) are critical for the expression of some forms of stress-related changes in pain sensitivity. In barbiturate anesthetized rats, microinjection of agonists for the mu opioid receptor into the amygdala results in inhibition of the tail flick (TF) reflex evoked by radiant heat. We tested the idea that TF inhibition following opioid stimulation of the amygdala is expressed through a serial circuit which includes the PAG and RVM. Rats were anesthetized and prepared for microinjection of DAMGO (0.5 microg/0.25 microl) into the basolateral amygdala (BLA) and lidocaine HCl (2.5%/0.4-0.5 microl) into either the ventrolateral PAG or RVM. Lidocaine did not significantly alter baseline values for TF latency or TF amplitude. When injected into the PAG prior to DAMGO application in the BLA, lidocaine significantly attenuated DAMGO-induced antinociception for the entire 40 min testing session. Similar treatment in the RVM also resulted in an attenuation of antinociception although rats showed significant recovery of TF inhibition by 40 min after lidocaine injection. Since acute injection of lidocaine into the RVM also affected baseline heart rate, separate animals were prepared with small electrolytic lesions placed in the RVM. Chronic RVM lesions also blocked TF inhibition produced by amygdala stimulation but did not affect heart rate. These results, when taken together with similar findings in awake behaving animals, suggest that a neural circuit which includes the amygdala, PAG, and RVM is responsible for the expression of several forms of hypoalgesia in the rat.
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PMID:Antinociception following opioid stimulation of the basolateral amygdala is expressed through the periaqueductal gray and rostral ventromedial medulla. 947 12

Epidural administration of drugs is becoming more common in the treatment of severe forms of pain. To improve present therapies, a long-acting single-dose gel injection would be beneficial. The present study investigated the use of three different polymers as additives in injectable poloxamer gel in controlling the drug release. The release of lidocaine.HCl and ibuprofen.NA from 25% poloxamer (PO) gel and poloxamer gel with hydroxypropylmethylcellulose (HPMC), sodium carboxymethylcellulose (CMC), or dextran (DE) was studied in vitro. Cellulose additives significantly prolonged ibuprofen release, whereas additives were found to have a slight release-increasing effect on lidocaine as compared with the PO gel. The structural differences of the gels, more than the macroviscosity, seem to regulate the release of drugs. The drug permeation-prolonging effect of the respective gels, along with the control solutions, was evaluated in vitro using porcine dura mater membrane. The compact gel depot acted as the rate-limiting step, and significantly prolonged the dural permeation of both drugs in comparison with control solutions. The difference in the drug release and permeation-reducing effects of the gels demonstrated the possibility for interactions between dural membrane and the gel. The findings are promising for further experimental in vivo animal testing of these injectable poloxamer-based gels.
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PMID:Controlled release and dura mater permeability of lidocaine and ibuprofen from injectable poloxamer-based gels. 968 47

Capsaicin (CAP) excites small sensory neurons, causing pain, neurogenic inflammation, and other visceral reflexes. These effects have been proposed to be the result of CAP activation of a nonselective cation current. It is generally assumed that CAP binds to an extracellular domain of the membrane receptor. However, the exact binding site is not known because of the lipophilic nature of CAP. To determine whether the binding domain is extracellular or intracellular, we tested the effect of a synthetic water-soluble CAP analog, DA-5018.HCl, on current activation. CAP activated the 45 pS (at -60 mV) nonselective cation channel from either side of the membrane. However, DA-5018.HCl, which had a greater potency and efficacy than CAP, activated the channels only from the cytosolic side of the patch membrane in a capsazepine, a CAP receptor antagonist, reversible manner. When applied extracellularly, DA-5018. HCl did not, but CAP did, activate whole-cell currents in sensory neurons, as well as in oocytes expressing vanilloid receptor 1, a recently cloned CAP receptor. Hydrogen ions, reported as a possible endogenous activator of cation current, failed to elicit any current when acidic medium (pH 5.0-6.0) was applied intracellularly, indicating that H+ does not mediate the CAP effect. These results indicate that CAP and its analog bind to the cytosolic domain of the CAP receptor and suggest that an endogenous CAP-like substance other than H+ may be present in the cell.
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PMID:Capsaicin binds to the intracellular domain of the capsaicin-activated ion channel. 988 May 73

Burning mouth syndrome (BMS) is an oral pain disorder of uncertain origin. Central or peripheral pain mechanisms may play a role in the oral burning of BMS. We tested the effect of a topical anesthetic (dyclonine HCl) on patients' intensity ratings for oral burning, taste dysgeusia and the taste of two chemical stimuli (1.0 M NaCl and 1.0 M sucrose). A total of 33 patients (9 male and 24 female, average age: 60 yr) are included in this analysis. The anesthetic reduced the perceptual intensity of both chemicals in these patients on four out of five postanesthesia trials (p < 0.01). The BMS cohort included 12 patients whose burning increased (p < 0.001), 14 patients whose burning did not change, and 7 patients whose burning decreased (p < 0.001) after anesthesia. Baseline dysgeusias (n = 13) decreased in intensity (p < 0.001) after anesthesia, suggesting BMS dysgeusia is related to the activation of peripheral taste mechanisms. The results also suggest that BMS oral burning may be a disorder of peripheral pain pathways in some patients.
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PMID:The effects of topical anesthesia on oral burning in burning mouth syndrome. 992 83

Transcutaneous electrical nerve stimulation (TENS) has been suggested as a means to reduce the amount of intravenous analgesia/sedation in patients undergoing extracorporeal shock wave lithotripsy (ESWL). A retrospective analysis of 79 ESWL procedures on 73 consecutive unselected patients was done in an attempt to determine the effectiveness of TENS in reducing the amount of intravenous fentanyl citrate and/or midazolam HCl needed to control pain and anxiety during the ESWL procedure. The study was divided into two parts: (1) all patients receiving TENS (n = 44) versus a non-TENS group (n = 35), and (2) comparison of the early (n = 22) and late non-TENS (n = 22) groups against each other; separately the late non-TENS group was compared to the entire TENS group. In the study, TENS reduce the amount of fentanyl citrate needed to control anxiety by 22.9% (P less than 0.025). No difference was noted when the early and late non-TENS group of patients were compared to each other. A gender difference was noted with a significant reduction in the dose of fentanyl citrate only in female patients receiving TENS (45.4%). Likewise, there was a significant reduction in the dose of midazolam HCl only in males who had TENS (38.9%). The data suggests that TENS may be a useful addition to reduce the amount of sedation and analgesia during ESWL.
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PMID:The use of transcutaneous electrical nerve stimulation during the biliary lithotripsy procedure. 1014 74

The reduction in propofol-induced pain on injection caused by the addition of lignocaine results mainly from a drop in pH, which reduces the concentration of propofol in the aqueous phase of the emulsion. It is not an effect of the local anaesthetic per se. Propofol emulsion mixed with lignocaine destabilizes within hours. We mixed 10 parts of propofol 1% emulsion with one part of 0.0064 M HCl or 0.013 M HCl, respectively. These mixtures were stored for 3 months and compared with a freshly prepared solution of propofol 1% emulsion and saline, in the same proportion, regarding their ability to induce anaesthesia in the rat. There was no significant difference in the amount of propofol required to induce anaesthesia, nor was there any difference in recovery time between the three groups.
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PMID:Acidified propofol retains its anaesthetic potency after storage. 1022 65

A retrospective study was undertaken at Morristown Memorial Hospital to evaluate the cost impact of buprenorphine HCl, a Schedule V injectable analgesic, versus the Schedule II drugs morphine and meperidine HCl. Time-and-motion studies were conducted in the pharmacy and nursing units. Algorithms were used to determine the cost of auditing, ordering, dispensing, recording, and administering a single dose of Schedule II and Schedule V injectable analgesics. Based on acquisition costs and duration of analgesia, total 24-hour dose costs were calculated for buprenorphine, morphine, and meperidine. The resultant cost comparisons demonstrated that the use of buprenorphine as an alternative to morphine and meperidine for moderate to severe postoperative pain is highly cost-effective and, in this hospital, resulted in a total cost avoidance of up to 67% of analgesic cost per patient per day.
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PMID:Buprenorphine: a cost-effective alternative to Schedule II analgesics for moderate to severe pain relief. 1031 32


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