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)

Luxatio erecta humeri is a rare type of glenohumeral dislocation. The pathomechanics of this injury involve either direct axial loading on a fully abducted extremity or leverage of the humeral head across the acromion by a hyperabduction force. The clinical presentation of this type of shoulder dislocation is unique, with the affected extremity held rigidly above the head in abduction. Reduction is accomplished by a form of traction-countertraction under intravenous sedation and analgesia. A variety of neurologic and vascular injuries may be associated with luxatio erecta humeri, involving the brachial plexus and axillary artery, respectively. Concomitant fracture of the acromion, clavicle, coracoid, greater tuberosity, and humeral head may also be seen. A computed tomography scan of the case reviewed here revealed a large humeral head defect oriented perpendicular to the classic Hill-Sachs lesion. Luxatio erecta humeri is associated with significant late morbidity, including recurrent dislocation, instability, and adhesive capsulitis.
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PMID:Luxatio erecta humeri. A case report. 230 79

Suprascapular nerve block may provide sufficient analgesia in painful immobilisation of the shoulder joint. In the following case report a 41 year old male presenting with adhesive capsulitis (frozen shoulder) has been treated successfully by performing continuous delivery of local anesthetics to the suprascapular nerve via catheter. The location of the catheter has been verified using MRI examination. Pain relief was quantified by using visual analog scale (VAS 1 - 10) and showed decretion from VAS 8 - 10 pre treatment to VAS 1 - 2 after insertion of the catheter and throughout five days of intensive physiotherapy, respectively. The technique of catheterization using a nerve stimulator and alternative peripheral nerve blocks are discussed. In summary, continuous suprascapular nerve block offers an advantageous alternative for pain relief in patients with frozen shoulder. It may provide better pain control and earlier discharge in the ambulatory setting than repetetive single dose blocks.
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PMID:[Frozen shoulder--MRI-verified continuous block of suprascapular nerve]. 1157 29

Salmon calcitonin (especially intranasal) provides an interesting analgesic effect in a series of painful conditions including reflex sympathetic dystrophy syndrome, adhesive capsulitis, ankylosing spondylitis, rheumatoid arthritis, vertebral crush fractures and metastasis, phantom limb pain, etc. In addition, in preliminary series, calcitonin shows an unexpected benefit to vasomotor changes and peptic ulcer. Yet the experience in these conditions is limited and needs confirmation. By comparison with the injectable, the intranasal route seems particularly interesting because of less undesirable effects, and a more rapid and probably more powerful analgesia.
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PMID:Calcitonin in reflex sympathetic dystrophy syndrome and other painful conditions. 1200 65

Trigeminal neuralgia (TN) has been recognized as one of the most common neurovascular syndromes caused by the vascular contact of the trigeminal nerve in its root entry zone (REZ) with a branch of the superior or anterior inferior cerebellar arteries, leading to a demyelinization of trigeminal sensory fibers within either the nerve root or, less commonly, the brainstem. There is a lack of certainty regarding the aetiology and pathophysiology of TN, therefore the treatment of trigeminal neuropathic pain disorders continues to be a major therapeutic challenge. The identification of novel therapeutic agents for the treatment of these disorders is important. Calcitonin (especially intranasal) provides an interesting analgesic effect in a series of painful conditions including reflex sympathetic dystrophy syndrome, adhesive capsulitis, ankylosing spondylitis, rheumatoid arthritis, vertebral crush fractures and metastasis, phantom limb pain, etc. Exogenous calcitonin is thought to cross the blood-brain barrier and to accumulate slowly in the brain, inducing analgesia once sufficient receptors are occupied. We hypothesize that calcitonin may has anti - trigeminal neuralgia properties. From the clinical point of use, the analgesic effect of calcitonin will be beneficial throughout the whole period of medical treatment of trigeminal neuralgia patients.
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PMID:Could calcitonin be a useful therapeutic agent for trigeminal neuralgia? 1834 43

Idiopathic adhesive capsulitis is an enigmatic shoulder disorder that causes pain and reduced range of motion from joint capsule fibrosis. In most cases, the fibrosis resolves and shoulder function returns to normal or near normal. Physicians' major tasks are to differentiate adhesive capsulitis from rotator cuff dysfunction and other causes of shoulder pain and to assist the patient in choosing appropriate treatment. Conservative therapies include rest, analgesia, and range-of-motion exercises. Other treatments include corticosteroid injections, capsular distention, manipulation under anesthesia, and surgical capsular release.
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PMID:Adhesive capsulitis: optimal treatment of 'frozen shoulder'. 2008 57

A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim. Novel insertion sites include the adductor canal, interpectoral, quadratus lumborum, lesser palatine, ulnar, superficial, and deep peroneal nerves. Noteworthy new indications include providing analgesia after traumatic rib/femur fracture, manipulation for adhesive capsulitis, and treating abdominal wall pain during pregnancy. The preponderance of recently published evidence suggests benefits nearly exclusively in favor of catheter insertion using ultrasound guidance compared with electrical stimulation, although little new data are available to help guide practitioners regarding the specifics of ultrasound-guided catheter insertion (eg, optimal needle-nerve orientation). After some previous suggestions that automated, repeated bolus doses could provide benefits over a basal infusion, there is a dearth of supporting data published in the past few years. An increasing number of disposable infusion pumps does now allow a similar ability to adjust basal rates, bolus volume, and lockout times compared with their electronic, programmable counterparts, and a promising area of research is communicating with and controlling pumps remotely via the Internet. Large, prospective studies now document the relatively few major complications during ambulatory CPNB, although randomized, controlled studies demonstrating an actual shortening of hospitalization duration are few. Recent evidence suggests that, compared with femoral infusion, adductor canal catheters both induce less quadriceps femoris weakness and improve mobilization/ambulation, although the relative analgesia afforded by each remains in dispute. Newly published data demonstrate that the incidence and/or severity of chronic, persistent postsurgical pain may, at times, be decreased with a short-term postoperative CPNB. Few new CPNB-related complications have been identified, although large, prospective trials provide additional data regarding the incidence of adverse events. Lastly, a number of novel, alternative analgesic modalities are under development/investigation. Four such techniques are described and contrasted with CPNB, including single-injection peripheral nerve blocks with newer adjuvants, liposome bupivacaine used in wound infiltration and peripheral nerve blocks, cryoanalgesia with cryoneurolysis, and percutaneous peripheral nerve stimulation.
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PMID:Continuous Peripheral Nerve Blocks: An Update of the Published Evidence and Comparison With Novel, Alternative Analgesic Modalities. 2798 6