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 study was conducted on twenty-four patients who underwent surgery for retinal detachment as to the clinical effect of acupuncture from the viewpoints of anesthetic dose, intraoperative changes in blood pressure and heart rate, postoperative analgesic state, nausea and vomiting. The patients were divided into two groups: group A, eleven patients receiving neuroleptanesthesia combined with acupuncture analgesia and group N, thirteen patients receiving usual neuroleptanesthesia without acupuncture. A significant difference was found in the dose of fentanyl, used as the narcotic, between group A (0.11 mg) and group N (0.48 mg). No difference was noted in blood pressure between the two groups, but it was high in group N in the postoperative period. There was no difference in heart rate between the two groups. Two patients from group A and five from group N required analgesics in the postoperative period. Nausea and vomiting were encountered in one patient in group A and three in group N. Therefore, it would seem that anesthesia in combination with acupuncture is capable of reducing the required dose of narcotic and offering more comfortable postoperative conditions than usual anesthesia alone.
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PMID:Acupuncture in the anesthetic management of eye surgery. 288 Apr 73

The chemistry, pharmacology, pharmacokinetics, clinical use, adverse effects, dosage, and administration of the short-acting synthetic narcotic analgesic alfentanil hydrochloride are reviewed. Alfentanil is a tertiary amine with an ionization constant of 6.5, resulting in approximately 10% ionization at physiologic pH. When compared with fentanyl, alfentanil has a faster onset and one third the duration of action, one fourth to one tenth the potency, less lipid solubility, greater protein binding, and a much greater unionized fraction at physiologic pH. Alfentanil is approximately 20-40 times less potent than sufentanil on a weight basis, but it has a faster onset and shorter duration of action. After i.v. injection, alfentanil is distributed in the body according to a two- or three-compartment model. When given to young and middle-aged patients for various surgical procedures, alfentanil has an elimination half-life of 70-99 minutes independent of the dose or route of administration. Clinical studies comparing alfentanil with fentanyl in short surgical procedures are reported; alfentanil produces earlier peak analgesic effect, faster recovery of consciousness, and a more pronounced narcotic effect without increased adverse effects. When alfentanil was given in high doses for anesthesia induction, chest-wall rigidity occurred frequently. Like fentanyl, alfentanil was found to produce a high incidence of nausea and vomiting. It was more effective when administered by infusion than by bolus. Alfentanil is useful for supplementation of analgesia for outpatient surgical procedures, as an infusion for maintenance of anesthesia during surgery, and perhaps as an induction agent.
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PMID:Alfentanil hydrochloride: a new short-acting narcotic analgesic for surgical procedures. 288 59

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)
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PMID:Analgesia and ventilatory response to CO2 following epidural sufentanil in children. 289 31

Domperidone 20 mg, droperidol 2.5 mg, metoclopramide 10 mg and placebo (saline) were given i.v. 10 min before the end of anaesthesia, to 200 women undergoing major gynaecological surgery, and the incidence of postoperative nausea and vomiting following a standard anaesthetic technique was assessed. Droperidol was significantly more effective than domperidone, metoclopramide or placebo in reducing emetic sequelae. There were no significant differences between the groups in the incidence of extrapyramidal effects and postoperative sedation. Patients given droperidol required less postoperative analgesia than those given domperidone or metoclopramide. It was concluded that, of the drugs studied, droperidol alone was effective in protecting against nausea and vomiting after major gynaecological surgery.
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PMID:Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following major gynaecological surgery. 294 64

Postoperative pain relief and stress hormones were examined during the use of continuous epidural infusion of morphine at a rate of 0.1 mg/hr in 30 patients (Group B) after coronary artery bypass grafting. This was compared to our routine method of postoperative analgesia of intravenous morphine 2 mg/2 hr and as needed in another 30 patients (Group A). Continuous epidural morphine infusion required occasional supplementation with intravenous morphine and achieved effective analgesia in 80% of the patients. Pain relief was adequate in 50% of the patients in Group A. The mean dose of morphine used in Group B during the first 3 postoperative days was 5 mg per patient per day and was significantly lower than that used in Group A (mean 18 mg per patient per day). Serum morphine was undetectable (below 2.5 ng/ml) in Group B and was significantly lower than that in Group A (17 ng/ml). Epidural analgesia was associated with adequate postoperative pulmonary and cardiovascular functions; nausea and vomiting occurred in two patients. Levels of postoperative stress, serum cortisol, and beta-endorphin were significantly lower in Group B than in Group A. This study shows that continuous epidural infusion of morphine at a rate of 0.1 mg/hr provides selective and effective pain relief and reduces postoperative stress after cardiac operations. This method of analgesia was also associated with minimal side effects and provides an alternate approach for treatment of pain after cardiac operations.
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PMID:Continuous epidural infusion of morphine for pain relief after cardiac operations. 295 42

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.
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PMID:A comparative study of tramadol and pethidine in laparoscopic interval sterilization. 304 3

The effects of epidural morphine (50 micrograms X kg-1) after abdominal and urologic surgery were studied in 20 children ranging in age from 2 to 15 yr and weighing between 9 and 54 kg. The onset and the duration of analgesia were 30 +/- 12 min and 19.5 +/- 8 h, respectively (mean +/- SD). Side effects were pruritus (4/20), nausea and vomiting (8/20), and urinary retention (4/14). No apnea was observed. Ventilation control was studied in seven children. No significant change in resting respiratory variables occurred after both surgery and epidural morphine injection. However, the slope of the ventilatory response to CO2 was significantly (P less than 0.05) decreased after surgery but before morphine, as compared with its preoperative control value (0.84 +/- 0.44 versus 1.51 +/- 0.72 l X min-1 X mmHg-1), and remained low for 22 h after epidural morphine (0.90 +/- 0.57 l X min-1 X mmHg-1). Sixty minutes after morphine injection, the plasma morphine concentration was always less than 12 ng X ml-1 in the seven children studied. Pharmacokinetic parameters were similar to those observed after epidural injection of morphine in adults, except for a shorter terminal half-life (73.8 +/- 41.6 min) attributed to a greater total body clearance of morphine in the children (28.3 +/- 3.4 ml X min-1 X kg-1). It is concluded that epidural morphine provides effective and prolonged analgesia in children after abdominal and urologic surgery and that it is associated with prolonged respiratory depression that requires close monitoring for at least 24 h.
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PMID:Epidural morphine in children: pharmacokinetics and CO2 sensitivity. 309 37

The efficacy of prophylactic intravenous infusion of indomethacin as a postoperative analgesic was studied in 100 children aged one to 16 years. At the end of surgery a bolus dose of indomethacin 0.35 mg.kg-1 followed by an infusion 0.07 mg.kg-1.hr-1 for 24 hr or placebo was given in double-blind manner. The efficacy of the treatment was measured by the need of additional morphine given 0.1 mg.kg-1 intravenously in the Recovery Room and 0.15 mg.kg-1 intramuscularly on the ward according to clinical needs. The other measure of the efficacy was assessment of pain intensity in the Recovery Room and pain relief on the ward. In the Recovery Room the pain scores differed between the groups in advantage of indomethacin only at 30 minutes (p less than 0.05) but the need of morphine was significantly less (p less than 0.01) in the indomethacin group. On the ward the mean doses of morphine given and the nurses' pain relief scores were not different between the study groups. However, in the indomethacin group the total dose of morphine given during 24 hr was lower (p = 0.02) and the children assessed the pain relief to be significantly better (p less than 0.02). Twenty per cent of the children in both groups had transient nausea and vomiting. No skin reactions or other allergic manifestations were observed. Prophylactic indomethacin infusion diminished the need of morphine and resulted in better postoperative analgesia than morphine p.r.n. alone.
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PMID:Does prophylactic intravenous infusion of indomethacin improve the management of postoperative pain in children? 328 64

Forty patients scheduled to undergo thoracotomy were randomly allocated to receive either transcutaneous electrical nerve stimulation with intramuscular papaveretum (20 patients) or intramuscular papaveretum alone (20 patients) for postoperative pain relief. Total intramuscular analgesic requirements in the first 24 hours, time to satisfactory transfer to oral analgesia, antiemetic requirements and length of stay in hospital postoperatively were noted. Peak expiratory flow rate was compared pre- and postoperatively in the two groups. Use of nerve stimulation did not significantly alter the requirements for analgesia although there was a reduction in postoperative nausea and vomiting in the nerve stimulation group. There was no difference between the two groups with respect to changes in peak expiratory flow rate.
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PMID:Transcutaneous electrical nerve stimulation after thoracotomy. Pain relief and peak expiratory flow rate--a trial of transcutaneous electrical nerve stimulation. 328 99

Propofol is an intravenous anaesthetic which is chemically unrelated to other anaesthetics. Induction of anaesthesia with propofol is rapid, and maintenance can be achieved by either continuous infusion or intermittent bolus injections, with either nitrous oxide or opioids used to provide analgesia. Comparative studies have shown propofol to be at least as effective as thiopentone, methohexitone or etomidate for anaesthesia during general surgery. The incidence of excitatory effects is lower with propofol than with methohexitone, but apnoea on induction occurs more frequently with propofol than with other anaesthetics. Additionally, a small number of studies of induction and maintenance of anaesthesia have found propofol to be a suitable alternative to induction with thiopentone and maintenance with halothane, isoflurane or enflurane. Propofol is particularly suitable for outpatient surgery since it provides superior operating conditions to methohexitone (particularly less movement), and rapid recovery in the postoperative period associated with a low incidence of nausea and vomiting. When used in combination with fentanyl or alfentanil, propofol is suitable for the provision of total intravenous anaesthesia, and comparative studies found it to be superior to methohexitone or etomidate in this setting. Infusions of subanaesthetic doses of propofol have been used to sedate patients for surgery under regional anaesthesia, and also to provide sedation of patients in intensive care. In the latter situation it is particularly encouraging that propofol did not suppress adrenal responsiveness during short term studies. If this is confirmed during longer term administration this would offer an important advantage over etomidate. Thus, propofol is clearly an effective addition to the limited range of intravenous anaesthetics. While certain areas of its use need further study, as would be expected at this stage of its development, propofol should find a useful role in anaesthetic practice.
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PMID:Propofol. A review of its pharmacodynamic and pharmacokinetic properties and use as an intravenous anaesthetic. 329 8


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