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)

In 70 patients (maxillo-facial-, neurosurgical-, abdominal- and gynaecological operations) the technique of "analgetic anaesthesia" using high doses of fentanyl (0.025 mg/kg body weight) and naloxone as its antagonist (0.02 mg/kg body weight) has been employed. All patients were artificially ventilated with N2O/O2 in a 3:1 ratio. Muscle relaxation was achieved with pancuronium-bromide (0.08 mg/kg). The patients had no apparent heart or lung disease. The youngest patient was 4 years of age, the oldest 82 years of age (average age 48.9). The necessity for a reinjection of fentanyl (half the initial dose) was determined by continously monitoring heart rate. This variable appeared to be the most subtle index indicating a reduction in analgesia. Sufficient analgesia was maintained once the heart rate stayed 20% below preanaesthetic levels. At the end of the operation naloxone reversed the respiratory depression. There was no evidence indicating postoperative pain, which may have required administration of additional analgesics. If deep analgesia was maintained up to the last surgical procedures no emesis appeared in the post operative period. The incidence of emesis was higher 10% compared to the classical neuroleptanalgesia with droperidol this was often noted in cases where blood accumulated in the stomach (maxillo-facial operations) (70%). In 3% of all cases psychomotor agitation with delirium appeared right after the injection of naloxone. This lasted for about 15 minutes. We suspect that due to the sudden and powerful effect of naxolone, in replacing fentanyl from its receptor site, acute withdrawal symptoms may be precipitated.
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PMID:[High doses of fentanyl as the sole anaesthetic agent and naloxone as its antagonist (author's transl)]. 113 60

Combined spinal and epidural anesthesia is a new regional anesthetic modality which combines the benefits of both the spinal and epidural approaches. 24 patients (11 after cesarean section and 13 after orthopedic operations on the lower limbs) were studied. Muscle relaxation and anesthesia were excellent, and regional anesthesia can be prolonged after the original spinal anesthesia wears off. No other anesthetics were needed. Methadone or morphine were given through the epidural catheter in the recovery room for postoperative analgesia. All patients were followed for 24 hours postoperatively.
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PMID:[Combined spinal-epidural anesthesia]. 206 21

Eighteen dogs of Tanzanian breeds divided into three groups of 6 were anaesthetized using either azaperone-metomidate (2 mg/kg, i.m. and 10 mg/kg i.p., respectively), propionyl promazine-xylazine-metomidate (2 mg/kg i.m., 1 mg/kg i.m. and 10 mg/kg i.p., respectively), or xylazine-ketamine (1 mg/kg i.m. and 11 mg/kg i.m., respectively). The clinical effects on respiration rate, heart rate and body temperature were studied until recovery. Hypersensitivity to noise was associated with azaperone metomidate anaesthesia. The other combination produced a smooth and uneventful induction and recovery from anaesthesia. Muscle relaxation and analgesia were adequate in all groups. Duration of xylazine-ketamine anaesthesia was shortest (30 +/- 5 minutes) followed by azaperone metomidate (50 +/- 15 minutes) and the longest duration was with propionyl promazine-xylazine-ketamine (120 minutes). Azaperone and metomidate was associated with marked increases in cardiac and respiration rates and marked hypothermia, which persisted throughout. Minimal changes were observed in the other combinations. Azaperone-metomidate seems to be preferable due to the moderate period of anaesthesia adequate for most operations. However, all the three combinations offer a practical application because of the convenient route of administration.
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PMID:Clinical effects of azaperone-metomidate, as compared to propionylpromazine-xylazine-metomidate or xylazine-ketamine combinations in anaesthesia of dogs. 256 60

Interscalene brachial plexus block is a simple and effective alternative to intravenous benzodiazepines or general anaesthesia for manipulation of the dislocated shoulder. Thirty interscalene brachial plexus blocks were performed on 29 patients with dislocations of the shoulder to provide regional anaesthesia for reduction. Pain was abolished by 14 out of the 30 blocks performed, improved by 13 and unchanged by three. Muscle relaxation (MRC grade 3 or less) occurred in 21 patients. In 26 cases the block allowed reduction of the dislocation without additional analgesia or sedative. Reduction was not possible in four cases. There were no significant complications.
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PMID:Interscalene brachial plexus blocks in the management of shoulder dislocations. 278 84

Twenty-seven patients received an alfentanil loading dose of 100 micrograms kg-1 in two 50-micrograms aliquots followed by a fixed rate infusion of 1 microgram kg-1 min-1. At clinical signs of response to surgical stimulus, an alfentanil dose of 1 mg was added. Patients were ventilated with a N2O/O2 mixture. Muscle relaxation was achieved with a vecuronium infusion. No other drugs were given during the procedure. Major orthopaedic or maxillo-facial surgery patients were studied. The duration of infusion was from 2-7 h (mean of 3.9 +/- 1.6 h SD). In 25 of 27 cases the anaesthesia was considered adequate and stable. A mean of two additional doses per patient were needed in 25 patients, with a range of zero to four doses in the group. This study supports the view that after an appropriate loading dose a fixed-rate infusion of alfentanil at 1 microgram kg-1 min-1 can be given for up to 7 h to provide satisfactory stable analgesia without undue post-operative ventilatory depression or prolonged recovery in the majority of cases.
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PMID:Clinical experience with a fixed rate of alfentanil infusion. 312 53

The anaesthetic management of two patients with severe muscle weakness--one suffering from acute dermatomyositis, the other from acute polymyositis--is described. Both patients presented for surgery for malignancy. Anaesthesia was induced with etomidate in one, thiopentone in the other. Alfentanil was used for analgesia and atracurium for muscle paralysis in both. Neuromuscular blockade was monitored using a peripheral nerve stimulator and no problems were experienced. Recovery of neuromuscular transmission and ventilatory function after operation were normal.
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PMID:Anaesthesia and acute dermatomyositis/polymyositis. 313 34

The use of ketamine hydrochloride and sodium pentobarbitone in the anaesthesia of two species of Australian skink was examined. The effects of ketamine at ambient temperatures of 15 degrees C and 30 degrees C were studied. Ketamine produced consistent responses up to and including anaesthesia at dose rates of 170 to 230 mg/kg at 30 degrees C. The effect of temperature on the anaesthetic dose, respiratory and cardiac rates, muscle relaxation, analgesia and the onset and duration of anaesthesia was examined. Respiration in both species was depressed but heart rate was increased in Bobtail skinks (Tiliqua rugosa) and depressed in King's skinks (Egernia kingii). Muscle relaxation was good when anaesthetic doses were given. Generally, the onset and duration of anaesthesia were extended at 15 degrees C while the dose rates required for this effect were reduced. Although there was individual variation in the response to ketamine, it was found to be a useful and practical agent for the anaesthesia of large skinks. Pentobarbitone was found to be unsuitable as an anaesthetic agent because it produced inconsistent results and several fatalities.
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PMID:Anaesthesia in two species of large Australian skink. 342 Jul 84

This is a case report of a 35-year-old female with acute intermittent porphyria who presented for elective vagotomy and pyloroplasty. The diagnosis of porphyria was made two years previously when she developed acute abdominal pain and lower motor neurone paralysis following ingestion of a barbiturate. The urine porphobilinogen test was positive. The patient had no other acute attack of porphyria and had not had a previous anaesthetic. Anaesthesia was induced with etomidate 0.3 mg X kg-1 IV. Muscle relaxation was obtained with pancuronium 6 mg IV and ventilation was mechanically controlled. Intraoperative analgesia was with 66 per cent nitrous oxide in oxygen and intermittent doses of fentanyl. The patient was stable during anaesthesia and surgery. The postoperative period was uneventful and patient did not have an acute attack of porphyria. This experience suggests that etomidate is safe for intravenous induction of anaesthesia in acute intermittent porphyria. However, reports of its use in more patients with this disease will be necessary before a final conclusion can be made.
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PMID:Induction of anaesthesia with etomidate in a patient with acute intermittent porphyria. 398 54

A technique of total intravenous anaesthesia using etomidate by bolus intravenous (IV) injection for induction and by continuous intravenous infusion for maintenance of anaesthesia, with supplementary intravenous fentanyl analgesia, is described. Muscle relaxation was provided by competitive neuromuscular blockade, allowing controlled ventilation of the lungs with oxygen-enriched air. Arterial blood pressure, heart rate and rhythm remained stable throughout the procedure. Few complications were encountered of which the most significant was a 13% incidence of nausea and/or vomiting. Pain on injection, abnormal muscular movements on induction, and post operative venous sequelae were uncommon. Patients were easily rousable shortly after termination of drug infusion. The technique proved acceptable to the patient, surgeon and experienced anaesthetist and, thereby, would appear to offer a reasonable alternative to the more conventional inhalational anaesthetic technique.
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PMID:Total intravenous anaesthesia for major gynaecological surgery. 725 8

The anaesthetic management and postoperative complications of 110 grossly obese patients undergoing weight-reducing surgery have been reviewed. The major problems were technical, related to the bulk of the patient, and respiratory, caused by alterations in pulmonary physiology. Extradural catheters were placed in 70 patients before induction of general anaesthesia. In all patients the trachea was intubated during anaesthesia and the lungs ventilated with large tidal volumes and appropriate inspired oxygen concentrations. Muscle relaxation was achieved with extradural block in 35 patients; the remainder received pancuronium i.v. Extradural analgesia with bupivacaine provided excellent analgesia after surgery and greatly facilitated nursing care.
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PMID:Anaesthesia for the morbidly obese. Experience with 110 patients. 727 44


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