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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a randomized double-blind study of 51 primigravida, we have examined the relative efficacies of bupivacaine, diamorphine or diamorphine with adrenaline given by the extradural route for relief of pain during labour. Group 1 (n = 18) received diamorphine 5 mg in 0.9% sodium chloride 8 ml; group 2 (n = 19) received diamorphine 5 mg in 0.9% sodium chloride 8 ml with 1:200,000 adrenaline; group 3 (n = 14) received 0.375% bupivacaine 8 ml. All patients received 0.375% bupivacaine 8 ml as a supplement after the initial analgesia had subsided. Patients in all groups had satisfactory and comparable analgesia 20 min after the initial injection. However, after 60 min and up to 8 h, analgesia was superior in group 2 as assessed by linear analogue pain scores, with statistical significance at 4, 6 and 8 h. Groups 1 and 2 required bupivacaine supplements less frequently than group 3 (P less than 0.001). There were no serious adverse effects in any group, but pruritus was a feature in the diamorphine groups. Diamorphine 5 mg may be used as an alternative to bupivacaine 0.375% 8 ml in the first stage of labour and provides a longer duration of action. The addition of adrenaline 1:200,000 appears to augment both the quality and duration of analgesia.
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PMID:Extradural diamorphine with adrenaline in labour: comparison with diamorphine and bupivacaine. 181 29

Artificial tears, commonly prescribed for correction of the dry-eye syndrome, are formulated with suitably preserved aqueous polymeric solutions to promote corneal wetting without causing such side-effects as burning, itching, blurred vision and scratchiness. Four of the most commonly used commercial tear-replacement solutions were investigated after complaints of irritation by some users. The solutions were tested for tonicity, viscosity and pH and found to be in the tolerable range (tonicity equivalent to 0.5-1.5% m/v sodium chloride, viscosity 1-15 centipoise and pH 4-9). A double-blind cross-over study was conducted on 16 subjects and the degree of discomfort (non-irritant, irritant, and highly irritant) was determined subjectively. Results indicated that 3 of the tear solutions were acceptable. However, over 50% of the subjects reported irritation from the solution comprising polyvinyl alcohol 1.4% m/v preserved with 0.5% m/v chlorobutanol. To identify the cause of irritation, two extemporaneously prepared controls containing polyvinyl alcohol 1.4% m/v, with and without chlorobutanol 0.5% m/v as preservative, were also included in the study. The irritant response was found to be caused by the presence of chlorobutanol in the formulation. An attempt is made to identify and explain formulation properties likely to elicit adverse responses.
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PMID:Irritation associated with tear-replacement ophthalmic drops. A pharmaceutical and subjective investigation. 264 9

Preparations containing urea were found to be effective in the treatment of ichthyosis vulgaris and so we were encouraged to test their use in other dry skin conditions. Urea creams are well applied to dry skin which is not inflamed. In the treatment of psoriasis, which requires a stronger water-binding substance, a combination of sodium chloride and urea in equal concentrations is optimal. Urea creams can be used in the prophylactic treatment of hand eczema and also as a prophylactic against infection, but not in the treatment of already existing infections. In psoriasis and ichthyosis urea is effective in creams substitution therapy. Though urea creams provided relief from itching in neurodermatitis, their use after treatment of eczema with fat-containing salves caused burning sensations. In our experience creams with a urea concentration of 5%-10% offer possibility for treating dry skin.
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PMID:[Urea as a single drug in dry skin]. 280 24

A study was undertaken to determine the pressor and toxic effects of etoposide, an antineoplastic agent, when administered IV in 0.9% sodium chloride solution (0.4 mg of etoposide/ml) over a 30-minute period to dogs at a dosage of 40 mg/m2 of body surface. On day 1, 6 adult German Shorthaired Pointers were anesthetized with halothane, and blood pressures were measured via a femoral artery catheter before, during, and after the etoposide was administered. Systolic, diastolic, and mean blood pressures of each dog decreased [corrected] significantly (P less than 0.01) within 30 minutes after initiation of etoposide infusion. On day 3, when the dogs were not anesthetized, etoposide was again administered to each dog, using the same dosage. Each dog developed a moderate to severe cutaneous reaction characterized by moderate to severe pruritus, urticaria, and swelling of the head and extremities that began during the second infusion of etoposide. These same cutaneous reactions were seen on day 30, when etoposide was administered to 3 of the previously treated dogs and 2 previously untreated Beagles. We concluded that the administration of the commercial preparation of etoposide is likely to cause a significant reduction in blood pressure of anesthetized dogs, and that the drug is likely to induce a moderate to severe cutaneous reaction when administered to unanesthetized dogs.
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PMID:Hypotension and cutaneous reactions associated with intravenous administration of etoposide in the dog. 297 35

The effects of epidural morphine for pain relief after orthopaedic surgery of the lower extremity were examined in 60 patients. Intraoperative analgesia was achieved with epidural administration of 2% mepivacaine. The patients were divided in a double-blind, random fashion into 3 groups. Group I received 2 mg morphine base (2.63 mg morphine hydrochloride) in 10 ml 0.9% sodium chloride, Group II received 2 mg morphine base in 10 ml 5% glucose, and Group III, 10 ml 5% glucose as placebo. The quality of analgesia was judged by 1) the amount of i.m. pentazocine (0.5-1 mg/kg) required during the first 24 h, and 2) the analysis of a visual analog scale. The duration of epidural morphine analgesia was 13 +/- 9.4 h. For supplementary postoperative analgesia, the patients in Group I required a mean dose of 24 mg, Group II 18 mg, and Group III 48 mg of pentazocine (P less than 0.001 and 0.05 respectively) within the first 12 h. The solution (glucose or normal saline) had no influence on morphine effectiveness. The side effects were urinary retention in 8 patients (20%) and pruritus in one (3%). It is concluded that 2 mg of morphine base administered epidurally is an effective method of postoperative pain relief in orthopaedic patients.
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PMID:[Investigations on epidural morphine. Efficacy, solvent, analgesic supplementation]. 712 77

Sixty patients, scheduled for Caesarean section were randomly allocated to receive by the epidural route in a double-blind fashion one of the following patient-controlled analgesia mixtures for the relief of postoperative pain: sufentanil 2 micrograms.ml-1 in 0.9% sodium chloride, sufentanil 2 micrograms.ml-1 + adrenaline 2.5 micrograms.ml-1, or sufentanil 2 micrograms.ml-1 + clonidine 3 micrograms.ml-1. Patient-controlled analgesia settings were a basal infusion rate of 2.5 ml.h-1, an incremental dose of 2.5 ml, a lockout interval of 10 min and a 1-h limit of 10 ml. Whereas patient demographics and pain scores between the groups were not different, the 24-h consumption of sufentanil was significantly lower in the groups receiving a combination (167.5 SD 45 and 139.1 SD 31.9 micrograms for the adrenaline and clonidine groups respectively) as compared to the plain sufentanil regimen (208.2 SD 38.9 micrograms). Although sufentanil requirements were the lowest in the clonidine admixture group, there were no differences with regard to sedation as compared to the plain sufentanil group. The quality of sleep appeared to be significantly better in the sufentanil/adrenaline group despite a significantly lower degree of sedation and higher incidence of pruritus. Treatment of pruritus with naloxone did not seem to influence the quality of analgesia.
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PMID:Patient-controlled epidural analgesia with sufentanil following caesarean section: the effect of adrenaline and clonidine admixture. 797 30

We analysed vasoreactions and sensations of atopic eczema (AE) patients and healthy controls after intracutaneous (i.c.) injection of vasoactive intestinal polypeptide (VIP) and acetylcholine (ACh). Blood flow was measured by laser Doppler flowmetry (LDF). Plasma extravasation and flare size were evaluated planimetrically, and sensations were recorded using visual analog scales. Three groups of subjects (controls, AE patients suffering from acute eczema and AE patients during a symptom-free period) were investigated. We administered VIP separately at concentrations of 1.5 x 10(-7), 1.5 x 10(-6) and 1.5 x 10(-5) M and in combination with ACh (5.5 x 10(-6) M) into the volar forearm of the subjects. Both substances led to an increase in LDF measurements and induced a wheal and flare reaction. Blood flow was elevated as a function of dose after a single VIP application in all groups. Compared with healthy controls, a significant increase in blood flow was measured after combined VIP and ACh administration in AE patients suffering from acute AE, whereas flare area and plasma extravasation were significantly reduced after single VIP and combined VIP and ACh injections, respectively. In all groups, VIP induced dose-dependent pruritus. Compared with a control stimulus (0.9% sodium chloride and ACh), combined injections of VIP and ACh had no additional effect on the magnitude of the sensation. In AE patients, the intensity was similar to that experienced by the control subjects, but the quality of sensation was different: ACh induced pain in the control subjects, pruritus in AE patients, and a mixture of pain and itching in AE patients showing no symptoms. Our results suggest that VIP- and ACh-induced skin reactions and the quality of the sensations depend on the activity of the atopic eczema. Confirming our former studies, AE patients develop a different quality of sensation after ACh administration and also after administration of VIP combined with ACh. Therefore, we suggest that ACh might be involved in the pathomechanisms of pruritus in AE.
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PMID:Cutaneous reactions and sensations after intracutaneous injection of vasoactive intestinal polypeptide and acetylcholine in atopic eczema patients and healthy controls. 961 39

Moisturizing creams have beneficial effects in the treatment of dry, scaly skin, but they may induce adverse skin reactions. In a randomized double-blind study, 197 patients with atopic dermatitis were treated with one of the following: a new moisturizing cream with 20% glycerin, its cream base without glycerin as placebo, or a cream with 4% urea and 4% sodium chloride. The patients were asked to apply the cream at least once daily for 30 days. Adverse skin reactions and changes in skin dryness were assessed by the patient and a dermatologist. Adverse skin reactions such as smarting (a sharp local superficial sensation) were felt significantly less among patients using the 20% glycerin cream compared with the urea-saline cream, because 10% of the patients judged the smarting as severe or moderate when using glycerin cream, whereas 24% did so using urea-saline cream (p < 0.0006). No differences were found regarding skin reactions such as stinging, itching and dryness/irritation. The study showed equal effects on skin dryness as judged by the patients and the dermatologist. In conclusion, a glycerin containing cream appears to be a suitable alternative to urea/sodium chloride in the treatment of atopic dry skin.
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PMID:A double-blind study comparing the effect of glycerin and urea on dry, eczematous skin in atopic patients. 1201 98

A case of papular itching lesions after microsclerotherapy with chromated glycerin (CG) at a 72% concentration for telangiectases of the thighs is reported. Patch-test results were strongly positive for nickel sulfate (+++/+++) and thimerosal (++/++) whereas results were negative for the sclerosing agent CG 72% and glycerol (control). Intradermal injection of CG 72% in the thigh and intravascular injection of CG 72% into telangiectases of the knee produced erythematous papular itching lesions in about 5 to 6 hours. As a negative control, glycerol and sodium chloride 0.9% injected intradermically on the thigh did not cause any reaction. CG can elicit allergic reactions in patients who are sensitive to chromium and can cause new sensitizations to chromium. In our case, no positivity to potassium dichromate was observed.
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PMID:An unusual local reaction after microsclerotherapy with chromated glycerin. 1715 Jan 70

Microneurography was used to record action potentials from afferent C-fibers in cutaneous fascicles of the peroneal nerve in healthy volunteers. Afferent fibers were classified according to their mechanical responsiveness to von Frey stimulation (75g) into mechano-responsive and mechano-insensitive nociceptors. Various concentrations of Endothelin1 (ET1) and Histamine were injected into the receptive fields of C-fibers. Activation and heat sensitization were monitored. Axon reflex flare and psychophysical ratings were assessed after injection of ET1 and codeine into the forearms after pre-treatment with an H1 blocker or sodium chloride. 65% of mechanosensitive nociceptors were activated by ET1. One-third showed long lasting responses (>15min). In contrast, none of thirteen mechano-insensitive fibers were activated. Sensitization to heat was observed in 62% of mechanosensitive and in 46% of mechano-insensitive fibers. Injection of ET1 produced a widespread axon reflex flare, which was suppressed by pre-treatment with an H1 receptor blocker. In addition, pain sensations were induced more often than itching by ET1 in contrast to codeine. No wheal was observed after injection of ET1. Both itching and pain were decreased after H1 blocker treatment. In summary: (1) In humans ET1 activates mechanosensitive, but not mechano-insensitive, nociceptors. (2) Histamine released from mast cells is not responsible for all effects of ET1 on C-nociceptors. (3) ET1 could have a differential role in pain compared to other chemical algogens which activate additionally or even predominantly mechano-insensitive fibers.
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PMID:Endothelin 1 activates and sensitizes human C-nociceptors. 1788 95


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