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)

A double-blind random study compared the effects of lorazepam and pantopon an intra-muscular premedication in healthy women for uterine curettage (D & C). Anxiety, as assessed by a self-rating test by the patient and by a trained observer, showed a significant reduction at one and one-half hours after lorazepam and a smaller reduction after pantopon, which was not significant. Sedation was satisfactory with no significant difference between the two drugs in the change before and after the premedication. Lorazepam showed much more amnesia than pantopon (p less than 0.001). The patients who had lorazepam required higher doses of thiopentone for the operation, and this, in part, led to longer intervals in recovery times after lorazepam. However, it is suggested that lorazepam itself was partly responsible for the longer recovery. Pantopon was followed by more nausea, vomiting and headaches, than lorazepam. The intra-muscular injection of lorazepam hurt more patients than did pantopon, but other local complications were negligible and comparable in both groups. The results of this study show that lorazepam produces better reduction of anxiety and much more amnesia than pantopon, with comparable sedation and much less nausea and vomiting. The only disadvantage of lorazepam is the lack of analgesia and, therefore, the need for more anaesthesia during the operation. The conclusion is that lorazepam is a very satisfactory premedication and warrants more use as such.
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PMID:Lorazepam as a premedication. 0 77

Three anaesthetic premedication regimens have been compared by double-blind controlled trial in 158 patients undergoing day-case surgery for varicose veins or hernia. Atropine plus droperidol was superior to atropine plus diazepam or atropine alone in lessening nausea and vomiting and in reducing the need for postoperative analgesia.
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PMID:Double-blind clinical trial of anaesthetic premedication for use in major day surgery. 5 98

Salpingectomy by laparoscopy in 200 healthy outpatients employed local analgesia and "pentazepam" (pentazocine 90 mg and diazepam 30 mg in 250 ml of 5% D/W) as anesthesia. Patients received no premedication, ventilated spontaneously, without tracheal intubation, but were given nasal O2 at 3 L/min throughout the procedure. N2O was used for abdominal insufflation, and the abdominal pressure and Trendelenburg position were restricted to less than 20 cm H2O pressure and 30 degrees, respectively. Changes in arterial blood gases measured in 12 patients were unremarkable. Prolonged recovery, unsatisfactory surgical conditions, tachycardia, nausea and vomiting were infrequent.
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PMID:"Pentazepam" (pentazocine + diazepam) supplementing local analgesia for laparoscopic sterilization. 13 Aug 13

A double-blind, between-patient, two-dose comparison was comparison was performed with pethidine and nefopam in 100 subjects, the majority of whom were recovering from upper abdominal surgery. Either 15 or 30 mg of nefopam or 50 or 100 mg of pethidine were given by i.m. injection in a random order. All assessments were made by the same observer on the first day after operation, at least 4 h after the previous analgesic injection. Nefopam 15 mg was equipotent with pethidine 50 mg, peak analgesia being achieved 1 h after the i.m. injection. Pethidine 100 mg provided significantly better pain relief than nefopam 30 mg, the latter being not more effective than nefopam 15 mg apart from the duration of analgesia which was longer. The incidence of nausea and vomiting was similar after both drugs. Sweating and tachycardia were observed more frequently after nefopam, whereas sedative side-effects were more common after pethidine.
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PMID:Comparison of nefopam and pethidine in postoperative pain. 33 83

Four analgesic agents were studied during labour: pethidinesparine, ketamine hydrochloride, nitrous oxide-oxygen, and trichloroethylene in air (Trilene). Excellent analgesia was achieved with ketamine, however hallucinations were troublesome. Trichloroethylene analgesia was good without side-effects. Pethidine-sparine produced moderate analgesia but with nausea and/or vomiting. Nitrous oxide 50% presented poor analgesia. Uterine activity was insignificantly diminished in the late first stage after administration of all analgesic agents except with ketamine. There were no untoward effects on fetuses.
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PMID:Effects of analgesics during labor. 58 90

Different modes of naloxone administration were studied in 100 patients following N2O-O2-relaxant anaesthesia, where fentanyl was administered for analgesia according to a standardized dose schedule (mean 4.3 microgram/kg/h). After reversal of muscular relaxation, the patients were randomly given naloxone--either 1.0 or 2.5 microgram/kg i.v. or 2.5 or 5.0 microgram/kg i.m., or none (control). Each group consisted of 20 patients. Awakening was fastest after 2.5 microgram/kg i.v. of naloxone (1.8 +/- 0.1 min), the time being significantly shorter (P less than 0.025) than in the control group (2.7 +/- 0.4 min). After 15 min, the minute volume and frequency of respiration were significantly higher (P less than 0.05) in all naloxone groups than in the control group. However, the arterialized venous PCO2 did not show significant differences during the recovery. It is therefore suggested that naloxone reversal may cause an increase in CO2 production. The immediate postoperative pain (score 0-3) was mildest in the control group (1.0 mean) and severest after 2.5 microgram/kg i.v. of naloxone (1.8 mean); the difference was statistically significant (P less than 0.05). The groups receiving 1.0 microgram/kg i.v. and 2.5 microgram/kg i.m. did not differ from each other (1.2 mean). Nausea and vomiting were reported more often after 5.0 microgram/kg im. of naloxone than in other groups. After moderate doses of fentanyl during balanced anaesthesia, routine use of naloxone does not seem to be necessary, but if rapid recovery is essential, 1.0 microgram/kg i.v. or 2.5 microgram/kg i.m. of naloxone may be recommended and these doses do not cause a higher incidence of side effects.
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PMID:Naloxone as narcotic antagonist after balanced anaesthesia. 60 62

The pain relieving properties of orally administered meptazinol, a new hexahydroazepine analgesic, were studied in 51 patients recovering from major surgery. In doses of 250, 400 and 500 mg it produced significant analgesia which was maximal at the end of one hour and had a duration of action of approximately four hours. Arterial pressure and heart rate were not affected significantly by meptazinol. Nausea and vomiting were the main side-effects observed in a few patients and there were no abnormal hematological or biochemical findings.
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PMID:Clinical assessment of oral meptazinol in postoperative pain. 80 81

Fentanyl was replaced by R 30730/Janssen (Fentatienyl) for neurolept analgesia (with intubation) of 34 persons who had ophthalmic surgery on account of detachment of the retina. The effects of the drug on the size of the pupils, blood pressure, heart rate and respiration were observed; also the duration of analgesia and the incidence of nausea and vomiting. There was a very slight negative effect on the size of the pupil, similar to that seen with halothane; systolic blood pressure fell by an average of 20%; the duration of analgesia and the degree of respiratory depression varied considerably. 12 of the 35 patients suffered from marked nausea and vomiting after the operation.
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PMID:[Clinical experience with r30730/Janssen in anaesthesia for ophthalmic surgery (author's transl)]. 91 72

Until recently, nonsteroidal anti-inflammatory drugs (NSAIDs) were regarded as weak analgesic agents with a potent antiplatelet effect that severely limited their perioperative usefulness. However, the recent development of injectable NSAIDs has stimulated a re-evaluation of the potential role of this class of drugs in postoperative pain management. In general surgery, NSAIDs have been shown to be effective analgesics when administered after surgery, as judged by either a reduction in pain scores and/or by an opioid sparing effect. Parenteral NSAIDs alone, notably ketorolac and diclofenac, may be adequate or even preferred analgesic agents after minor surgery. In dental surgery, NSAIDs produce greater initial analgesia than steroids, although the latter produce greater suppression of swelling and less functional loss. NSAID pretreatment results in only modest suppression of swelling compared with placebo. These data suggest that the acute analgesic effects of NSAIDs in oral surgery and probably other models result from suppression of a nociceptive process, rather than a generalised anti-inflammatory effect. This view challenges the traditional association between inhibition of prostaglandin synthesis and the therapeutic effects of these drugs. The variety of NSAIDs leads to a range in half-lives from short, e.g. diclofenac (1 h), intermediate, e.g. ketorolac (5h), to long, e.g. tenoxicam (60h), which has implications for both convenience of the dosage regimen and drug accumulation. For some racemic NSAIDs (e.g. ibuprofen), metabolic 'activation' of the inactive R-enantiomer to the active S-enantiomer occurs. Renal dysfunction may increase both the plasma concentration and body residence time of NSAIDs, thereby increasing the risk of adverse effects. The concomitant effects of anaesthesia have not yet been studied. The principal concern regarding the use of perioperative NSAIDs is the risk of decreased haemostasis and wound healing. Although it has been found that NSAIDs prolong bleeding times in patients, values generally remain below the upper limits of those in generally healthy patients. Healing of gastrointestinal anastomoses may be compromised by NSAID administration but corneal healing and bone remodelling are not. There is a need for further research into the potential for renal side effects with NSAIDs in the perioperative setting, where the effects of anaesthesia and surgery may increase the risk of side effects, particularly in elderly patients. The main benefits of NSAIDs derive from opioid sparing (e.g. reduction in perioperative nausea and vomiting and improvement in ventilation), although some studies allude to an enhanced quality of analgesia from the combination compared with either NSAID or opioid alone. The question of pre- vs postinjury treatment with NSAIDs remains unresolved.
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PMID:Do the pharmacodynamics of the nonsteroidal anti-inflammatory drugs suggest a role in the management of postoperative pain? 128 57

Nonsteroidal anti-inflammatory drugs (NSAIDs) are very effective for the management of acute postoperative pain. These agents can be used in combination with opioid analgesics and local anaesthetics for the relief of severe postoperative pain, when the combination results in reduced narcotic requirements and improved analgesia compared with opioids and/or local anaesthetics. NSAIDs have been shown to be effective in a wide variety of postoperative pain states, including thoracotomy, major orthopaedic surgery such as hip arthroplasty, upper and lower abdominal surgery and minor outpatient surgery. The benefits of combining NSAIDs with opioid analgesics in the immediate postoperative period include not only improved analgesia but also the benefits associated with narcotic sparing (improved respiratory function, reduction in nausea and vomiting, reduced sedation) and there is a suggestion that NSAIDs may improve not only the quality but also the speed of recovery. By adding the NSAIDs to a routine analgesic armamentarium the goal of preventing or eliminating postoperative pain, rather than treating or reducing postoperative pain, is achieved. To use these agents more effectively, further research is required to distinguish the differences between the various NSAIDs, the optimal dosage schedules and route of administration, and, finally, the cost-effectiveness and impact on the quality and speed of postoperative recovery of NSAIDs.
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PMID:Efficacy of nonsteroidal anti-inflammatory drugs in the management of postoperative pain. 128 58


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