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 spinal anesthesia with barbotage versus without barbotage on the spread of analgesia was investigated. For comparison, hyper- and isobaric bupivacaine 0.5% with adrenaline 1:200,000 was used. MATERIAL AND METHODS. Barbotage was accomplished as follows: after lumbar puncture 0.5 ml CSF was aspirated into the local anesthetic solution, followed by reinjection of 1.0 ml of the solution. This process was repeated six times. Sixty patients who were scheduled for urological or lower limb surgery under spinal anesthesia were selected for this study. Patients were each arbitrarily assigned to one of four groups (isobaric and hyperbaric, without and with barbotage). RESULTS. There was no statistically significant difference in the maximum level of sensory analgesia. The mean maximum level of sensory analgesia reached T9 (group 1), T8 (group 2), T9 (group 3) and T8 (group 4). Time to highest dermatome was significantly shorter with barbotage (groups 1-4: 19.0 min, 13.0 min, 18.7 min, 12.3 min). Times for regression of analgesia to T12 (mean maximum duration) were 142 (+/- 54.9) min, 164 (+/- 29.7) min, 130 (+/- 40.4) min and 144 (+/- 36.2) min (groups 1-4). Motor block grade 3 (Bromage) was achieved in significantly shorter times with barbotage than without. The shortest onset time was recorded with isobaric bupivacaine. The onset time of a complete motor block was 12.5 (+/- 5.5) min in group 1, 6.1 (+/- 2.9) min in group 2, 15.8 (+/- 4.7) min in group 3, and 11.7 (+/- 5.1) min in group 4. CONCLUSIONS. The results showed no significant differences between the maximum segmental sensory levels or duration of anesthesia observed with isobaric and with hyperbaric bupivacaine (with and without barbotage). Sufficient analgesia was obtained with barbotage and without barbotage. Uncontrolled cephalad spread of spinal anesthesia was not observed. Barbotage has the advantage of shortening time for spread to highest dermatome and the time to onset of complete motor block.
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PMID:[The effect of barbotage on the sensory spread in spinal anesthesia using isobaric and hyperbaric 0.5% bupivacaine]. 223 14

Bupivacaine (0.5%) 20 ml was administered extradurally to six healthy volunteers. It was found that simultaneous application of 10 needles to the skin could evoke pain when analgesia was obtained to one needle stimulation. In addition, a laser beam was used as a quantitative technique to activate simultaneously many cutaneous nociceptors. For 7 h, thresholds (sensory and pain) and pain-evoked brain potentials (amplitude and latency) to laser stimulation were monitored and used for quantitative assessment of onset, efficacy and duration of analgesia at various dermatomes (C7, T8, T10, T12, L1, L3, S1). The onset time of analgesia was shortest and conduction delay longest at the dermatome related to the site of injection (L3). Full analgesia was obtained at L1, L3 and S1, although the peak efficacy at S1 was delayed for 120-180 min after injection. A minor effect was found at dermatome C7 approximately 60 min after injection.
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PMID:Quantitative assessment of extradural bupivacaine analgesia. 224 40

Analgesia was assessed quantitatively at various dermatomes (C7, T8, T10, T12, L1, L3, S1) for the first 30 min after subarachnoid administration of 0.5% bupivacaine 3.5 ml. Stimulation with 10 needles and laser stimulation could evoke pain in dermatomes with adequate analgesia to single needle stimulation. Analgesia was assessed by thresholds (sensory and pain) and by pain-related brain potentials (amplitude and latency) to laser stimulation. Little analgesia was found at T10, but it increased gradually towards caudal segments. The dermatome related to the site of the injection (L3) was not blocked to a greater extent than the surrounding dermatomes. Conduction time (the latency of the evoked brain potential) was increased relatively more from the S1 dermatome compared with L1.
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PMID:Onset phase of spinal bupivacaine analgesia assessed quantitatively by laser stimulation. 224 41

Ropivacaine 0.5%, 0.75% and 1.0% with epinephrine 5 micrograms/ml was investigated in an open, multi-center study for lumbar epidural anesthesia in 46 patients undergoing urologic surgery. The onset time for analgesia to T12 was 5-7 minutes after the end of the ropivacaine injection. Maximum segmental levels of analgesia (T4-6) were not different between the groups. Complete motor blockade was obtained in 3/15, 7/15 and 10/15 patients in the 0.5%, 0.75% and 1.0% groups, respectively. Duration of analgesia at the T10 level was 2.5 hours in the 0.5% group, and increased to 4 hours in the 1.0% group. Analgesia was satisfactory for surgery in all patients except for 2/15 in each of the 0.5% and 0.75% groups and 1/15 in the 1.0% group. Hypotension was experienced by three, six and three patients in the 0.5%, 0.75% and 1.0% groups, respectively. Bradycardia was seen in two patients in the 0.5% group and one patient in the 1.0% group. Backache was experienced by seven patients (four in the 0.5%, two in the 0.75% and one in the 1.0% group). No late-occurring adverse experiences were observed. In conclusion, 0.5%, 0.75% and 1.0% ropivacaine with epinephrine provide adequate analgesia and motor blockade for urologic surgery.
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PMID:An open study comparison of 0.5%, 0.75% and 1.0% ropivacaine, with epinephrine, in epidural anesthesia in patients undergoing urologic surgery. 226 55

The effects of drug volume on spinal anesthesia with 10 mg tetracaine in 1 ml or 2 ml isobaric solution were studied in 100 demographically compatible patients in a randomized double-blind manner. Identical technique was used for every patient in the study except for the volume of anesthetic solutions. Drugs were administered in a lateral decubitus position and patients remained horizontal during the study. Hoghest cephalad spread of analgesia varied from T12-T3, with a median sensory level of T7 in those who received 2 ml solutions, compared with T12-T5 and a median level of T10 in those who received 1 ml solutions. The time for maximum spread was longer in 2 ml--group (7.54 +/- 1.76 min vs 4.85 +/- 1.54 min). The 2-segment regression times were 180 +/- 53.44 min (mean) with a range of 75-270 min, and 219 +/- 34.11 min (mean) with a range of 150-300 min respectively for the 2 ml--group and the 1 ml--group. The differences were statistically significant. Complete motor blockade of the lower extremities as assessed by the modified Bromage scale was achieved in 35 out of 50 patients given 2 ml solutions, while all those who received 1 ml solutions achieved complete motor blockade. The onset times of maximum blockade were 5.42 +/- 1.59 min (mean) with a range of 2-10 min, and 5.98 +/- 1.79 min (mean) with a range of 2-12 min respectively. The difference between the degree of maximum motor blockade was also statistically significant but was insignificant regarding the time to maximum motor blockade.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effect of drug volume on spinal anesthesia with isobaric tetracaine]. 227 76

In an open, nonrandomized dose response study, the efficacy of 0.75% ropivacaine (plain) for epidural analgesia was evaluated during 46 orthopedic surgical procedures (18 total hip replacements, 10 knee prostheses, 3 forefoot operations, 14 arthrotomies or osteotomies). Group 1 received 15 ml (112.5 mg); group 2 20 ml (150 mg); and group 3 25 ml (187.5 mg). The times to initial onset (6.7-7.9 min) and to the maximum level of sensory analgesia (25.7, 27.1, and 30.7 min) hardly differed. The mean maximum level of sensory analgesia increased from T6 (group 1), to T5 (group 2) and T3 (group 3), with an absolute maximum level of C3 (statistically not significant). Times for two-segment regression increased from 146 min and 169 to 192 min, for regression of analgesia to T10 from 193 and 189 to 246 min and to T12 from 220 min and 244 to 296 min (significant). The mean maximum durations were 239(+/- 54), 267(+/- 49.8) and 355(+/- 59.2) min. The degree of motor blockade varied with the volume. Motor block grade I was recorded in 100% of cases, and motor block grade II in 64% of patients in group 1, in 73% in group 2, and in 100% in group 3. Motor block grade III was only seen in 7.1% in group 1, 20% in group 2, and 47% in group 3. The duration was 102 min, 133 min and 188 min for grade I, 158 min, 199 min and 263 min for grade III when this occurred. MAP, HF and RPP varied by a maximum of -8.3%, -11.5% and -17.6% from the initial value.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ropivacaine for peridural anesthesia. Studies on the dose-response relationship in orthopedic surgery]. 235 45

Ropivacaine 0.5%, 0.75% and 1.0% was investigated in an open study of extradural anaesthesia in three groups of 15 patients undergoing urological or orthopaedic surgery. Following a test dose of 3 ml of 1.0% lignocaine with 1:200,000 adrenaline, ropivacaine 20 ml was given in incremental doses over 4 min via a lumbar extradural catheter. The onset time for analgesia was short in all groups: T12 was blocked 4-6 min after the end of the injection of ropivacaine. The maximum segmental level was significantly higher in the 0.75% and the 1.0% groups (T2) than in the 0.5% group (T5). Complete motor block was obtained in seven, four and nine patients in the 0.5%, 0.75% and the 1.0% groups, respectively. Duration of analgesia increased with increasing concentration of ropivacaine: mean duration of analgesia was 203 and 266 min at T10 and 253 and 314 min at L5 for the 0.5 and 1% solutions, respectively. Mean duration of complete motor block was 94 and 192 min for the same solutions. Analgesia was satisfactory for surgery in all patients except for one in the 0.75% group. Hypotension was experienced by three, seven and three patients in the 0.5%, 0.75% and 1.0% groups, respectively. Bradycardia occurred in seven patients and was associated with hypotension in five. Backache was experienced after operation by four patients, and three patients complained of a brief mild headache. No late adverse events were seen.
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PMID:An open study of ropivacaine in extradural anaesthesia. 240 97

The effects of somatostatin, injected into the epidural space, on analgesia and control of ventilation were studied in 25 patients aged 41 +/- 9 yrs (mean +/- SD). The patients were allocated to three groups to receive: Group I--1 mg of somatostatin in 2 ml saline (n = 13); Group II--1 mg of somatostatin in 10 ml saline (n = 6); and Group III--somatostatin in a loading dose of 250 micrograms followed by an infusion of 125 micrograms h-1 (n = 6). Segmental cutaneous analgesia, assessed by pinprick, without loss of thermal sensibility or motor blockade was found in all patients. Onset times and durations of analgesia were 15 +/- 2 min and 69 +/- 19 min (mean +/- SD) in Group I and 14 +/- 2 min and 68 +/- 11 min in Group II. The extent of dermatome analgesia at 30 min and 60 min after somatostatin injection, respectively, was: T6 +/- 2 to T12 +/- 1, T4 +/- 2 to L1 +/- 2 in Group I, and T7 +/- 3 to L1 +/- 3, T3 +/- 1 to T12 +/- 2 in Group II. Continuous analgesia with onset of 16 +/- 2 min and extending from T7 +/- 1 to T12 +/- 1 was observed in Group III. No side-effects were observed. The control of ventilation studies in eight patients in Group I by the Read's rebreathing method did not show any significant change.
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PMID:Spread of analgesia and ventilatory response to carbon dioxide following epidural somatostatin. 256 94

Spinal anaesthesia with 3 ml, 4 ml or 5 ml of plain 0.5% bupivacaine was performed in three groups of 20 orthopaedic (ASA 1) patients at the LIV-V interspace. Patients aged less than 20 years or more than 60 years and those outside the normal range of body mass index were excluded. The spread of analgesia was greater in the 4-ml and 5-ml groups compared to the 3-ml group at each testing time (P less than 0.05). The mean maximum cephalad spread of pinprick analgesia (+/- s.d.) 60 min after injection was significantly higher (P less than 0.05) in the 4-ml group (T10 +/- 3.2) and in the 5-ml group (T10 +/- 2.7) than in the 3-ml group (T12 +/- 2.1). The interindividual variability of the cephalad spread of analgesia was greater in the 4-ml and 5-ml groups compared to the 3-ml group (P less than 0.05). The degree of motor block was higher in the 5-ml group than in the 3- and 4-ml groups at 5 and 15 min after injection. In seven patients the first sign of motor block was the patient's inability to flex the ankle, rather than inability to raise an extended leg as was the case in the other patients. In all patients satisfactory anaesthesia for surgery of the lower extremity was achieved.
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PMID:Spread of spinal anaesthesia using various doses of plain 0.5% bupivacaine injected at the LIV-V interspace. 258 97

Sixty postoperative orthopaedic patients were randomly assigned to three equal groups to study, in a double-blind fashion, the analgesic effects, durations of action and side effects of the extradural administration of lofentanil 5 micrograms, buprenorphine 0.3 mg or physiological saline. No systemic analgesics were given before, during or after surgery, and all the patients had operations on the lower extremities under extradural analgesia (lignocaine and bupivacaine). Eleven millilitre of the test drug was injected at T12-L1 as soon as pain occurred in the postoperative period. We observed a long duration of action and a marked analgesic effect with lofentanil, a shorter duration of action and less pain suppression with buprenorphine and a rather marked placebo effect after saline. The only side effect noticed in this study was drowsiness in three patients in the lofentanil group and in two patients in the buprenorphine group.
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PMID:Efficacy of the extradural administration of lofentanil, buprenorphine or saline in the management of postoperative pain. A double-blind study. 286 48


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