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)

Propanidid was used for the induction of anaesthesia at Caesarean section in 50 healthy mothers. All parturients were considered to have normal placental function. Anaesthesia was maintained with nitrous oxide, oxygen, muscle relaxant and controlled ventilation. The patients were tilted laterally with a 15 degrees rubber wedge during the procedure in order to obviate the effects of aorta-caval occlusion. At the time of delivery, arterial blood was drawn from the mother and from the vessels of a double clamped section of umbilical cord, for blood-gas analysis. The results obtained are compared with those previously reported in a similar series anaesthetised with thiopentone, gas, oxygen and relaxant. Maternal blood-gas and acid-base levels were similar in the two groups at delivery. The clinical status of the infants in the present series, as judged by the modified Apgar score at 2 minutes after birth, was satisfactory. Umbilical venous and arterial pH values after propanidid were both 0-054 units (P less than 0-001) less than those following thiopentone; and average base deficits were 3-1 (Uv) and 3-9 (Ua) mEq/litre greater after propanidid (P less than 0-001). Mean oxygen levels in the umbilical cord bloods were 8-0 (Uv) and 3-5 (Ua) mmHg lower (P less than 0-001 & P less than 0-025 respectively) in the propanidid group. Derived oxygen contents was also significantly less than in the previous thiopentone series. (Ma-Uv) and (Ma-Ua) gradients were 0-053 and 0-051 pH units higher after propanidid than that following thiopentone (P less than 0-001). Mean (Ma-Uv) and (Ma-Ua) base deficits were 3-5 and 3-9 mEq/litre greater (P less than 0-001). Five patients offered definite evidence of factual recall, of whom three experienced pain. Propanidid, therefore, appeared to be associated with a greater degree of foetal acidaemia than did thiopentone. In addition, painful factual recall during surgery was encountered in 6 percent of cases. It is concluded that propanidid, although theoretically offering advantages over thiopentone to the obstetric anaesthetist, in practice, did not fulfil this promise.
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PMID:Anaesthetic induction for Caesarean section with propanidid. 0 51

Thirty-five patients with occlusive disease of the arteries underwent metabolic studies. The arteriovenous differences of lactate, glucose and oxygen varied with the severity of the ischemic process, as assessed clinically. Lactate release and glucose extraction were significantly different from control values of patients with rest pain or with ischemic gangrene, while values in patients with claudication were comparable with those in the control group. Percutaneous muscle surface pH measurements, which reflect lactate release, decreased directly with diminished perfusion. Metabolic assessment of arterial occlusive disease may prove to be a useful clinical approach.
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PMID:A metabolic approach to the evaluation of peripheral vascular disease. 1 79

Two comparable groups of ten patients were studied. After nitrous oxide-oxygen fentanyl-pancuronium anesthesia, half the patients were reversed with a titrated dose of naloxone. Even in titrated doses naloxone rapidly abolished residual post-operative fentanyl analgesia in 80 p. 100 of the patients. In the control group none of the patients complained of pain for an average of six to eight hours. Blood gases in the recovery room were practically the same in reversed and non-reversed patients and were satisfactory.
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PMID:[Effects of naloxone on postoperative analgesia]. 1 85

Lorazepam has been studied as preanaesthetic medication given by mouth, i.m. and i.v. Sediation and side-effects and the incidence of anterograde amnesia in patients having a standard operation under methohexitone-nitrous oxide-oxygen anaesthesia were assessed. In a preliminary study of three i.m. (2-, 4- and 8-mg) and six oral (1-,2-,2.5-,4-,5- and 8-mg) doses, the optimum dose was found to be 4 mg for patients with an average weight of 60 kg. This dose was studied in detail when given by all three routes and compared with the commercially available 2.5- and 5-mg tablets. Even when given i.v., there was a delay of 30-40 min in the onset of maximum sedative effect and drowsiness persisted for at least 4 h. Although the onset of action by i.m. injection was slightly faster than when the drug was given by mouth this advantage was more than offset by the high frequencies of pain at the site of injection and restlessness which persisted for 20-40 min. Oral lorazepam in doses of 2.5-5.0 mg was a reliable, effective sedative which could be recommended for routine preanaesthetic medication, provided rapid recovery was not essential. Its soporific effect was accompanied by an appreciable incidence of anterograde amnesia.
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PMID:Studies of drugs given before anaesthesia XXVI: lorazepam. 2 78

The analgesic effect of self-administered nitrous oxide 50%/oxygen 50% ('Entonox" analgesic apparatus) was compared with air given by the same method in a double-blind trial in 81 patients with myocardial infarction. Self-administered nitrous oxide/oxygen, which was associated with a low frequency of side-effects, proved significantly more effective than air in the early relief of severe cardiac pain, but not in the relief of moderate or slight pain or when administration was continued after ten minutes.
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PMID:A double-blind trial of patient-controlled nitrous-oxide/oxygen analgesia in myocardial infarction. 4 60

Thirty-two patients (group I: 7 normal subjects; group II: 25 coronary subjects) underwent coronary arteriography, and measurements were made both in normal rhythm and under atrial stimulation of the pulmonary capillary pressure and the pressure in the femoral artery, of cardiac output, of coronary sinus flow (by continuous thermodilution), of the coronary arterio-venous oxygen difference, of oxygen consumption, and in 28 of the patients of the coefficient of extraction of K lactates. During stimulation, the only differences to appear between the subjects of group I and group II were an increase in capillary pressure (p less than 0.01) and a decrease in the coefficient of extraction of lactates (p less than 0.001) in the coronary patients. Similar differences were found between coronary patients with a stenosis greater than 70% in the anterior descending or circumflex artery (group IIa) and those without it (group 11b), and between the patients with pain during atrial stimulation (n = 9) and those without it. There was a good correlation between a double score (IVA + circumflex artery, Rowe's method) and the coefficient of extraction of lactates during atrial stimulation (n = 28, p less than 0.01).
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PMID:[Hemodynamic and coronary effects of atrial stimulation in normal subject and patients with coronary disease: correlation with coronary arteriography]. 10 Nov 66

In 50 healthy mothers scheduled for elective Caesarean section, anaesthesia was induced with propanidid (7 mg/kg body weight). Thereafter, ventilation was controlled with nitrous oxide, oxygen and muscle relaxants. A further dose of propanidid (1 mg/kg body weight) was administered 3 minutes after the initial injection of this drug, as a means of preventing maternal awareness during equilibration with the anaesthetic gas mixture. The acid-base status of the mothers before the induction of anaesthesia, and at delivery, revealed a mild degree of respiratory alkalosis with a compensatory metabolic acidosis. Umbilical cord blood gas results indicated the presence of significant fetal acidosis, both respiratory (mean pCO2 Uv 46,3 torr (SD 11,3) and Ua 54,3 torr (SD 12,0)), and metabolic (mean base excess Uv-9 mEq/l (SD 4,2) and Ua-11,8 mEq/l, (SD 5,0)) in origin. The average umbilical cord blood oxygen tensions were Uv 25,9 torr (SD 10), and Ua 15,4 torr (SD 8,5); mean maternal to fetal base-excess gradients were Ma-Uv 4,1 mEq/l (SD 2,8) and Ma-Ua 6,5 mEq/l (SD 3,5). Five mothers (10%) offered convincing evidence of factual recall during surgery, and 3 of these were aware of pain. Nausea and vomiting occurred in 5 patients and in 4 there were clinical signs of postoperative chest infection. The degree of fetal biochemical asphyxia, and the incidence of maternal awareness during surgery, were significantly greater than previously reported when thiopentone was used for the induction of anaesthesia for Caesarean section. The results obtained are discussed, and the conclusion is drawn that propanidid for anaesthesia appears to offer no advantage over thiopentone in obstetric practice.
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PMID:Propanidid for anaesthetic induction at Caesarean section. 23 56

Eight patients suffering from severe ergotamine-induced peripheral ischaemia were transferred to our institution for hyperbaric oxygen treatment after unsuccessful therapy in the primary hospital. The patients were exposed to 3 ATBS oxygen for 1 hour 2-3 times daily and they were given an epidural block for the purpose of analgesia where there was severe pain. The circulation and vitality of tissue were restored in all patients. One had tarsal amputations performed half a year later. Hyperbaric oxygen in combination with epidural analgesia is recommended in severe cases of ergotism.
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PMID:Ergotism treated with hyperbaric oxygen and continuous epidural analgesia. 27 60

Transcutaneous oxygen tension at 44 degree C and maximal isotope clearance (90m Tc-pretechnetate + histramine) just proximal to the 1st toe and systolic toe blood pressure (strain gauge) were studied on a tilt table in patients with various degrees of obstructive arteriosclerotic disease. In legs with moderate obstruction, the oxygen tension reached zero at a toe systolic blood pressure of 5--10 mmHg (tilt toe up) and reached arterial oxygen tension at about 50 to 70 mmHg (tilt toe down). In legs withsevere arterial obstruction and ischaemic rest pain, oxygen tension rose from zero not before systolic toe blood pressure reached 20--50 mmHg. Significant isotope clearance was seen at pressures below the limits just mentioned for both types of patients. This phenomenon here seen of a perfusion without oxygen supply is explained by a gas leak (rendered significant because of the slow flow rate) from the arterioles into the tissue sink and counter current gas shunting. The hypoxia in spite of a positive perfusion pressure up to 50 mmHg explains our experience that ischemic ulcers in feet such low pressures never heal.
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PMID:Transcutaneous oxygen tension in imminent foot gangrene. 27 91

O2 and CO2 tensions were measured in the gastrocnemius muscles of patients submitted for reconstructive arterial surgery due to obstructive arteriosclerosis (37) or abdominal aortic aneurysm (5). Four patients without signs of arterial ischaemia served as controls. Measurements were carried out by means of implanted silastic tonometers during breathing of air and 100% O2 and immediately after walking on a treadmill. Peripheral blood pressures in the ankles were recorded with a Doppler apparatus. Baseline tissue gas tensions showed no essential differences between the various groups of patients: intermittent claudication, pain at rest, praegangrene, abdominal aortic aneurysm and controls. In contrast, baseline ankle pressures correlated well with the severity of the disease. During breathing of oxygen, the smallest increases of muscle PO2 were observed in extremities with pain at rest or praegangrene and the highest responses were recorded in controls and aneurysm patients. Muscle PCO2 values showed no alterations during oxygen breathing. In physical exercise, muscle PO2 and PCO2 levels as well as ankle blood pressures remained unchanged in controls and patients with aneurysm but no claudication. However, in all groups with arterial ischaemia, the exercise test resulted in a profound fall of muscle PO2 and ankle blood pressure and an increase of muscle PCO2.
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PMID:Tissue gas tensions in the calf muscles of patients with lower limb arterial ischaemia. 43 76


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