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)

After the war of liberation, Mao Tse Tung encouraged an integration of Western and traditional Chinese medicine. Several schools of therapeutic acupuncture have defined different points of puncture, originally assumed to be on an empiric basis but now rationalized as areas where nerve endings congregate. Results of therapeutic acupuncture in China cannog be evaluated because of inadequate record keeping. At the University of Washington Pain Clinic, immediate results (two to three days) are good but never lasting, nor do they decrease concomitant medication. For anesthesia, acupuncture acts to produce only hypalgesia in most patients, although some experience total analgesia. Patient selection and mental preparation are careful. Hence, the method is used in much less than 10% of the operations in China, and in these the analgesia is satisfactory by Western standards in only approximately 30%. Concepts as to the mode of action of acupuncture analgesia range from an attitudinal change towards sensory input to the release of a neurohumoral analgesic substances.
 ...
PMID:Acupuncture analgesia and anesthesia. 32 79

A case of spinal cord arteriovenous malformation was reported, in whom serial selective spinal angiogram and pantopaque myelogram showed a successful demonstration of intramedullary nidus. A 25-year-old male was admitted with paraparesis, impotence, hypesthesia and hypalgesia in his legs in 1974. He was diagnosed to have a spinal cord arteriovenous malformation of so-called "glomus type" with intramedullary nidus by the selective spinal angiogram and pantopaque myelogram. The nidus was fed by the anterior spinal artery through the 8th intercostal artery, from which a major draining vein extended caudally, but there was also some cranial drainage. The arteriovenous malformation was treated by surgical excision combined with afferent vessels coagulation in order to prevent the rupture of the remaining intramedullary nidus. After operation the patient develop a transient analgesia and girdle pain at T9-10 level, but after 42 days he regained full muscle power in his legs and could run by himself, while sensory disturbance remained about the same as before surgery.
 ...
PMID:[Treatment of spinal cord arteriovenous malformation by surgical excision combined with afferent vessel coagulation-report of a case (author's transl)]. 94 84

The hypoalgesic effect of EMLA cream (Eutectic Mixture of Local Anesthetics) applied for 5, 15, and 30 min on facial skin was evaluated. Hypoalgesia was assessed by changes in pain thresholds to brief argon laser stimuli 0, 2, 5, 10, 15, 20, 25, 30, 45, and 60 min after removal of EMLA cream. The local cutaneous vascular changes induced by EMLA cream was evaluated by Erythema Index determined by reflectance spectroscopy and by laser Doppler blood flowmetry. A large inter-individual variability in analgesic efficacy was observed. The volunteers could be divided into two groups, one group of 6 persons where EMLA induced analgesia or considerable hypoalgesia, and one group of 4 persons where EMLA had no or only slight hypoalgesic effect. This great variability should be considered when EMLA cream is used for facial application in the clinic. Differences in local blood flow probably contribute to the variability. Application of EMLA cream for 5 and 15 min did not change erythema of the skin, while 30 min of application caused minor blanching.
 ...
PMID:The analgesic effect of EMLA cream on facial skin. Quantitative evaluation using argon laser stimulation. 135 87

In 1990, the Second National Acute Spinal Cord Injury Study reported that high-dosage methylprednisolone improves neurologic recovery in spinal-injured humans. The study showed that patients who received the drug within 8 hr after injury improved, whereas those who received the drug later did not. The drug significantly increased recovery even in severely injured patients who were admitted with no motor or sensory function below the lesion, contradicting a long-held dogma that such patients would not recover. Some researchers, however, have questioned the stratification of the patient population, the use of summed neurologic change scores, and the absence of functional assessments. The stratification by injury severity and treatment time was planned a priori and based on objective criteria. Detailed analyses revealed no differences between groups attributable to stratification or randomization. While multivariate analyses of the summed neurologic scores were used, the conclusions were corroborated by other analytical approaches that did not rely on summed scores. For example, treatment with methylprednisolone more than doubled the probability that patients would convert from quadriplegia or paraplegia to quadriparesis or paraparesis, analgesia to hypalgesia, and anesthesia to hypesthesia. The treatment also significantly improved neurologic scores in lumbosacral segments, indicating that beneficial effects were not limited to segments close to the lesion site. The treatment did not significantly affect mortality or morbidity. The study strongly suggests that methylprednisolone has significant beneficial effects in human spinal cord injury, that these effects occur only when the drug is given within 8 hr, and that it helps even in patients with severe spinal cord injuries. These conclusions have important implications for spinal cord injury care and research.
 ...
PMID:The Second National Acute Spinal Cord Injury Study. 158 30

Starting from a case of marked pain insensitivity in a patient suffering from catatonic schizophrenia we state in this paper that analgesia seems to be an ubiquitous phenomenon which is not only caused by physical disorders of the central nervous system. Different models of interpretation as to be found in scientific literature are reviewed. On the basis of today's physiological knowledge, five hypotheses on causal explanation of pain insensitivity in schizophrenics are discussed: Hypalgesia and analgesia are an expression of motorial inability to react; a consequence of a disorder of consciousness; an analgetic effect of neuroleptic drugs; a basic deficit in schizophrenia and; a result of a disturbed psycho-physiological development.
 ...
PMID:[Disorders of pain perception in schizophrenia]. 170 99

In two double-blind, placebo-controlled investigations, morphine and lidocaine were administered perineurally to the ulnar nerve. Thresholds (warmth and pain) and pain-evoked brain potentials (amplitude and latency) to argon laser stimulation were measured up to 120 min after the injection. Hypalgesia to laser pain was detected 15 min after the injection of morphine and 5 min after the injection of lidocaine. The duration of hypalgesia and analgesia was less than 15 min for morphine and 85 min for the lidocaine injection. Both morphine and lidocaine increased the latency of the brain potentials, which indicates that the same blocking mechanisms could be involved. Pin-prick analgesia was obtained 5 min after the injection of lidocaine, but 15-30 min elapsed before the laser pain was inhibited maximally. Laser pulses can activate larger skin areas than needle pricks, indicating that a central summation of the activity from many cutaneous nociceptors is important in order to obtain a reliable indicator of adequate analgesia.
 ...
PMID:A quantitative double-blind evaluation of the antinociceptive effects of perineurally administered morphine compared with lidocaine. 200 95

The goal of this study was to assess the effects of the dorsal root entry zone (DREZ) lesioning procedure, microsurgical DREZ-otomy (MDT), on spinal cord somatosensory function based on peri- and intraoperative clinical and electrophysiological data. The study was performed prospectively on a series of 20 patients suffering from either chronic neurogenic pain or spasticity. Physiological observations were made of the intraoperative evoked electrospinographic recordings as collected from the surface of the spinal cord. The MDT procedure produced analgesia or severe hypalgesia, moderate hypesthesia, and only slight deficits in proprioception and cutaneous spatial discrimination on the body segments operated on. These clinical data correlated well with evoked electrospinographic recordings, which showed a moderate effect of MDT on presynaptic compound action potentials recorded from the spinal cord (N11 and N21), a partial or even reversible effect on the cortical postcentral N20 wave, a more marked effect on the postsynaptic dorsal horn waves N13 and N24 related to large primary afferent fibers, and a disappearance of dorsal horn waves related to finer afferents (N2 and possibly N3). These data provide evidence for an acceptably selective action of MDT on spinal cord nociceptive mechanisms, and for a partial, often slight, involvement of the other somatosensory domains. The presence of abnormal evoked electrospinographic waves is discussed in relation to the mechanisms of neurogenic pain and spasticity. The hypothesis of a "retuning" of the dorsal horn as the mode of action of MDT is presented.
 ...
PMID:Somatosensory function following dorsal root entry zone lesions in patients with neurogenic pain or spasticity. 203 52

Percutaneous retrogasserian glycerol instillation was performed under local anesthesia for treatment of trigeminal neuralgia in 162 patients. A simplified technique that did not involve cisternography was used. Initial pain relief was achieved in 146 patients (90.1%). Recurrent pain was noted in 27 patients (18.5%) and was more frequent (50%) in patients who had undergone surgical treatments prior to glycerol injection than in those who had no previous surgical treatment (12.3%). A second glycerol injection was carried out in nine patients and a third injection in two patients. The follow-up period extended from 6 to 67 months and 77.8% of patients are totally pain-free after one or more glycerol injections. Another 8.6% experienced good pain relief with the addition of small doses of pharmacological agents. Thus, 140 (86.4%) of the original 162 patients experienced satisfactory pain control following glycerol rhizolysis. Initial sensory loss on the face occurred in 117 patients (71.6%) but at last follow-up examination only 46 patients (28%) experienced mild orofacial hypalgesia and 13 patients (8%) noted analgesia. The corneal reflex was absent in three patients (1.8%) and reduced in five (3.1%). No patients noted corneal ulceration or anesthesia dolorosa. Percutaneous retrogasserian glycerol rhizolysis offers a rapid, safe, reliable, and relatively inexpensive surgical approach to treatment of trigeminal neuralgia.
 ...
PMID:Glycerol rhizolysis for treatment of trigeminal neuralgia. 245 4

The duration of analgesia and the cardiovascular changes during anesthesia of spinal blockade with isobaric bupivacaine were examined in 36 patients between 21 and 75 years old undergoing percutaneous nephro-ureterolithotomy. Injection of 0.25% or 0.5% bupivacaine 3.0-4.0 ml through the L3-4 or L2-3 intervertebral space in the horizontal posture resulted in spread of hypalgesia to T6 in 30 patients and of analgesia to T6 in about a half of the patients. In six patients, another intrathecal injection of 2 ml of bupivacaine was performed because their analgesia level had been under T8. Although the operation took 32-141 min. (mean 77.7 +/- 27.5 min.), there was no case requiring exigent exchanging anesthesia for general anesthesia. The frequencies of the hypotension, bradycardia and nausea in spinal blockade with isobaric bupivacaine were not so different from those of the previous epidural anesthesia in 29 patients undergoing the same operation. Most of the cardiovascular changes in the spinal blockade with isobaric bupivacaine happened within 20-30 min. after intrathecal injection of bupivacaine. Spinal anesthesia with isobaric bupivacaine proved satisfactory for percutaneous nephro-ureterolithotomy.
 ...
PMID:[Spinal anesthesia with isobaric bupivacaine for percutaneous nephro-ureterolithotomy]. 344 27

Twenty-one patients who had undergone total hip replacement were randomly assigned to one of three groups in order to compare a single dose of 1 mg/kg of pethidine im (I) and 20 mg (II) or 60 mg of extradural pethidine (III) in a double-blind design. The degree of analgesia, the adverse effects, and the kinetics were studied for 18 h. Pain was monitored using a visual analogue scale (VAS). Supplementary doses of oxycodone if required were given no earlier than 0.75 h after pethidine. Plasma concentrations of pethidine were measured with gas chromatography mass spectrometry (GCMS). Hypoalgesia to pin prick test was evaluated. Low pain scores were observed in the extradural groups between 0.25 and 1.5 h after the dose. A significant difference in pain score compared with the im group was found after the higher extradural dose only between 0.5 and 1 h (p less than 0.05). The area under the curve (AUC) of pain score versus time (0-18 h) was not significantly different between groups. The recorded adverse effects were minor in all three groups. The terminal half-lives and plasma clearances of pethidine, and the time to peak concentration were not different between the groups. Single patients in the extradural groups showed hypoalgesia to pin prick in parallel to the effect. The present study shows that extradural pethidine produces shortlived analgesia, in contrast to the long-lasting effect of morphine found in other studies.
 ...
PMID:Extradural and parenteral pethidine as analgesia after total hip replacement: effects and kinetics. A controlled clinical study. 395 58


1 2 Next >>