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)

Labetalol is an alpha- and beta-blocking agent commonly used in anti-hypertensive therapy. Because of its beta-blocking and local anesthetic effect, labetalol via peridural catheter was supposed to reduce pain in patients suffering from gynecologic cancers. Thirty patients with terminal carcinomas (breast, uterus, ovary), whose pain was caused either by bone metastases or by primary invasion cancer, were treated. Peridural catheters were inserted and fixed at various levels, thoracic or lumbar, and 50 mg labetalol was injected every 4 h at the beginning and every 12-24 h on the following 2-3 days. The analgesia started immediately during the injection. No sensitive damage or neurovegetative block appeared. In 40% of the patients the catheter was removed after a 3-day treatment because of the definitive suppression of pain. Other analgesics were not required during the treatment; no tolerance to the drug was developed. The peridural catheter remained in situ for an average period of 4-30 days. Afterward it was possible to treat more cases as outpatients depending on their general conditions and with the help of their family doctors. After a few days of therapy, almost all the patients reported a burning pain at the site of the injection; this problem was easily resolved by prior injection of a 4-mg dose of betamethasone.
 ...
PMID:Analgesic effect of peridural labetalol in the treatment of cancer pain. 683 67

A series in which six cases of ruptured uterus occurred following previous lower segment Caesarean section, out of a total of 222 'trials of scar', is presented, and the literature reviewed in an attempt to clarify the term 'relative contra-indication' as applied to this clinical circumstance. The symptoms and signs of ruptured uterus likely to be blocked by an epidural, i.e. maternal tachycardia, scar tenderness and continuous lower abdominal pain, have been shown to be either unreliable (tachycardia and tenderness) or frequently not to occur at all (pain). When pain does occur it is not necessarily masked by an epidural. It is concluded that previous lower segment Caesarean section is not a contraindication to epidural analgesia in a subsequent labour provided certain conditions are fulfilled.
 ...
PMID:Epidural analgesia and previous Caesarean section. 684 63

A report is presented on 114 terminations of pregnancy during the second and third trimesters of pregnancy with a new (PGE) prostaglandin E2 derivative Sulprostone. In 84 cases, legal therapeutic abortions were induced. In 30 women an abnormal pregnancy was terminated. Sulprostone is a PG with selective activity in the uterus. It can be administered parenterally or locally. 48 women received intravenous sulprostone, 35 patients had extraamniotic injections and 31 patients had extraamniotic injections following an intramuscular injection for priming of the cervix the night before. In 103 women, the pregnancy was terminated within the first 24 hours after the administration of sulprostone (90.3%). 8 patients (7.0%) had a cervical dilatation over 2 cm. In 3 women no effect was noted. In 1 patient, the PG application was stopped because of severe vomiting. The mean administration abortion interval was 12 hours with intravenous infusion of sulprostone, 12 hours and 54 minutes following extraamniotic application and 10 hours and 30 minutes with extraamniotic administration following intramuscular priming. In 5 patients the abortion was completed after the priming administration. More than 90% of the patients required analgesia. 32.4% displayed side effects, all of mild character. The results and the methods are described and compared to other methods. (Author's modified)
 ...
PMID:[Induction of abortion during the second and third trimester of pregnancy with sulprostone (author's transl)]. 721 68

We report a case of spontaneous rupture of unscarred uterus, during labour and under epidural analgesia in a 43 year-old patient at her third pregnancy and third delivery. The tear was vertical and took place on the left postero-lateral side of the uterus, occurring in the whole height of the lower segment and overlapping towards the uterine corpus and cervix. Analysis of medical, surgical, gynaecological and obstetrical past history has displayed no predisposing factors explaining this rare occurrence. This clinical case reminds us that spontaneous rupture is always possible even on an unscarred uterus.
 ...
PMID:[Spontaneous rupture of an unscarred uterus during labor and epidural anesthesia]. 749 47

The aim of this study was to determine how varying the dose of spinal amethocaine influences the incidence of visceral pain associated with exteriorization of the uterus after delivery. In a double-blind study, we examined the incidence of visceral pain in 40 parturients undergoing Caesarean section under spinal anaesthesia with amethocaine 8, 10, 12 or 14 mg in 2 ml of 5% glucose. The dose of spinal amethocaine was found to influence the incidence of visceral pain associated with exteriorization of the uterus after delivery. The incidence of visceral pain was lower in the 12-mg (P < 0.05) and 14-mg (P < 0.01) groups than in the 8-mg group, although there were no differences in maximum spread of analgesia and circulatory changes between the four groups. This study suggests that a slightly higher dose of spinal amethocaine (12-14 mg) is preferable for Caesarean section.
 ...
PMID:Visceral pain during caesarean section: effect of varying dose of spinal amethocaine. 867 64

A primigravida with the Klippel-Trenaunay syndrome was admitted to the hospital at 34 weeks' gestation with a complaint of right calf pain. Superficial thrombophlebitis was diagnosed, and she was treated with compresses and analgesia. Speculum examination failed to reveal the presence of lower genitourinary tract arteriovenous malformations. Color flow mapping of the uterus did not identify any arteriovenous malformations. The patient delivered vaginally at term, and the postpartum course was unremarkable. Pregnancies complicated by the Klippel-Trenaunay syndrome are at increased risk of adverse perinatal outcomes, related primarily to the increased risk of hemorrhagic diathesis. The mode of delivery should be considered carefully in an attempt to minimize the risk to both mother and fetus.
 ...
PMID:Pregnancy complicated by the Klippel-Trenaunay syndrome. A case report. 777 15

A total of 956 epidural anesthesia procedures during cesarean section have been reviewed. In 234 cases epidural anesthesia was used repeatedly for analgesia during cesarean section in women with scars on the uterus. The course and quality of anesthesia were compared during the first and repeated procedure. High efficacy of analgesia was noted in more than 90% of patients of both groups. The differences between groups in the rate of development, duration of anesthesia, intensity of motor block and quality of analgesia were insignificant. It has been concluded that epidural anesthesia is highly effective during cesarean section in women with scars on the uterus and can be used repeatedly without the quality of analgesia being deteriorated.
 ...
PMID:[Repeated epidural anesthesia in cesarean section in parturients with uterine scars]. 794 83

This report describes the use of microcatheters to provide continuous spinal analgesia for the relief of labour pain. Bupivacaine 0.025% was administered through a 28G spinal microcatheter resulting in a differential block which provided effective labour pain relief. Conduction by the smaller pain fibres from the uterus were blocked, while relatively sparing the larger A fibres. Motor power, sense of touch, and discrimination between blunt and sharp objects were therefore left relatively intact. Patients were thus spared the discomfort of motor paralysis and an intense sensory block. No patient had hypotension (blood pressure fall greater than 20%). However one patient suffered a severe post-dural puncture headache which required an epidural blood patch. Continuous intra-thecal spinal analgesia is a potential alternative to continuous epidural analgesia in the relief of labour pain.
 ...
PMID:Continuous spinal analgesia--initial experiences with differential sensory block and labour pain relief. 800 77

Despite of a chronic volume overload the left ventricle function of pregnant women is preserved by both afterload reduction (arterial vasodilatation) and a facilitation of heart filling through an increase in peripheral venous tone. Fetal oxygenation results from an equilibrium between placental and umbilical blood flows. During regional anaesthesia the sympathetic blockade leads to a peripheral vasodilatation (mainly in the capacitive territories) which is the cause of arterial hypotension through a decrease in cardiac output. Placental flow may therefore be altered by the reduced perfusion pressure and/or a reflex or pharmacological vasoconstriction. Hypotension is an infrequent event during labor epidural analgesia. However the incidence of hypotension is higher during regional anaesthesia for cesarean section, up to 35% following intrathecal injection of local anaesthetic. Prevention of hypotension requires (i) release of aortocaval compression by gravid uterus (ii) volume preloading (15 min i.v. infusion of crystalloid, 20 ml.kg-1 with ephedrine, 15 mg if spinal anaesthesia is chosen), and (iii) limitation of plain local anaesthetic dosage (epinephrine, 1:200,000 with fentanyl, sufentanil or clonidine). Hypotension must be promptly reversed to avoid placental and umbilical flow alteration. Titrated doses of vasopressors are useful, either ephedrine or phenylephrine. Finally regional anaesthesia is beneficial for the mother and the fetus through a reduction in plasma catecholamines, provided that arterial pressure remains unchanged. Thus during pregnancy-induced hypertension (PIH) epidural analgesia leads to an improvement of the reduced placental blood flow. However PIH renders the women susceptible to sympathetic blockade and the fetus easily vulnerable to an additional stress factor like acute decrease in placental flow due to hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Maternal-fetal cardiovascular effect of spinal anesthesia]. 808 40

Because of its slow onset of action, intrathecal morphine may not be the optimal drug for intraoperative analgesia during short cases, such as cesarean sections. It is not known whether adding fentanyl to a morphine-lidocaine spinal solution would provide any benefits to patients undergoing cesarean sections. Sixty-two women scheduled for elective cesarean section received intrathecal 5% lidocaine with dextrose (50-70 mg), epinephrine 200 micrograms, preservative-free morphine 0.2 mg, and either 10 micrograms of fentanyl (study group) or preservative-free normal saline (placebo group) in a 0.2-mL volume. Patients were asked to rate their severity of pain on a visual analog scale (VAS) intraoperatively as the uterus was exteriorized and again when the dermatomal level had receded to L1. Intravenous fentanyl was administered if the patient experienced intraoperative discomfort. The VAS scores were 0.8 +/- 1.5 and 2.3 +/- 1.6 (mean +/- SD) in the placebo group at the time of uterine extrusion and in the post-anesthesia care unit (PACU). The corresponding scores in the fentanyl group were 0.4 +/- 1.1 and 2.7 +/- 2.2. There was a significant difference between the two groups in the VAS scores intraoperatively (P < 0.014) but not in the PACU (P not significant). There was also a significant difference (P < 0.015) in the need for supplementation with intravenous (i.v.) fentanyl. Six patients in the placebo group received i.v. fentanyl as compared with none of the patients in the fentanyl group.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The use of fentanyl added to morphine-lidocaine-epinephrine spinal solution in patients undergoing cesarean section. 816 Sep 90


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