Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Buerger's disease is rare in the West but common in parts of Asia and the Middle East. A total of 39 patients with Buerger's disease were investigated in the setting of a hospital in Bangladesh. All but one were male and the mean age at onset of symptoms was 34 years. All but two were current smokers with a mean duration of smoking history of 17 years before the onset of symptoms. No other risk factors were identified. The majority of patients had ulceration or gangrene at presentation, and all but one had palpable femoral pulses. Vascular reconstruction was not possible in this institution and the main treatment options adopted were antibiotics, analgesia, chemical sympathectomy and amputation.
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PMID:Buerger's disease and cigarette smoking in Bangladesh. 147 44

From 1989 to 1995, 25 ICU-patients underwent cholecystectomy for acute acalculous cholecystitis (AAC). Preoperative diagnosis remains difficult and ultrasound imaging proved to be the most valid instrument for early diagnosis. Predisposing factors like duration of respiratory failure, extent of surgery, amount of blood loss and mode of analgesia were analyzed. Undelayed surgical treatment was important to avoid further complications such as gangrene or perforation of the gall bladder.
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PMID:[Acute cholecystitis--a rare complication in intensive care patients?]. 910 77

Diclofenac sodium is a very common drug used in medical practice for analgesia and is freely available over the counter without any medical prescription. The drug is also the most commonly used or misused by quacks working all over India. Many case reports have been published on upper limb catastrophe of unintentional intra-arterial injection of barbiturates, thiopental sodium, narcotics, and tranquilizers but only two cases of inadvertent intra-arterial injection of diclofenac have been reported till date. Potential serious complication of inadvertent intra-arterial injection of diclofenac sodium leading to gangrene has been recently reported in medical literature. It is a medical emergency and literature has shown that timely diagnosis with early intervention can salvage the limb. We hereby report a case of accidental intra-arterial injection of diclofenac sodium in the ulnar artery by a quack for pain abdomen leading to gangrene of the distal part of affected little, ring and part of middle finger of right hand.
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PMID:Accidental intra-arterial injection of diclofenac -case report. 2573 31

Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. We present the perioperative analgesic management of a patient with gangrene of the bilateral upper and lower extremities as a result of septic shock and prolonged vasopressor administration who underwent four-limb amputation in a single procedure. A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation.
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PMID:Pain Management in Four-Limb Amputation: A Case Report. 2601 96

Pain from pressure ulcers can severely impact a patient's quality of life. Evidence-based treatment of ulcer-related pain typically relies on systemic opioids with limiting side effects. Literature exists on the use of topical ketamine for neuropathic pain, but not for tissue injury in general and for decubitus ulcer pain specifically. Ketamine has a number of actions including blocking of the glutamate NMDA ionophore in the periphery. Preclinical evidence suggests that NMDA receptors located on peripheral sensory afferent terminals may play a role in initiating pain signaling in inflamed tissues. Topical ketamine, therefore, has the potential to provide analgesia when applied to decubitus ulcers. Here a case is reported of a 54-year-old female with diffuse large B-cell lymphoma who during a critical period in her illness experienced gangrene leading to chronic bilateral stage IV decubitus heel ulcers. The severe pain reported by the patient was poorly managed using high doses of systemic opioids and resulted in intermittent systemic side effects. Adding a compounded ketamine gel to her wound dressings twice daily over an interval of several months drastically reduced her opioid use and, more important, her pain, with minimal side effects.
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PMID:Opioid-Sparing Effects of Topical Ketamine in Treating Severe Pain From Decubitus Ulcers. 3070 79