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)

Two hundred and eleven children aged 1-5 years were studied after undergoing herniorrhaphy or orchiopexy. In 111 cases a caudal block was used for postoperative analgesia. This was administered immediately after induction of anaesthesia, using bupivacaine 0.25% plain (0.7 ml/kg lean body mass), and was successful in 100 patients. A mean analgesic level (+/- SE) of T9.9 +/- 0.47 was achieved (range L2-T6). In 5 cases no block occurred and in 6 the level was below T12. The other 100 children acted as controls. Behaviour patterns were more restful in the caudal block group on awakening and less opiate was required during the first 5 postoperative hours. No complications resulted.
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PMID:Caudal block for analgesia after paediatric inguinal surgery. 289 Dec

Eight adult Holstein cows were used to compare the effects of lumbar segmental epidural analgesia (SEA) and lumbar segmental subarachnoid analgesia (SSA). A modified 17-gauge Huber point (Tuohy) needle was used to place a catheter with stylet into either the epidural space at the thoracolumbar (T13-L1) intervertebral space or the subarachnoid space at the lumbosacral intervertebral junction. The catheters were advanced so that their tips lay at the anterior lumbar (L1-L2) epidural space or at the thoracolumbar (T13-L1) subarachnoid space. The position of the catheter was confirmed radiographically. A 5% solution of procaine HCl was used at mean doses of 300 mg (6 ml) to induce SEA and 84.4 +/- 12.9 mg (1.7 +/- 0.3 ml) to induce SSA. Onset of analgesia to superficial and deep muscular pinprick stimulation was significantly (P less than 0.05) faster in cows with SSA than in those with SEA (10.4 +/- 2.3 minutes vs 15.9 +/- 3.8 minutes). Maximal thoracolumbar analgesia extended from spinal cord segments T12 to L4 on one or both sides of the vertebral column during SEA and from T10 to L3 on one or both sides during SSA. Duration of analgesia lasted significantly (P less than 0.05) longer in cows with SEA than in those with SSA (76.2 +/- 16.2 minutes vs 53.7 +/- 14.3 minutes). The advantages and disadvantages of the SEA catheter technique are discussed.
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PMID:Comparative study of continuous lumbar segmental epidural and subarachnoid analgesia in Holstein cows. 291 26

Effects of age on spinal anesthesia using glucose-free 0.5% bupivacaine without epinephrine were studied in two groups of patients, one between 20 and 55 yr old, the other older than 55 yr. All patients received 15 mg bupivacaine. The time to onset of analgesia in caudad segments and the time to maximal motor blockade decreased with age. The upper level of analgesia did not change significantly with increasing age. The times to recovery from analgesia at T12 and for the total disappearance of analgesia were longer in the older patient group. Effects of age on duration of motor blockade could not be demonstrated. Peak plasma concentrations of bupivacaine were significantly greater and the total plasma clearance significantly decreased in older patients. Age had no effect on time to peak concentration or the terminal half-life.
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PMID:Spinal anesthesia with glucose-free bupivacaine: effects of age on neural blockade and pharmacokinetics. 363 92

D-Ala-D-Leu-enkephalin (DADL) is a pentapeptide which, compared to morphine, preferentially binds to the delta receptor. We compared the analgesic and side effects of intrathecal (i.t.) DADL and i.t. morphine sulfate (MS) in 10 tolerant cancer patients with chronic pain at or below the T12 level who were receiving inadequate relief or unacceptable side effects from systemic opiates. These patients were given i.t. DADL and i.t. MS in a randomized, double-blind, cross-over study on separate days at least 1 day apart. I.t. DADL produced analgesia in all patients tested. Total pain relief was greater with DADL than MS in 6 patients, equal in 1 patient and less with DADL in 3. Side effects, most commonly drowsiness, were similar with both MS and DADL and suggest supraspinal effects by both drugs. At the doses given i.t. DADL produced effective pain relief in patients tolerant to systemic opiates although no significant difference in analgesic efficacy between MS and DADL was observed. Studies of the relative analgesic potency of i.t. DADL in man are necessary to fully assess its value in those patients tolerant to systemic or i.t. opiates.
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PMID:The analgesic efficacy of intrathecal D-Ala2-D-Leu5-enkephalin in cancer patients with chronic pain. 390 16

Skin conductance responses (SCR, "sympatho-galvanic reflex") were measured before and during spinal analgesia in 17 patients scheduled for transurethral surgery. Responses were provoked by standardized electrical stimulation over the clavicle opposite to the recording side; alternatively, a short deep breath, pinching, verbal stimuli or sharp sounds were used. Measuring sites (two electrodes 6 cm apart) were the hand, levels T5, T9, T12-L1 and the foot. Spinal analgesia reached a median cephalad level of T4 (mean T4, range +/- 3 segments) 20-25 min after injection. SCR was markedly depressed in the foot in 15 of 17 patients, at T12-L1 in 12 of 17, at T9 in 10 of 17, at T5 in 9 of 16 and in the hand in 6 of 17. Total abolition of the SCR in the foot was accomplished in only seven cases and sympathetic activity reappeared long before regression of analgesia or motor blockade was observed. In four cases of five with an analgesic level T1-T2, the SCR was preserved in the hand. No consistent correlation between blood pressure change and SCR-change was seen. The conclusion from this study is that preganglionic sympathetic B-fibres are more difficult to block than A-fibres during spinal analgesia. The duration of sympathetic blockade was far shorter than analgesia and motor blockade. Thus, sympathetic blockade during spinal analgesia seems to be far less extensive than that described in the literature.
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PMID:Skin conductance responses during spinal analgesia. 397 23

Three millititre of 0.75% plain bupivacaine and 0.5% amethocaine 3 ml in 5% glucose were used for spinal anaesthesia and compared in a double-blind study of 20 patients undergoing urological surgery. The onset time to maximum cephalad spread of sensory analgesia was approximately 45 min for bupivacaine and approximately 30 min in the amethocaine group (ns). The mean maximum spread of sensory analgesia was similar for both agents: T6-7 180 min after injection, although the cephalad spread of sensory analgesia with bupivacaine persisted for longer at a significantly higher level than that of amethocaine. Duration of sensory analgesia was significantly longer in the bupivacaine group from S3 to S5 and from T12 to L2 levels. Onset time to complete motor blockade of the lower limbs was similar for both agents. Nine of 10 bupivacaine patients and seven of the 10 patients receiving amethocaine had complete motor blockade of the lower limbs. Duration of motor blockade was significantly longer for all degrees in the bupivacaine group.
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PMID:Spinal anaesthesia with 0.75% bupivacaine and 0.5% amethocaine in 5% glucose. 404 24

Seven groups of patients with and without hypertension or with ischaemic heart disease, treated with different beta blockers were investigated to study the circulatory effects of neurolept anaesthesia alone or combined with thoracic epidural analgesia from T4 to T12/L2 during abdominal surgery. The combination of thoracic epidural analgesia and neurolept anaesthesia in hypertensive subjects treated with non-cardioselective beta blockers induced slightly lower blood pressure than measured in similar patients on cardioselective beta blockers with neurolept anaesthesia only. Patients on non-selective beta blockers with intrinsic stimulatory activity (ISA) had higher blood pressure and heart rate after neurolept anaesthesia induction than patients on cardioselective blockers. During surgery, heart rate remained at a higher level in the patients treated with ISA blockers, whereas blood pressure increased to the same level as in patients with cardioselective blockers. Cardiovascular stability was, however, best maintained in the epidural group, where myocardial energy expenditure during maximal surgical stress was comparable to that in a group of healthy subjects with the same format of anaesthesia and significantly lower than in healthy subjects with neurolept anaesthesia alone. No circulatory side effects of the combination of thoracic epidural analgesia and beta blockade were seen. In patients with ischaemic heart disease, with or without non-selective beta blockade, similar haemodynamic changes were recorded following neurolept anaesthesia. During maximal surgical stress, unmasking of alpha adrenergic activity with marked rise in blood pressure was seen in the beta-blocked patients. Despite the more accelerated haemodynamic changes in the blocked patients, a lower increase in myocardial oxygen consumption was recorded compared with the non-blocked patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Beta-blockers and thoracic epidural analgesia. Cardioprotective and synergistic effects. 615 83

Changes in skin blood flow and skin temperature during spinal analgesia and "sham" spinal analgesia were studied using laser Doppler flowmetry and skin temperature measurements on patients scheduled for transurethral resection. Infrared thermography was also used. During "sham" spinal analgesia skin blood flow decreased 17.7% +/- 37% (s.d.) and skin temperature fell 0.05 degrees C +/- 0.6 (s.d.) degree C. The height of the blockade was T10 or above in all cases. Using the laser Doppler technique with measuring points from the clavicle to T12, a tendency towards increased skin blood flow was seen in six cases out of 20 at T10 (significant elevations in 3/20) and in 14 cases out of 20 at T12 (significant elevations in 7/20). Skin temperature measurements and thermography showed a tendency towards cooling in the thoraco-abdominal region in the vast majority of the cases and a marked temperature elevation in the foot only. No differences between hyperbaric and glucose-free solutions for spinal analgesia were noticed. The conclusion of this study is that during spinal analgesia the extent of sympathetic blockade is less than the extent of analgesia.
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PMID:Changes in skin blood flow and temperature during spinal analgesia evaluated by laser Doppler flowmetry and infrared thermography. 624 Aug 82

The skin conductance response (SCR) (the "sympatho-galvanic reflex") was studied in volunteers and in a few patients undergoing spinal analgesia. Electrical stimulation over the clavicle, breath-holding during inspiration, a short, deep breath and a sharp sound provoked a marked change in conductance not only in the hand and foot but also in dermatomes T5, T9, T12-L1. Thus, the SC response can be used to study sympathetic activity not only in the hand and foot, but also on the chest and abdomen. Electrical stimulation over the clavicle or a short, deep breath were the best means of provoking SC responses in patients receiving spinal analgesia. This restricted pilot study indicates that skin conductance response is maintained at dermatome levels far below anaesthetised levels during spinal analgesia, and a larger study is now under way to investigate these results further.
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PMID:Can the "sympatho-galvanic reflex" (skin conductance response) be used to evaluate the extent of sympathetic block in spinal analgesia? 649 20

Six adult horses were used to compare the effects of segmental epidural analgesia (SEA) and segmental subarachnoid analgesia (SSA). A 17-gauge Huber point directional needle was used to place a catheter with stylet into the epidural space or the subarachnoid space at the lumbosacral intervertebral junction and to catheterize the thoracolumbar epidural or subarachnoid space. The position of the catheter was confirmed radiographically. A 2% solution of mepivacaine hydrochloride was used at average doses of 80 mg (4 ml) to produce SEA and 30 mg (1.5 ml) to produce SSA. Onset of analgesia in response to superficial and deep muscular pinprick stimulations was significantly (P less than 0.05) faster in horses with SSA than with SEA (8.0 +/- 1.9 minutes vs 15.8 +/- 3.8 minutes). Maximal thoracolumbar analgesia extended from spinal cord segments T14 to L3 on both sides of the spinal column during SSA and from T12 to L2 on one or both sides during SEA. Duration of analgesia lasted significantly (P less than 0.05) longer in horses with SEA than in those with SSA (80.8 +/- 16.9 minutes vs 44.8 +/- 14.5 minutes). There was a significant (P less than 0.05) increase in subcutaneous temperature at the right and left 18th thoracic (T18) dermatomes and decreases of respiratory rate and rectal temperatures in horses with SEA. Respiratory rate and rectal temperature were not significantly (P greater than 0.05) decreased in horses with SSA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Segmental epidural and subarachnoid analgesia in conscious horses: a comparative study. 663 47


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