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)

It is a tragedy that morphine is scarcely available for between 1.3 and 2.5 billion people whilst 3.5 million cancer patients suffer needlessly. In only 10 countries is its consumption rising, in many more only codeine consumption shows an increase, and in many areas even in the Western world prescribing is grossly limited, fears of psychological addiction persist, professional education of doctors and nurses in analgesia remains minimal and too much importance is attached to expensive sophisticated methods of administration. Doctors have a professional and a moral responsibility to press for improved morphine availability in the most useful and economical forms worldwide.
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PMID:Morphine: myths, morality and economics. 175 20

Two major consequences of placentophagia, the ingestion of afterbirth materials that occurs usually during mammalian parturition, have been uncovered in the past several years. The first is that increased contact, associated with ingesting placenta and amniotic fluid from the surface of the young, causes an accelerated onset of maternal behavior toward those young. The second, which probably has importance for a broader range of mammalian taxa than the first, is that ingestion of afterbirth materials produces enhancement of ongoing opioid-mediated analgesia. The active substance in placenta and amniotic fluid has been named POEF, for Placental Opioid-Enhancing Factor. Recent research on both consequences is summarized, with particular attention to POEF, the generalizability of the enhancement phenomenon, its locus and mode of action, and its significance for new approaches to the management of pain and addiction.
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PMID:Enhancement of opioid-mediated analgesia: a solution to the enigma of placentophagia. 195 10

This review draws on data obtained in the cancer pain, nonmalignant pain, and addict populations to examine critically the major issues raised by the use of chronic opioid therapy in nonmalignant pain. The available evidence suggests that there is probably a selected subpopulation of patients with chronic nonmalignant pain who may obtain sustained partial analgesia without the development of toxicity or the psychologic and behavioral characteristics of addiction. Future discussions of this approach must adequately define the terminology of addiction and strive to distinguish medical considerations from the societal and regulatory influences that may affect prescribing behavior. Those who treat patients with chronic pain must actively participate in these discussions lest decisions with enormous impact on patient care be made solely by those whose primary responsibility is the elimination of substance abuse.
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PMID:Chronic opioid therapy in nonmalignant pain. 196 92

The study of 65 cancer patients has demonstrated the advantages and disadvantages of tramal as an agent used for the relief of acute and chronic pain syndrome. In 18 patients tramal was used in postoperative analgesia, in 17 patients it was used for the treatment of chronic pain syndrome. It has been shown that in the postoperative period tramal has no noticeable advantages over promedol. However, tramal had definite advantages over other opiate agonists when used for the treatment of chronic pain syndrome in incurable cancer patients. Thus, the data obtained show that tramal, a synthetic analgesic of a new generation, has no dangerous side effects, is effective in a convenient, non-invasive drug form, interacts well with non-narcotic and supplementary agents and causes no clinical signs of drug tolerance or addiction in prolonged application.
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PMID:[Tramal in the treatment of acute and chronic pain syndromes in cancer patients]. 207 35

Transcutaneous electrostimulation is a somewhat controversial technique used in the management of the opiate withdrawal syndrome. We report an animal study of a particular transcutaneous electrostimulation called transcutaneous cranial electrostimulation, based on a technique used for many years on heroin addicts for the rapid severance of their addiction, which has been validated in a clinical setting by a double-blind trial. This technique involves the application of an intermittent high-frequency current (Limoge's current). Our experimental data show that this transcutaneous cranial electrostimulation increases morphine analgesia by threefold on the tail flick latency measure and produces a 48% attenuation of the abstinence syndrome observed after abrupt cessation of morphine administration. These results were obtained using a double-blind paradigm.
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PMID:Transcutaneous electrical stimulation with Limoge current potentiates morphine analgesia and attenuates opiate abstinence syndrome. 217 29

Patient-controlled analgesia is an increasingly popular method of postoperative pain relief. However, patients often worry about new therapies. Eighty ASA 1 and 2 patients aged 18-65 years were asked to list the advantages and disadvantages of using patient-controlled analgesia. The most important advantage as perceived by patients was the reduced time spent by nurses in giving medication, but there was concern that direct personal contact would also be lessened. Preservation of self control, autonomy, rapid onset of analgesia, ability to titrate analgesia and lack of injections were seen as an advantage. Addiction and machine faults were seen as minimal problems. Preservation of patient-nurse contact is of great importance to ensure success of postoperative analgesia.
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PMID:Patients' expectations of patient-controlled analgesia. 227 34

The pharmacological properties of centrally acting alpha2-receptor agonists such as clonidine suggest a potentially important role as ideal adjuvants for anesthesia since they produce sedation, analgesia anxiolysis, xerostomia and cardiovascular stability without respiratory depression, development of tolerance or addiction liability. Further clinical experience with this exciting development will undoubtedly establish the ultimate role and optimal use of alpha2 -receptor agonists in anesthetic practice. Beta-blockage can result in significant bradycardia, atrial ventricular conduction problems, bronchospasm and left ventricular contractile dysfunction. Thus, the use of long-acting beta-blockers is of limited value in the perioperative period. Esmolol, because of its ultrashort action, cardioselective properties and titratability, has been shown to be safe and effective for the treatment of tachycardia and hypertension. Doses from 50 to 300 micrograms/kg/min for up to 7 hours in the perioperative period have been shown to cause no apparent cumulative effect. It has been used in the treatment of asthmatic patients with tachycardia and hypertension without significant increases in airway resistance. Studies using esmolol during general anesthesia have demonstrated no significant interaction with several anesthetic regimens.
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PMID:Clinical pharmacology of alpha2-agonist and beta-adrenergic blocker. 257 80

A method for postoperative analgesia is described on 200 patients operated on abdominal organs and anterior abdominal wall. The technique of pharmacological stimulation of acupuncture points was used. Placental suspension was used as a stimulator. The method is highly effective, simple in use and cheap. The use of reflex therapy technique ensures early postoperative activation of patients. The method does not affect adversely the functions of the patients' organs and systems and makes it possible to detect early signs of postoperative complications and identify and eliminate cases of addiction to narcotic analgesics, as it is possible to restrain from their use in the postoperative period.
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PMID:[Pharmacologic stimulation of acupuncture points for postoperative analgesia]. 271 79

From the data in the literature it can be seen that 40% of the surgical population has insufficient postoperative analgesia. Many reasons have been given for this: pain control delegated to the doctor on duty and/or the nursing staff; administration of drugs 'on demand', if the patient asks for them, or the nurses feel it to be necessary; fear of causing side effects such as respiratory insufficiency; or provoking addiction by giving narcotics. The aim of this paper is to evaluate the intensity of pain, the side effects, the degree of activity, anxiety, feeling of weakness and the mood of patients surgically treated for oncological diseases of the thorax and upper abdomen, comparing two different antalgic approaches. Thirty-five patients were studied. Pain was treated on demand with a narcotic, or an anti-inflammatory drug, or not treated at all; 20 patients were treated with analgesics given at predetermined hours, following the regime: methadone 10 mg intramuscularly (i.m.) every 12 h from the first to the third day following surgery and sodium diclofenac 75 mg (i.m.) every 12 h from the fourth to the seventh day. Results showed that patients treated with analgesics given intramuscularly at fixed hours have a significantly better pain control during the whole week of treatment (P less than 0.001), on average sleep more (P less than 0.001), spend more time standing or sitting and fewer hours lying down (P less than 0.001), have a higher performance status and feel less weak (P less than 0.05) than the group of patients treated with drugs 'on demand', or not treated at all.
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PMID:Treatment of postoperative pain: comparison between administration at fixed hours and 'on demand' with intramuscular analgesics. 273 11

We report the intraarterial injection of a flunitrazepam tablet dissolved in water in a patient with intravenous drugs addiction. Several ecchymotic lesions were present at different sites of the arm. In order to achieve analgesia and the sympathetic blockade of the arm, we performed an axillary perivascular block of the brachial plexus by means of the intermittent injection through a catheter of 0.25% bupivacaine with a 1:200,000 epinephrine solution. In addition, an anticoagulant treatment with heparin was started as prophylaxis of the thrombosis of the vessel. There was a satisfactory clinical course even though a distal phalange had to be amputated on the 18th day. We propose the continuous perivascular block as the method of choice of this type of medical problem.
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PMID:[Use of axillary perivascular blockage of the brachial plexus with a catheter as treatment in accidental intra-arterial injection of drugs]. 276 12


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