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)

The effect of adding hyaluronidase to regional ophthalmic anaesthesia with etidocaine 1.5% was examined. Two studies were performed in a double-blind fashion. In Study #1, 70 patients were given peribulbar anaesthesia with etidocaine either with or without hyaluronidase (7.5 IU.ml-1) using a standard intraorbital injection and separate lid injections. The block was supplemented as needed. Lower intraorbital volumes (6.4 +/- 2.2 ml vs 8.2 +/- 2.3 ml, P < 0.01) and improved scores for globe akinesia (P < 0.01), lid akinesia (P < 0.01) and analgesia (P < 0.05) were recorded in the hyaluronidase group than in the plain etidocaine group. In Study #2, 80 patients were randomized to receive etidocaine and hyaluronidase either at a concentration of 7.5 IU.ml-1 or 15 IU.ml-1 using a two-injection-site technique. No differences were noted in the volumes of local anaesthetics required or in the success rates between the two groups. It was concluded that the addition of hyaluronidase to etidocaine decreases the volume needed and improves the quality of block compared with plain etidocaine. Doubling the dose of hyaluronidase does not improve the effectiveness of block.
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PMID:Hyaluronidase improves regional ophthalmic anaesthesia with etidocaine. 145 Dec 20

Peribulbar and retrobulbar anaesthesia are commonly used techniques in cataract extraction. They offer satisfactory analgesia and akinesia but serious complications although uncommon are consistently reported. Intravenous sedation combined with a facial nerve block offers an alternative method of anaesthesia. This is a retrospective study of patients who underwent extracapsular cataract extraction using this technique between 1 January 1986 and 1 September 1990. The operating conditions were judged to be very suitable with minimal peroperative complications. The postoperative ocular complication rate was low (minimum follow-up 3 months) and no serious medical complications were noted: 93.8% of patients achieved 6/12 vision or better. This study demonstrates that it is possible to achieve satisfactory ocular analgesia and akinesia during cataract extraction under local anaesthesia without the use of a periocular injection.
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PMID:Neuroleptanalgesia and extracapsular cataract extraction. 154 May 58

To determine the effectiveness of various combinations of lidocaine, epinephrine, and hyaluronidase with bupivacaine, a prospective, randomized, masked study on 117 patients having cataract extraction under local anesthesia was undertaken. All patients were given a 9 ml peribulbar block by one surgeon, and a graded assessment of analgesia and akinesia was made in a masked fashion one hour later. A mixture using all these agents gave significantly better results than any of the combinations (P = .001). No single agent was shown to be the major determinant of effectiveness. The result suggests a synergistic effect found only when all the agents are combined.
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PMID:Choice of anesthetic agents for peribulbar anesthesia. 200 63

This paper describes an assisted local anaesthetic technique which we have used almost exclusively for extracapsular cataract extraction and posterior chamber intraocular lens implant surgery over the last 12 months. This ALACS technique was developed from a combined neurolept-local anesthetic into an assisted local anaesthetic suitable for day-stay cataract surgery. The technique combines the advantages of purely local (retrobulbar and facial) anaesthesia with the advantages usually inherent in a good general anaesthetic. Thus the patient is in a state of general quiescence and psychic indifference throughout the procedure. ALACS provides excellent and long-lasting akinesia and analgesia, with adequate proptosis of the eye which facilitates surgical access. ALACS is suitable for almost all adult cataract and implant surgery. Our results in 104 cases of ALACS are reviewed in terms of visual results and complications both ocular and anaesthetic; the results appear good and the complications minimal. The results of blood gas estimations done intraoperatively in a small number of patients are also presented, and suggest that the technique is systemically safe.
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PMID:Assisted local anaesthesia for cataract surgery (ALACS). 367 10

A method of producing ocular hypotony, a decrease in motility, sufficient akinesia of the facial nerve as well as deep analgesia is described. This procedure seems to be more comfortable for the patient and preferable for the surgeon because it is safe. It consists of a single retrobulbar injection using a high-capacity syringe and oculopression at a higher pressure with a special instrument over a period of 20 minutes. The advantage of this method, some theoretical information, and the author's experience with it are communicated.
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PMID:[Preoperative preparation for cataract operation in artificial lens implantation]. 371 86

In ophthalmology, increasing attention has been directed to methods of local anesthesia and akinesia that provide complete analgesia and immobilization of the eye conducive to work with the surgical microscope, particularly in operations for cataracts. The volume of anesthetic agent often used to achieve these goals may approach the toxic level of the drug in some patients. A method of producing akinesia of the temporal, zygomatic, and buccal divisions of the facial nerve that requires only a small volume of anesthetic is described. In our experience, this method can, in many cases, provide akinesia of the orbicularis oculi equal in effect to some established methods of infiltrative akinesia that require large doses of anesthetic.
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PMID:Facial nerve akinesia. 394 Jan 36

Three groups of 15 patients each were randomly assigned to receive a retrobulbar anesthetic block with 0.5% bupivacaine, 0.5% bupivacaine/2% lidocaine or 0.5% bupivacaine/2% lidocaine/1:100 000 epinephrine for unilateral cataract surgery. Hyaluronidase was added to each of the preparations, which were used in double-blind fashion. Lid and globe akinesia and corneal anesthesia were graded after 4 minutes of ocular massage and 36 minutes later (at the end of the procedure) to assess the rapidity of onset and the duration of action of the anesthetics. Overall, bupivacaine/lidocaine/epinephrine was the most effective in producing akinesia of the lids and globe. Bupivacaine alone was more effective than bupivacaine/lidocaine without epinephrine in producing akinesia, although it was slower in producing anesthesia. There was no difference between the groups in the frequency of pain or of the need for analgesia 6 hours postoperatively.
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PMID:Retrobulbar anesthesia for cataract surgery: comparison of bupivacaine and bupivacaine/lidocaine combinations. 405 61

Bupivacaine 0.75% with epinephrine and/or hyaluronidase and lidocaine 2% with epinephrine and hyaluronidase were compared as to onset and duration of surgical anesthesia and akinesia in a prospective, randomized, double-blind study in 111 patients undergoing 128 elective intraocular surgical procedures. There was no significant difference in onset time to adequate surgical anesthesia among any of the drug groups at 15 minutes following retrobulbar injection, but the bupivacaine with epinephrine group lagged for akinesia. Mean duration of akinesia was 11 hours for the bupivacaine groups compared to four hours for lidocaine. During the eight hours following surgery, 70-90% of the patients receiving bupivacaine required no postoperative analgesia compared to less than 40% of the lidocaine group. There were no drug-related complications.
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PMID:Bupivacaine and lidocaine retrobulbar anesthesia. A double-blind clinical study. 634 30

Effects of taurine on tolerance to [D-Ala2, Met5]enkephalinamide (DAME) were investigated in rats. Tolerance was produced by five intraventricular administrations of DAME (50 microgram) during 3 consecutive days. The magnitude of developed tolerance to DAME was not uniform for each behavioral parameter; tolerance to analgesia effects developed more intensively and rapidly from the repeated injections of the peptide than that to akinesia effects. Pretreatment with taurine (9.5 X 10(-2) M) which was injected in a volume of 10 microliter intraventricularly 10 min prior to every administration of DAME suppressed the development of tolerance to both analgesia and akinesia effects of this peptide, whereas pretreatment with L-leucine at the same concentration did not. Spontaneous locomotor activity was measured for 1 h after the 90-min behavioral observation period was completed. That activity increased with the number of the peptide injections. Taurine pretreatment inhibited the induction of 'hyper'-locomotor activity. These results support the view that taurine may possess an ability to inhibit development of tolerance to morphine-like peptides in rats.
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PMID:Effects of taurine on tolerance to [D-Ala2, Met5]enkephalinamide in rats. 712 79

Effects of taurine or gamma-aminobutyric acid (GABA) on akinesia and analgesia induced by D-Ala2-Met-enkephalinamide were investigated in rats. Administration of taurine (dose range: 2.375 X 10(-2) M-9.5 X 10(-2)-Met-enkephalinamide were investigated in rats. Administration of taurine (dose range: 2.375 X 10(-2) M-9.5 X 10(-2) M/10 microliters) into the left lateral ventricle 10 min prior to the injection of D-Ala2-Met enkephalinamide (50 microgram/10 microliter) produced a dose-dependent reduction in the duration of akinesia and to some extent of analgesia, as estimated at 30 min and 60 min following the enkephalinamide injection; at the first estimation-time (10 min), taurine did not alter the duration of akinesia or that of analgesia. The median effective dose (ED50) for akinesia determined at 60 min after D-Ala2-Met-enkephalinamide was 5 times greater and that for analgesia assessed at the same time was 1.7 times greater in taurine-treated rats than the respective doses in control animals. Administration of GABA under similar experimental conditions produced a dose-dependent reduction in the duration of analgesia from the initial estimation time (10 min) following the injection of D-Ala2-Met-enkephalinamide. The ED50 for analgesia determined at 30 min after D-Ala2-Met-enkephalinamide was 3 times greater in GABA-treated rats than in control animals. Unlike the effects of taurine, GABA did not alter the duration of akinesia. Neither the duration of akinesia nor that of analgesia was modified by taurine or GABA alone in rats tested 9 min after the injection of each amino acid. These findings suggest that taurine may promote a recovery from both akinesia and analgesia, while GABA decreases only the analgesia induced by D-Ala2-Met-enkephalinamide.
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PMID:Effects of taurine and gamma-aminobutyric acid on akinesia and analgesia induced by D-Ala2-Met-enkephalinamide in rats. 724 12


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