Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
 ...
PMID:Efficacy of the extradural administration of lofentanil, buprenorphine or saline in the management of postoperative pain. A double-blind study. 286 48

The effects of extradural sufentanil 50 micrograms were investigated in 10 normal volunteers. Eight of these were studied at a second session when adrenaline 1:200,000 was added to the sufentanil. Well-defined segmental analgesia developed rapidly after plain sufentanil and lasted approximately 3 h. Respiration was depressed for about the same period and was greatest in the first 2 h, as shown by a 15% increase in PECO2, while the slope and VE50 of the carbon dioxide response curve were depressed by 45% and 55%, respectively. Moderate drowsiness occurred in most subjects, while other side effects of itching, nausea and urinary retention occurred less frequently and were not severe. Addition of adrenaline 1:200,000 intensified segmental analgesia and prolonged duration to 5 h, while side effects were lessened. It is concluded that extradural sufentanil shows considerable promise for clinical use, and that the risk: benefit ratio is improved by adding adrenaline 1:200,000.
 ...
PMID:Analgesic and respiratory effects of extradural sufentanil in volunteers and the influence of adrenaline as an adjuvant. 288 58

The authors studied the effects of epidural sufentanil (0.75 microgram.kg-1) after urologic surgery in 15 children ranging in age from 4 to 12 yr, and in weight from 14 to 47 kg. The onset and duration of analgesia were 3.0 +/- 0.3 and 198 +/- 19 min, respectively (mean +/- SEM). Side effects included pruritus (3/15), nausea and vomiting (5/15), drowsiness (10/15), and urinary retention (1/11). No apnea was observed. Periosteal analgesia and ventilation were studied in eight of the children (mean age 8.6 +/- 0.8 yr). There was significant periosteal analgesia of the tibia (30, 60, 90, and 120 min after injection) and of the radius (60, 90, and 120 min after injection). Resting respiratory rate and tidal volume did not change during the study. Resting minute-ventilation decreased from 6.3 +/- 0.5 l.min-1 preoperatively to 5.6 +/- 0.6 l.min-1 (P less than 0.05) postoperatively, before epidural sufentanil injection; it did not decrease further after epidural sufentanil. Similarly, end-tidal CO2 tension increased significantly from 37.2 +/- 0.7 mmHg preoperatively to 39.9 +/- 1.2 mmHg (P less than 0.05) postoperatively, before epidural sufentanil; epidural sufentanil did not cause a further significant increase in end-tidal CO2 tension. The slope of the CO2 ventilatory response curve decreased significantly from 1.68 +/- 0.12 l.min-1. mmHg-1 preoperatively to 1.10 +/- 0.13 l.min-1.mmHg-1 (P less than 0.01) postoperatively. There were further significant decreases to 0.68 +/- 0.10 and 0.89 +/- 0.16 l.min-1.mmHg-1 30 and 60 min after epidural sufentanil.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Analgesia and ventilatory response to CO2 following epidural sufentanil in children. 289 31

A series consisting of 32 women undergoing total abdominal hysterectomy received a standard narcotic-free anaesthetic. For the first 24 h postoperatively, eight were given the standard regimen of intramuscular morphine sulphate whilst the other three groups received continuous subcutaneous infusions of either morphine sulphate, ketamine hydrochloride or the two drugs combined. The amount of time they were pain free, the incidence of sleep and nausea, together with cardiovascular and respiratory changes were recorded. All three subcutaneous regimens produced significantly more pain-free readings than intramuscular morphine, but ketamine resulted in higher respiratory rates and less sleepiness. No patient reported psychomimetic side effects, but ketamine on its own produced feelings of malaise in three patients on the second postoperative day. Subcutaneous infusions provide better postoperative analgesia than intermittent intramuscular morphine. Ketamine on its own cannot be advocated, but combined with morphine it allows a single infusion rate to be used for all patients, decreasing the need for nursing and medical involvement.
 ...
PMID:Subcutaneous ketamine analgesia: postoperative analgesia using subcutaneous infusions of ketamine and morphine. 277 59

Patients (112) with acute low-back pain of recent onset were recruited to this double-blind, randomized, placebo-controlled parallel group study in general practice to evaluate the efficacy and tolerability of the muscle relaxant, tizanidine. They were treated for 7 days with tizanidine (4 mg three times daily) or matching placebo. Aspirin tablets (300 mg) were taken as required as 'rescue' medication. Symptoms were assessed by the patient and doctor before treatment, and after 3 and 7 days. Patients recorded pain and aspirin consumption in a daily diary. Both treatments were effective. In patients who had taken no medication prior to entry, aspirin consumption was almost halved in the first 3 days of taking tizanidine compared with placebo (P = 0.037). Results for pain at rest, pain at night, restriction of movement and pain on movement suggest that tizanidine may give greater improvement, earlier. No serious drug-related adverse events or abnormal biochemistry or haematology were observed in either group. Drowsiness occurred in 22% of patients taking tizanidine although, in patients with severe acute low-back pain, sedation, analgesia and bed rest might be beneficial and desired. Considerably more patients given aspirin/placebo had gastro-intestinal side-effects (P = 0.018). In conclusion, tizanidine may reduce the need for analgesics and be useful in the treatment of acute low-back pain.
 ...
PMID:A multicentre placebo-controlled study in general practice to evaluate the efficacy and safety of tizanidine in acute low-back pain. 296 80

The effectiveness, safety and acceptability of self-administered Entonox (50% nitrous oxide in oxygen) in 150 Nigerian women during labour was studied. 86.7% of those who received Entonox alone reported satisfactory pain relief while analgesia was also satisfactory in all those who received Entonox plus intramuscular analgesic. Severe drowsiness occurred in two patients and the method was acceptable to 90% of the mothers in the study. To prevent exhaustion of the mothers and marked drowsiness, intramuscular analgesic should be used early in labour followed by Entonox in the second half of the labour.
 ...
PMID:Self-administered Entonox (50% nitrous oxide in oxygen) in labour: report of the experience in Ibadan. 299 47

Meptazinol is a new opioid-type analgesic with mixed agonist/antagonist properties. It may be given orally, intravenously or intramuscularly. In studies in patients with moderate to severe pain of various aetiologies, usually following surgery or in obstetrics, the characteristics of analgesia with meptazinol were comparable to those seen with equianalgesic doses of pentazocine, pethidine or a combination of dextropropoxyphene and paracetamol. Preoperative use and use as a component of anaesthesia require further investigation before conclusions may be drawn on its effectiveness in these areas. Onset of action, recorded in a few studies, was faster than that with the other analgesics but duration was shorter than that of morphine, buprenorphine and pentazocine. Only a small number of patients with chronic pain have received long term therapy with meptazinol; in such patients there was no need for increased doses as treatment progressed. Respiratory depression has only been observed in patients receiving meptazinol as a premedication or while undergoing anaesthesia. Similarly any haemodynamic changes have been limited to preoperative patients or patients undergoing anaesthesia. Like other agonist/antagonist analgesic drugs, the abuse potential of meptazinol seems relatively low, but only wider clinical use for longer periods can establish this with certainty. The most commonly reported side effects have been gastrointestinal in nature, and although the incidence of central nervous system side effects has been relatively low, drowsiness and dizziness have caused occasional problems. Thus, meptazinol is a relatively potent but safe addition to the analgesics available for treatment of the patient with moderate to severe pain.
 ...
PMID:Meptazinol. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy. 299 23

DADL was administered to a patient who was analgetically tolerant to continuously infused, intrathecal morphine sulfate. DADL restored analgesia without respiratory depression but opiate withdrawal syndrome was not prevented. Somnolence, not responsive to naloxone but completely reversed with morphine, was seen as an idiosyncratic mu receptor opiate withdrawal symptom. Clonidine hydrochloride and decreasing doses of oral morphine were used to successfully treat the withdrawal syndrome, including somnolence. Further research is indicated to verify the findings of this one patient and investigate the efficacy of DADL to provide analgesia for morphine-tolerant patients.
 ...
PMID:Intrathecal D-Ala2-D-Leu5-enkephalin (DADL) restores analgesia in a patient analgetically tolerant to intrathecal morphine sulfate. 300 62

The new synthetic analgesic Tramadol was compared with pethidine in a double-blind prospective design for interval laparoscopic sterilization of 50 women in each group at Ramathibodi Hospital, Mahidol University, Bangkok. Drugs were administered iv by slow injection, after 15 mg midazolam had been given orally, 15 minutes before surgery. Both dose levels were 1 mg/kg. The laparoscopic technique was single-entry monopolar cautery without transecting the tubes. Analgesic effects were rated as slight (pain felt when fallopian tube was grasped, more medication needed); moderate (pain felt during cautery, verbalization); or good (slight or no pain during cautery). Analgesia was slight in 10% of both groups, moderate in 36% and good in 54% of the Tramadol group, and moderate in 24% and good in 66% of the pethidine group. Side effects were nausea and vomiting in 10-14% of women with both analgesics, and drowsiness and hypotension in 6 and 2% of the pethidine group (n.s.). Tramadol has the advantage of being non-addictive, and not contraindicated for asthmatics, nor is it listed as dangerous and restricted in Thailand.
 ...
PMID:A comparative study of tramadol and pethidine in laparoscopic interval sterilization. 304 3

Epidural meperidine (1 mg X kg-1) was administered for relief of sternal pain to ten patients, at a mean of 24.8 hours after infusion of high dose fentanyl for cardiac surgery. Lung function, cough, pain score, somnolence, respiratory rate, PaCO2, pulse and blood pressure were studied before and for six hours after analgesic administration. Following epidural meperidine, four of ten patients were pain-free, and three had only minimal pain. Duration of analgesia was 8.8 +/- 4.9 hours. Cough score was significantly improved for five hours. Postoperatively vital capacity was approximately 40 per cent, and FEV1 was approximately 55 per cent of the preoperative value. There was no significant change in FEV1 or vital capacity, following analgesia with epidural meperidine. The somnolence score increased in seven patients. In the first two hours after epidural meperidine, three patients exhibited a fall in their respiratory rate, one had a PaCO2 greater than 45, and two of these patients had marked hypotension. These side effects are easily treated without mechanical or pharmacological support, and do not preclude the use of epidural meperidine after a high dose fentanyl anaesthetic.
 ...
PMID:Epidural meperidine analgesia after cardiac surgery. 309 20


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>