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

Twenty-seven pregnant women with cicatrices on the uterus after cesarean section had US-monitored spontaneous deliveries with calypsol analgesia (the drug was permanently i.v. infused). The intactness of the uterine walls in the postpartum period was checked up by bicontrast ultrasonic scanning and hysteroscopy.
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PMID:[The problems and outlook for delivery in pregnant women with uterine scars following cesarean section]. 831 21

In Scotland, gynecologists used 200 mg mifepristone followed 36 hours later by 1 mg gemeprost pessary every 6 hours for the first 24 hours and, if termination did not occur, every 3 hours for the next 12 hours, to induce second trimester abortion (12-21 weeks gestation) in 100 women 13-42 years old, attending the Simpson Maternity Pavilion of the Edinburgh Royal Infirmary. Most women only required 2 pessaries (range, 1-9). 47 only needed 1 pessary. 96 and 99 women experienced an abortion within 24 hours and 48 hours, respectively. The median interval between gemeprost administration and abortion was 7.5 hours (range, 2.9-52.3 hours). Just 1 woman experienced the abortion after 48 hours, and she required intravenous infusion of oxytocin. The interval for primigravidas was significantly longer than for multigravidas (8.2 hours vs. 6.6 hours; p .01). 31 women vomited after insertion of the gemeprost pessary. 5 experienced diarrhea after gemeprost administration. 84 required intramuscular diamorphine for analgesia. Evacuation of the uterus was required in 33 women after they expelled the fetus. 24 of these women retained the placenta. None of the 100 women required a blood transfusion. These results compared favorably with those of a similar study using 600 mg mifepristone in combination with 1 mg gemeprost every 3 hours. In other words, clinical efficacy was not lost with a reduction in the dose of both mifepristone and gemeprost. These results demonstrated that 200 mg mifepristone followed by 1 mg gemeprost pessary is a cost-effective, simple, and noninvasive method to induce a second trimester abortion on an outpatient basis.
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PMID:Induction of second trimester abortion with mifepristone and gemeprost. 839 16

Two regimens of prostaglandin E1 analogue, gemeprost, in combination with mifepristone were compared in a randomized trial for termination of pregnancy at 12-19 weeks. 100 women requesting second trimester abortion were recruited at the Gynecological Department of the Edinburgh Royal Infirmary, Scotland. The women were given a single oral dose of 200 mg mifepristone in the medical abortion unit and allowed home. 36 hours after treatment with 200 mg mifepristone, women were allocated at random to receive either 4 x 1 mg (Group I) or 4 x 0.5 mg (Group II) gemeprost by vaginal pessary every 6 hours (n = 50 m each group). If abortion had not occurred after 24 hours, 5 x 1 mg of gemeprost was administered every 3 hours in both groups of women. Although the median abortion interval was slightly shorter in the 1 mg group (7.8 vs. 8.4 hours, p = 0.5), the cumulative abortion rates at 24 hours were similar (98% vs. 96%). Women in Group I required significantly more gemeprost to induce abortion than those in Group II (p 0.0001). Parous women in both groups required significantly less of the prostaglandin to induce abortion. Primigravidae took longer to abort than multigravidae, although the difference only reached statistical significance in Group II (median 9.5 hours vs. 6.1 hours; p 0.02). The women in Group II required a lower dose of gemeprost to complete the abortion than those in Group I (median 1 mg vs. 2 mg; p 0.0001). There were no significant differences between the groups in the incidence of vomiting, diarrhea or the request for analgesia. Surgical evacuation of the uterus because of retained or incomplete placenta was required in approximately 1/5 of women in each group. One woman in Group II required blood transfusion because of a retained placenta after expulsion of the fetus. The results suggest that in parous women the dose of gemeprost can be reduced to 0.5 mg every 6 hours within the first 24 hours without loss of clinical efficacy.
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PMID:A randomised study of two doses of gemeprost in combination with mifepristone for induction of abortion in the second trimester of pregnancy. 884 86

This study describes the introduction of hysterosalpingo-contrast sonography (HyCoSy) as a first line outpatient investigation of uterine and tubal factors in two fertility units. 136 infertile women had transvaginal scanning before and during the intrauterine injection of contrast medium (Echovist-200). HyCoSy was successfully completed in 132 cases (97%) within a mean time of 12.6 +/- 8.4 (4-50) min. The uterus and its cavity appeared normal in 108 (82%) women. Uterine abnormalities in the remaining 24 women (18%) included structural abnormality (n = 7), fibroids (n = 12) and endometrial polyps (n = 5). A total of 261 fallopian tubes in 132 women were assessed: 186 (71%) appeared patent and 55 (21%) blocked. The remaining 20 (8%) could not be assessed for technical reasons. Polycystic ovaries and ovarian cysts were diagnosed in eight women. The most common adverse effect was mild/moderate pain, similar to period pain, with 24 (18%) women requiring simple analgesia. HyCoSy is a simple and well tolerated outpatient procedure. The technique provides clinically valuable information about tubal patency, ovarian and uterine abnormalities.
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PMID:Hysterosalpingo-contrast sonography (HyCoSy) using Echovist-200 in the outpatient investigation of infertility patients. 903 25

To study the analgesia efficacy of drugs combined with acupuncture analgesia for painless labor, 462 normal pregnancy women were observed. During the latent phase in labor, several analgesia methods: acupuncture analgesia, analgesics, magnetotherapy and auricular acupressure, TENS combined with dihydroetorphine were used respectively. While the intrauterine pressure and the peripheral content of beta-EP were measured during labor, the experiments of SEPS were also performed on healthy adults to demonstrate the analgesia efficacy of those analgesia methods. The combination of drugs with acupuncture is an excellent method for painless labor without any complications and all the mothers and babies are safety. The effectiveness is 97.5%. The results demonstrate that the mechanism of analgesia efficacy should be regulated the incoordinate uterine action and improve the hypertonic status of uterus, but also can decrease the pain threshold and elevate the tolerance of uterine contractions during labor.
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PMID:[Clinical study on painless labor under drugs combined with acupuncture analgesia]. 938 34

The authors analyze early neonatal morbidity in 87 preterm babies and the values of perinatal mortality of newborns born to mothers whose labor was anesthesized by different methods. The task of this study was to assess the effect of long epidural anesthesia (LEA) used for preterm labor pain relief on the survival of small-for-date babies. Standard anesthesia of labor is compared to LEA. LEA ensured adequate analgesia and stable hemodynamics; moreover, it protected the intrauterine fetus from hypoxic injuries to the central nervous system due to normalization of uterine contractility and uteroplacental bloodflow and relaxation of the muscles of the fundus of the uterus.
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PMID:[Anesthesia in preterm labor]. 951 Dec 40

The purpose of this study is to define the time for different steps of Caesarean section from the moment the women lays on the operating table to the last stitch on the skin. The study is prospective and include 82 elective and emergent CS. The traditional surgical technique is used without omitting any step. The mean stay of the women in the operating theater is 90 min. The preparation for the anesthesia/analgesia is 23 min (range 8-41). The proper time of the operation is 44.3 min. The laparotomy by Pannenstiel incision takes 3 min. The opening time of the uterus is 37 sec (10-190) and the closer on two layers is 17 min (10-35). The extraction of the foetus takes 53 sec (15-180). The exteriorization of the uterus doesn't affect the repair time. Leaving the visceral and parietal peritoneum unsutured can spare 5.5 min. The elective CS takes more time than the emergent one. The time from the beginning of the operation to the extraction of the foetus is longer in resection (7 min) than in first CS (5 min).
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PMID:[The overall and step-by-step duration of cesarean section]. 1073 68

Nitroglycerin is administered intravenously in acute obstetric emergencies to relax the uterus. However, complications (eg, hypotension, acute uterine bleeding) are frequent, which prompted a search for alternative routes of administration. We hypothesized that the sublingual administration of nitroglycerin would reduce uterine tone and contractility with few complications. Intrauterine pressure was measured in 12 women who were actively laboring (>4 cm dilatation, regular contractions) with epidural analgesia and who were alert and responsive throughout the study. In a double-blind fashion, subjects were randomized to receive either placebo or sublingual nitroglycerin (3 doses, 800 microg each) 10 minutes apart. The obstetric anesthesiologist continuously monitored maternal blood pressure and fetal heart rate. Cervical dilatation was assessed at the beginning and the end of the protocol. The area under the intrauterine pressure curve (integral) was used to estimate uterine contractility. Intrauterine pressure was analyzed before the randomization code was broken. Nitroglycerin did not alter the intrauterine pressure integral after the first dose (placebo, 3147 mm Hg x s [95% CI, 2206-4088] vs nitroglycerin, 4146 mm Hg x s [95% CI, 2451-5841]; P =.22), second dose (placebo, 3123 mm Hg x s [95% CI, 2447-3799] vs nitroglycerin, 3611 mm Hg x s [95% CI, 2723-4499]; P =.28), or third dose (placebo, 3303 mm Hg x s [95% CI, 2616-3990] vs nitroglycerin, 3810 mm Hg x s [95% CI, 2306-5314]; P =.45). Cervical dilation, basal uterine tone, duration and frequency of uterine contractions, or fetal heart rhythm remained unaffected. Maternal mean arterial pressure decreased significantly after nitroglycerin was administered. All women were delivered vaginally without intervention. Three doses of sublingual nitroglycerin (800 microg per dose) reduce neither uterine activity nor tone, despite lowering maternal blood pressure. If a clinical option, sublingual nitroglycerin will require a higher dose, which would place mother and fetus at risk for complication.
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PMID:Effects of sublingual nitroglycerin on human uterine contractility during the active phase of labor. 1211 17

Spontaneous rupture of the uterus is a life-threatening obstetrical emergency. Diagnosis may be delayed because of the bizarre presentation or absence of significant pain and tenderness, which could have been masked by the analgesic medications used during labor. We present a case of spontaneous rupture in a multigravid female who was undergoing oxytocin-augmented labor while receiving epidural analgesia. She had had no previous cesarean deliveries or uterine surgery. Half an hour after an initial complaint of left inguinal pain, which was thought to be related to a patchy epidural block, she presented with changes in vital signs and significant fetal decelerations. At emergent cesarean section, a uterine rupture was noted. The uterine rupture extended down to the left vaginal angle, was not reparable and a hysterectomy was performed. The fetus survived.
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PMID:Spontaneous rupture of uterus. 1277 Jun 66

During April 1987-July 1992, a gynecologist inserted 300 Gyne-T 380 IUDs in 274 women attending the obstetrical-gynecologic service at the University Hospital St. Antoine in Paris, France. Exclusion criteria for IUD use were nulliparity, prior confirmed genital infection, and indication of intolerance to an IUD in situ. The physician did not consider uterine scars (especially cesarean section scars), uterine malposition, and painless uterine retroversion as absolute contraindications. Instead, he considered them relative contraindications. He inserted the IUD in the beginning of the cycle without analgesia. He followed-up with IUD users every six months. 94% were followed-up at least once; most were followed-up regularly. After 1989, IUD insertions fell significantly. Most women (126) were 40-44 years old. Mean parity was 2.38. 96 IUDs were removed. The leading reason for IUD removal was menstrual cycle troubles (51.2%). 0.8% became pregnant. Pelvic inflammatory disease occurred in 3 women. 17% of the women had a retroverted uterus. Careful insertion led to hardly any difficulties in these cases. Secondary effects were more common in women with a retroverted uterus, however. IUD use was shorter in this group than in the entire group (16 vs. 25 months). None of the 18 cases with a uterine scar suffered adverse effects of the IUD. These findings show that IUD use can be safely extended and the IUD can be a valuable alternative to other contraceptive methods.
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PMID:[The intrauterine device (IUD): are there still contraindications? A study of 300 Gyne-T 380 users (1987-1992)]. 1228 91


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