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)

We describe the use of flunitrazepam and fentanyl to produce sedation and analgesia, as an alternative to general anesthesia, for 96 children with malignancies or hematologic diseases, undergoing 122 bone marrow examinations (BME). In 82 cases there was no reaction to the puncture. Most children had complete amnesia and only two remembered some pain. In 10% the sedation and analgesia was considered inadequate and barbiturate was given; seven out of these 12 children were under the age of 3 years. During 117 procedures the children maintained adequate spontaneous ventilation; in five cases the ventilation was assisted. In 13 cases there were minor side-effects including drowsiness and nausea. One child had a short apnea after the procedure.
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PMID:Flunitrazepam-fentanyl-induced sedation and analgesia for bone marrow aspiration and needle biopsy in children. 376 98

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

The effect of a constant i.v. infusion of lysine acetyl salicylate (LAS) on pain after operation was compared with that of a constant infusion of morphine in 30 patients undergoing unilateral inguinal herniorrhaphy. LAS provided analgesia equivalent to that provided by morphine and was associated with significantly less drowsiness, nausea and vomiting. No patient in either group was noted to suffer from respiratory depression. No untoward side effects were noted during or following the administration of LAS.
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PMID:Comparison of infusions of morphine and lysine acetyl salicylate for the relief of pain after surgery. 391 45

A scheduled regimen of oral narcotic analgesics was compared with a regimen of oral narcotic analgesics plus ibuprofen for analgesic efficacy in patients with cancer. Ten patients with metastatic cancer were randomly assigned to receive either ibuprofen 400 mg or a look-alike placebo four times daily in addition to each patient's existing regimen of scheduled oral narcotics. A two-period changeover study design was used. The 24-hour narcotic intake equated to injectable morphine was computed for each patient at baseline and during the nine study days. A visual analogue scale was used to evaluate pain relief, nausea, mood depression, daytime drowsiness and nighttime sleeplessness. The analgesic efficacy of the narcotic-ibuprofen combination was significantly greater than the analgesic efficacy of the narcotic-placebo combination. Eight patients demonstrated a positive treatment effect with added ibuprofen; the overall improvement in analgesia averaged 39.1% in these patients. There was no significant increase from baseline in the incidence of nausea, mood depression, daytime drowsiness or nighttime sleeplessness. At the doses used in this study, a treatment regimen of oral narcotic analgesics plus ibuprofen was more effective than oral narcotics alone in relieving pain associated with cancer.
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PMID:Analgesia with oral narcotics and added ibuprofen in cancer patients. 397 83

Pentazocine or pethidine was administered to healthy parturients up to the time of delivery using a self-demand (self-administration on demand) intravenous apparatus, the Cardiff Palliator. Good analgesia was obtained with both drugs. The patients receiving pethidine exhibited side-effects (nausea, vomiting and drowsiness), whereas there were no side-effects among those receiving pentazocine. Apgar and neurobehavioural scores of the babies of mothers in both groups were the same and did not differ from those of a third group of babies, the mothers of whom had received 4-hourly intramuscular pethidine on demand according to the usual hospital routine. The self-administration technique proved a safe and effective means of providing analgesia during labour and delivery, with pentazocine having a decided advantage over pethidine because of its lack of side-effects.
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PMID:Self-administered intravenous analgesia during labour. A comparison between pentazocine and pethidine. 399 3

Buprenorphine was administered as sublingual tablets to 70 patients suffering from chronic pain of malignant or non-malignant origin. Daily doses ranging from 0.4 mg to 3.2 mg were administered and good analgesia was reported by the majority of patients. The most common unwanted effects were drowsiness/sleepiness, nausea and/or vomiting and sweating which appeared to be dose related but the incidence of dizziness was not related to daily dose. The incidence of all these unwanted effects except drowsiness/sleepiness decreased after the first week's treatment. No buprenorphine related changes in vital signs or laboratory values were observed and no signs of tolerance or physical dependence were seen in the short term period after discontinuation of treatment. A significant positive correlation between buprenorphine plasma concentration and daily dose was observed but there was no correlation between plasma levels and pain relief.
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PMID:A long-term open, clinical and pharmacokinetic assessment of sublingual buprenorphine in patients suffering from chronic pain. 401 31

Using a double-bolus technique, the efficacy and safety of epidural fentanyl with and without epinephrine 1:400,000 for post-Caesarean section analgesia was examined in 30 patients. The addition of 25 micrograms epinephrine to the fentanyl (100 micrograms) did not potentiate the speed of onset but did significantly prolong the duration of action of the second dose. The only side effect encountered was pruritus, which was significantly increased (from 17-44 per cent) when epinephrine was added. The results indicate a clinical advantage of prolonging the duration of action of fentanyl for post-Caesarean Section analgesia with the addition of epinephrine, but the cumbersome and time-consuming nature of a double-bolus technique limits its clinical value. The relative safety of epidural fentanyl with and without epinephrine was confirmed by the absence of respiratory depression, drowsiness or hypotension in all patients.
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PMID:Epidural fentanyl, with and without epinephrine for post-Caesarean section analgesia. 404 52

The analgesic action of fentanyl administered by epidural injection in a dose of 0.2 mg diluted in 10 ml of physiological saline proved to be satisfactory in 21 patients who had undergone abdominal surgery. The mean duration of analgesia was 6 hours. The subjective improvement was associated with an increase in V.C. (congruent to 30%) and good tolerance of postoperative chest physiotherapy. Despite the absence of respiratory depression, the existence of drowsiness is suggestive of central impregnation the degree and role of which remain to be defined.
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PMID:[Postoperative fentanyl analgesia by the epidural route]. 611 96

The relatively new technique of epidural morphine analgesia was compared with two well established method of pain relief in 90 patients undergoing gallbladder surgery and divided randomly into three groups of 30 patients each. The first group received intramuscular narcotic analgesic ketobemidone, the second group was given 0.5% bupivacaine-epinephrine intercostal nerve block, and the third group received a single dose of 4 mg of epidural morphine for postoperative pain relief. The mean duration of analgesia after ketobemidone was 5.5 hours, and after intercostal block 11 hours. Of the patients given epidural morphine, 40% did not require further analgesia after the initial injection; the remaining patients in this group were pain free for a mean duration of 19 hours. The mean reduction in postoperative peak expiratory flow was most marked following ketobemidone and least after epidural morphine. Postoperative changes in PaO2 and PaCO2 reflected the changes in peak expiratory flow. Plasma levels of morphine after epidural injection were so low that a regional spinal analgesic action of epidural morphine appeared more likely than a systemic effect. Delayed respiratory depression was not encountered after epidural morphine. It is concluded that a single dose of 4 mg of epidural morphine provides excellent regional analgesia of long duration without drowsiness or circulatory of respiratory depression thus facilitating early ambulation. The technique is superior to more common methods of pain relief after gallbladder surgery, e.g., intercostal nerve block and intramuscular narcotics.
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PMID:Epidural morphine for postoperative pain relief: a comparative study with intramuscular narcotic and intercostal nerve block. 611 33

Fifty-six surgical patients self-administered i.v. narcotic analgesics to combat postoperative pain. Analgesic demand per h was 2.7 +/- 1.1 mg of morphine, 26 +/- 10 mg of pethidine or 2.3 +/- 0.8 mg of ketobemidone, which reflects the equianalgesic ratios. Acute respiratory depression was seen in two hypovolaemic patients as evidenced by a raised PaCO2 on air breathing. Carbon dioxide retention disappeared upon correction of hypovolaemia. Late respiratory complications of short duration were encountered in 13%. Drowsiness and dry mouth were the most frequent complaints. Self-administered analgesia was considered highly satisfactory by the patients.
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PMID:Patient-controlled analgesic therapy: clinical experience. 612 76


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