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)

Nine hundred twelve patients received continuous epidural analgesia administered through an indwelling plastic catheter while undergoing vascular reconstruction of a lower extremity. During a portion of the operative event, the patients were totally, transiently anticoagulated with heparin. None of the patients had an untoward neurologic event that could be attributed to an epidural hematoma. Our results and those of others show that this form of regional analgesia is safe and far outweighs theoretic contraindications when anticoagulation with heparin is planned as a part of the operative event. In the patients with impaired pulmonary ventilation or a cardiac disorder, this method of analgesia offers many advantages over a general anesthetic, such as obviating aspiration pneumonitis and averting prolonged support in the recovery period after completion of the surgical procedure. The regional vasodilation ensuing from the epidural blockade is an additional advantage in patients undergoing vascular reconstruction for lower extremity ischemia.
 ...
PMID:Continuous epidural analgesia in the heparinized vascular surgical patient: a retrospective review of 912 patients. 361 64

In a sample of 10 healthy volunteers phasic pain ratings and evoked cerebral potentials (EPs) elicited by brief electrical skin stimuli were investigated in periods before, during, and after contralateral tonic ischemia pain. In all subjects the phasic pain ratings and the late EP components P80-N150 and N150-P260 were depressed under concurrent tonic pain. The magnitude of the mean reduction (31%, 40%, and 26%) is comparable to morphine analgesia. The early EP components with latencies below 80 ms, which are considered to be correlates of mechanosensitivity, were not influenced. The findings of tonic pain inhibiting phasic pain are discussed on the basis of changes in attention as well as of pain-specific physiological mechanisms like diffuse noxious inhibitory control.
 ...
PMID:Tonic pain inhibits phasic pain: evoked cerebral potential correlates in man. 386 Aug 87

To identify the opioid antagonist activity of nalmefene and to determine its duration in man, six healthy male subjects were pretreated on separate days with a saline placebo, 0.5 mg, 1 mg, or 2 mg nalmefene intravenously in a randomized double-blind fashion. Opioid challenges with fentanyl, 2 micrograms/kg, then were administered 1, 2, 4, 6, and 8 h afterward. Respiratory depression was monitored by ventilatory and occlusion pressure responses during CO2 rebreathing, while analgesia to experimental pain was identified with the submaximal effort tourniquet ischemia test. One hour following placebo pretreatment, the initial fentanyl dose produced marked respiratory depression. Minute ventilation and occlusion pressure at a PCO2 60 mmHg during rebreathing (VE60 and P(0.1)60) were reduced to 29 and 41% of control, respectively. The slopes of the ventilatory and occlusion pressure responses also decreased significantly to 51 and 55% of control. Respiratory effects were similar with all subsequent fentanyl doses. Pretreatment with 2 mg nalmefene completely prevented the subjective and respiratory effects of fentanyl for the entire 8 h of the experiment. Nalmefene, 1 mg, significantly blunted the fentanyl effects for the same period, but VE60 values at 6 and 8 h were depressed significantly (P less than 0.05) to 66 and 61% of control. The antagonist effects of the lowest nalmefene dose, 0.5 mg, persisted for about 4 h, at which time VE60 was 64% of control. Fentanyl administration produced consistent increases in pain tolerance (44-55% above control) throughout the experiment. Nalmefene pretreatment abolished this analgesic response in a dose-related time course that mirrored the respiratory effects almost exactly.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Prolonged antagonism of opioid action with intravenous nalmefene in man. 394 4

During a 10-year period 35 of 104 patients with torsion of the spermatic cord had preoperative manual detorsion. The detorsion was performed at the initial physical examination, most commonly without analgesia or sedation. In 34 evaluable patients all of the testes were salvaged without any evidence of atrophy. One patient whose testis appeared viable at operation was not available for followup. Recurrence was prevented by subsequent orchiopexy. The elapsed time between urological consultation and surgery ranged from 1 hour 40 minutes to 2 months. Six patients underwent an elective operation. Torsion did not recur between the time of manual detorsion and orchiopexy. Preoperative manual detorsion should be attempted at the initial physical examination because, if successful, the relief of testicular ischemia converts an acute urological emergency into an urgent or elective surgical procedure. More important, 100 per cent of the testes are salvaged.
 ...
PMID:Preoperative manual detorsion of the torsed spermatic cord. 398 20

The respiratory depressant and analgesic effects of intravenous dezocine were evaluated in six healthy volunteers. Single 0.15 mg/kg doses were compared with identical amounts of morphine, and the two drugs were given in combination. Five successive 0.15 mg/kg doses of dezocine also were given to identify dose-effect relationships. Respiratory center sensitivity was monitored by carbon dioxide (CO2) rebreathing and mouth occlusion pressure (P0.1) measurement, while analgesia to experimental pain was tested with submaximal tourniquet ischemia. Single 0.15 mg/kg doses of dezocine produced significantly more tolerance to experimental pain and greater respiratory depression than a comparable dose of morphine in the first hour, but effects of both drugs were similar thereafter. Multiple doses of dezocine progressively increased pain tolerance from 46 +/- 14% above control with the first dose to 70 +/- 18% above control with the second dose (cumulative total 0.30 mg/kg). Additional dezocine doses did not result in significantly more analgesia. Depression of CO2 sensitivity followed a similar pattern. Morphine 0.15 mg/kg, when given to subjects who had received a prior dose of dezocine, produced no additional effect beyond that observed with dezocine. With the reverse sequence, dezocine increased the respiratory depression of morphine but also produced a dramatic increment in analgesia, which suggested an additive action. Dezocine is therefore an effective analgesic with morphine-like effects. In human subjects it appears to be a slightly more potent analgesic than morphine in identical clinical doses (0.15 mg/kg). Dezocine is similar to other agonist-antagonist analgesics in that it exhibits a ceiling effect for respiratory depression that parallels its analgesic activity.
 ...
PMID:Ventilatory and analgesic effects of dezocine in humans. 615 Jun 61

During 2588 coronarography examinations conducted over a period of 4 years, assisted circulation was employed in 63 cases to reduce the risks of the examination procedure in particularly debilitated patients. These high risk cases included 48 patients with unstable angina resistant to medical treatment and 45 cases of recent infarcts with complications. Mortality with assisted circulation was very low, in spite of the severe nature of the affections, but the authors use this technique in only a limited number of cases, mainly because of the risk of lower limb ischemia, and the possibility of using intravenous nitroglycerin and analgesia from neuroleptics for examination. For this reason the number of cases examined in this way has dropped from 4% in 1977 to 2% in 1978, though assisted circulation is still employed in certain particularly severe cases of angina, and for infarcts with complications.
 ...
PMID:[Assisted circulation during coronarography: advantages and limitations. A report on 63 cases (author's transl)]. 625 75

Fifty-two paid volunteers participated in two separate factorial investigations of the effects of naloxone on time tolerance of and affective reactions to ischemia, as a function of the interaction between expectations of involvement in the experimental situation and experimental variables involving stress or suggestions of analgesia. Naloxone-induced reduction in tolerance to ischemia interacted significantly with the level of involvement expectancies. The suggestion of analgesia provided no significant naloxone-saline discrimination, but there was a significant interaction between variable memory task conditions and drug effects on the time ischemia was tolerated. These findings suggest that naloxone-opiate receptor interactions may depend on individual differences in attitudes to the situation, but may be potentiated by select environmental stimuli. Analyses of the effects of treatment on affective reactions to ischemia failed to show consistent results.
 ...
PMID:Reactions to ischemic pain: interactions between individual, situational and naloxone effects. 678 1

To compare the respiratory depressant and analgesic effects of nalbuphine and morphine, six healthy male subjects were given the drugs as single 0.15-mg/kg doses, and as four successive doses of 0.15 mg/kg. Respiratory depression was monitored by ventilatory and mouth occlusion pressure responses during CO2 rebreathing, while analgesia to experimental pain was tested with the submaximal effort tourniquet ischemia test. When given as single 0.15 mg/kg doses, both drugs significantly increases the threshold and tolerance for experimental pain. The analgesic effect was similar for both drugs at this dosage, as was depression of the ventilatory and occlusion pressure responses to CO2. Morphine administered in multiple doses progressively increased pain tolerance from 30 +/- 13% above control with the first dose of 0.15 mg/kg to 107 +/- 13% above control after the fourth dose (cumulative total 0.60 mg/kg). Nalbuphine produced a 40 +/- 12% increase in pain tolerance with an initial dose of 0.15 mg/kg, but additional increments of nalbuphine did not result in significantly greater analgesia. The increasing morphine dosage was associated with progressive rightward displacements and ultimately decreases in the slope of the CO2 response curves. Nalbuphine produced an initial rightward displacement of the CO2 response curves similar to morphine, but continued administration of the drug did not result in further displacement or changes in slope. These findings demonstrate that nalbuphine, in contrast to morphine, exhibits a ceiling effect for respiratory depression which is paralleled by its limited analgesic effect on experimental pain.
 ...
PMID:Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. 681 1

Bupivacaine was infused intravenously into healthy volunteers to assess its analgesic effect. In a double-blind manner, 11 male subjects received, on separate days, saline solution or 0.1% bupivacaine, at three rates of infusion. Experimental pain was produced by the tourniquet-induced ischemia test. Times to onset of ischemic pain (threshold) and unbearable pain (tolerance) were compared. Venous blood samples were analyzed for levels of bupivacaine and its metabolite, pipecolyxylidine, by gas chromatography. No significant difference in pain threshold or tolerance was found following control and bupivacaine infusion. In the 72-hour postinfusion urine collection period, only 0.7% of the infused dose was recovered as unmetabolized bupivacaine, with 4.8% recovered as pipecolyxylidine. Systemic blood levels of bupivacaine achieved during regional anesthesia did not produce analgesia in this model.
 ...
PMID:Evaluation of the analgesic effect and urinary excretion of systemic bupivacaine in man. 719 9

The purpose of this study was to evaluate the analgesic contribution of intravenously administered lidocaine and to correlate it with blood levels of the drug. In a double-blind manner, 14 healthy male volunteers received saline solution or lidocaine, 0.2 per cent, at three increasingly greater rates of infusion on two separate days. Experimental pain was produced by means of the submaximal tourniquet-induced ischemia test of Beecher and Smith. The times to the onset of ischemic (threshold) and unbearable (tolerance) pain were recorded for three control trials to two tests for the same end points during each infusion rate. Between the two ischemic trials, while the test solution continued to be infused, venous blood samples were drawn and analyzed for lidocaine by gas chromatography. No statistically significant difference in analgesia between the control and lidocaine values for threshold or tolerance was observed at blood levels from 1 to 3 micrograms/ml. The data suggest that lidocaine at these blood levels produces sedation but not analgesia.
 ...
PMID:Lidocaine as an analgesic for experimental pain. 735 40


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>