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)

Twenty-five neurones of the thalamic VB complex of the rat, first characterized under moderate volatile anaesthesia (1/3 oxygen - 2/3 nitrous oxide, 0.5% halothane) were subsequently studied under deep chloralose anaesthesia. As described in a previous study, neurones were classified during the control period as "noxious" (N) "non-noxious" (Nn), or "convergent" (NnN) according to their responsiveness to cutaneous mechanical stimulations. For all the N (n = 15) and NnN (n = 4) neurones, the responses induced by noxious stimuli (mechanical electrical or thermal) progressively disappeared after chloralose administration. Simultaneous with disappearance of the responses elicited by noxious stimuli, responses to non-noxious stimuli appeared for 12 N neurones: 5 responded to a brisk tap applied to any part of the body, and 7 to brushing of light touch from a new receptive field (RF), at a variable distance from the initial RF, but always contralateral to the recording site. The Nn neurones (n = 6) continued to be activated by light touch or brushing but there was a consistent concentric enlargement of their RF. The NnN neurones also presented an enlarged RF to the non-noxious stimuli. The depressive an "unmasking" effects of chloralose are discussed and compared to the various indications of pre-existing connections in the CNS.
Pain 1981 Aug
PMID:Functional changes in ventrobasal thalamic neurones responsive to noxious and non-noxious cutaneous stimuli after chloralose treatment: new evidence for the presence of pre-existing "silent connections" in the adult nervous system? 730 3

Intraneural microelectrode recordings were made from the nerve supplying the phantom area in two patients suffering from phantom limb pain. Spontaneous activity was prominent in both cutaneous and muscle fascicle of the nerves. Tapping the neuromata which accentuated the phantom limb pain, induced afferent discharges with both short and long latencies, the latter from fibres with a conduction velocity of only 0.5 m/sec. Blocking the neuromata with lidocaine completely abolished the tap-induced afferent discharges and the tap-induced accentuation of the phantom pain. The spontaneous pain was, however, unchanged, as was the spontaneous activity recorded.
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PMID:Microelectrode recordings from transected nerves in amputees with phantom limb pain. 732 53

Epidural injections were performed by obstetricians on 1012 patients in a pain relief service in which there was clinical co-operation between anaesthetists and obstetricians. A consultant anaesthetist collaborated in the training of staff providing the service. Midwives maintained the epidural analgesia with top-up doses as part of their traditional role in providing pain relief in labour. Eight-eight per cent of patients were fully satisfied, 10% were helped and 2% had failed epidurals. The forceps rate was 30% and the dural tap rate 1.4%. Junior obstetric staff in training grades can with adequate safeguards make a significant contribution to running an obstetric epidural service.
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PMID:An integrated pain relief service for labour: co-operation between obstetricians, anaesthetists and midwives. 740 85

The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior.
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PMID:Spa therapy for gonarthrosis: a prospective study. 748 82

We reviewed records of 31 children who had surgical release of 41 clubfeet under general anesthesia with supplemental caudal epidural anesthesia. Compared to an equivalent group of 27 children (39 feet), the caudal epidural group exhibited a statistically significant decrease in intraoperative narcotic requirement. One child had a bloody tap, and caudal epidural anesthesia was abandoned, but there were no other complications. Excellent postoperative pain relief persisted for > or = 8 h. Twenty-five of 31 caudal epidural patients were discharged safely on the same day as surgery without any surgical complications. Use of caudal epidural supplementation and outpatient surgery (where indicated) met with a high degree of parent satisfaction. Cost savings of outpatient clubfoot surgery, when compared to overnight stay, were disappointingly low.
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PMID:The use of caudal epidural anesthesia in clubfoot surgery. 759 71

A postal survey of all maternity units in the UK was conducted to gain information regarding the management of inadvertent dural taps occurring during the sitting of epidurals for pain relief in labour. Of the units surveyed only 58.5% had a written protocol for the management of dural taps. Following their occurrence, 99% of the units resited the epidural and in 22%, the midwives continued to give the top-ups. In only one-third of this latter group was the dose of the top-up reduced. In 46% of the units, patients who had a dural tap were allowed to push in the second stage of labour. As prophylaxis against the development of headache, 70% of the units infused crystalloids into the epidural space, whereas only 8.6% were in favour of an early prophylactic blood patch.
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PMID:Current management of inadvertent dural taps occurring during the siting of epidurals for pain relief in labour. A survey of maternity units in the United Kingdom. 771 30

Thirty-six non-hospitalized subjects with chronic pain from OA of the knee participated in an evaluation of transcutaneous electrical nerve stimulation (TENS) and naproxen, an NSAID. All pre-experiment treatment was withdrawn. Each subject experienced in some order three 3-week treatment phases: NSAID plus placebo TENS; TENS plus placebo drug; and double placebo. A broad range of pain measures was used, including daily diary ratings, and four-times-per-day ratings entered into a small electronic data logger (the PIPER) worn by the subject. A substantial placebo response occurred across all conditions, which may have masked treatment differences. Broad comparisons across subjects, combining the four main measures of pain, found no significant differences among the three experimental treatments. Analysis of diary and PIPER data for individuals suggested that, in a small minority of subjects, the NSAID plus placebo TENS combination may be more effective than double placebo. The PIPER ratings seemed to tap aspects of the pain experience different from those captured by conventional measures, suggesting the value of very frequent pain assessments, such as those entered by a subject into the PIPER, in the study of chronic pain.
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PMID:The comparative analgesic efficacy of transcutaneous electrical nerve stimulation and a non-steroidal anti-inflammatory drug for painful osteoarthritis. 817 50

Twenty-seven patients with acute severe headache of recent onset were prospectively recruited in the Emergency Room. Mean duration of headache was 61 hours. CT scan disclosed subarachnoid bleeding in 4 patients and spinal tap revealed subarachnoid hemorrhage (SAH) in 5 patients with normal CT scan. In most SAH cases pain was bilateral, very intense and involving the occipital region. Four of these patients had doubtful or no nuchal rigidity and in one, pain improved while in the Emergency Room. In every case with an intense acute severe headache of recent onset CT scan and (if normal) a lumbar puncture are warranted to help rule out a SAH.
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PMID:Acute headache of recent onset and subarachnoid hemorrhage: a prospective study. 792 36

Epidural analgesia is a very efficient method of postoperative pain management. Nevertheless, problems such as unilateral analgesia, sensory loss and inadequate pain relief are often difficult to handle. Radiologic evaluation of the position of the catheter and the spread of radiopaque dye (epidurography) is an important advance toward a solution of these problems. METHODS. The findings of 110 consecutive epidurographies from the acute pain service of the Department of Anaesthesiology of the University Hospital of Kiel, Germany, were analysed. Radiograms were obtained following the injection of 2 ml and an additional 8 ml of radiopaque dye (iopamidol) in the anterior-posterior and lateral plane. In addition, typical and instructive examples of epidurographies from the past 8 years are presented. RESULTS. In 99 of 110 patients the epidurography revealed a proper position of the catheter. Seven cases of partial displacement (e.g. paravertebral spread of radiopaque dye) and two cases of complete misplacement were documented. Allergic reactions or other side effects were not observed. The radiologic criteria for a proper epidural position of the catheter are discussed (Fig. 2a). Furthermore, examples of the following malpositions of epidural catheters are presented: intravascular misplacement (Fig. 2b), paravertebral misplacement (Fig. 2c), paravertebral escape of radiopaque dye (Fig. 2e) and correct distribution after the catheter had been withdrawn 2 cm (Fig. 2f), intrathecal misplacement (Fig. 2g), and simultaneous spread of dye in the subarachnoid and epidural space in a patient with preceding dural tap (Fig. 2h). In some cases unexpected reasons for problems in postoperative pain management were revealed by epidurography (e.g. disc prolapse, (Fig. 2d). CONCLUSION. In our view epidurography is a valuable way of improving the quality and safety of postoperative epidural analgesia. It is an important tool for decision-making in the event of clinical problems. The benefits for the patients have to be weighed against the radiation exposure.
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PMID:[Radiologic position control of epidural catheters (epidurography). An instrument of quality assurance for regional analgesia]. 836 75

The relationship between depressed affect and pain was examined in secondary analysis of data on 408 nursing home residents. Also assessed were cognitive impairment, activities of daily living impairment, quality of social networks, and number of medical diagnoses. Analysis revealed that depressed residents were more likely to have pain, regardless of the presence of cognitive impairment. Multiple regression revealed that depressed affect was predicted by more pain, a greater number of medical diagnoses, and poor quality of the social network. These findings corroborate and extend those from a recent study of nursing home and congregate apartment residents (Parmelee et al., 1991). This corroboration and extension of findings occurred despite differences between the two studies with regard to characteristics of participants (this research included residents with all levels of cognitive impairment, and research by Parmelee et al. excluded those who were too disoriented to respond to questions), type of data collection employed (this research used ratings by professional caregivers whereas research by Parmelee et al. used self-report), and assessment instruments used to tap constructs.
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PMID:Pain and depression in the nursing home: corroborating results. 847 3


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