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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report on 50 surgical or endoscopic cases in which local or regional anaesthesia was completed with a combination of diazepam and pentazocine (Pentazapam). This "diazanalgesia" was performed either as a routine or as a complement to regional anaesthesia (mostly an epidural) in which restlessness or insufficient analgesia were noted. Both drugs are injected separately. Diazepam being used to combat anxiety and pentazocine to allay pain. Sedation was considered to be sufficient in 43 cases out of 50 and analgesia in 47 cases out of 50. In all but one case, recovery was calm. In 24 cases, the patients regained consciensness quickly. There was only little effect on respiratory frequency, blood gases, blood pressure or cardiac rate. Thus, pentazepam combination can be considered as a useful method of "wake diazanalgesia" as far as it is used to complement a local or regional anaesthesia. This technique seems particularly useful in the aged or bad risk patient because of its moderate cardiovascular or respiratory aciton.
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PMID:[Use of the diazepam-pentazocine (pentazepam) combination in anesthesiology]. 1 78

The analgesic dose-effect relationship of nefopam was compared in a double-blind randomised trial with that of oxycodone in immediate postoperative pain. Nefopam 15 mg or oxycodone 4 mg was given every 10 min i.v. (maximum six times) to patients in pain after upper abdominal surgery until their wound pain (scored 0-3) disappeared. The mean pain intensity (PI), initially 2.2 in both groups, descreased by approximately the same extent for up to two doses in both groups (to 1.5 after nefopam 30 mg and to 1.1 after oxycodone 8 mg). Thereafter PI was significantly less in the oxycodone group and diminished almost linearily to 0.1 after the sixth dose (24 mg). In the nefopam group, the PI score fell to 1.1 after the fourth dose (60 mg). This seemed to be the "ceiling" effect since additional doses up to 90 mg did not result in greater pain relief. In the oxycodone group, only two patients (12%) needed maximal dosage (6 x 4 mg), one of them requiring 32 mg of oxycodone. In the nefopam group, 12 patients (75%) needed further pain relief after the maximal dosage (6 x 15 mg). In these patients, oxycodone (maximally 16 mg) gave satisfactory analgesia. Drowsiness and a decrease in the respiratory rate were the principal side-effects of oxycodone, whereas tachycardia, restlessness, sweating and nausea were more frequent after nefopam.
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PMID:Comparison of the analgesic dose-effect relationships of nefopam and oxycodone in postoperative pain. 39 11

1 A series of peptides derived from porcine lipotropin was examined for analgesic and other morphine-like properties on infusion into the cannulated third ventricle of cats.2 Lipotropin (LPH 1-91) itself produced no analgesia or other morphine-like effects when infused in a dose of 150 mug.3 C-fragment (LPH 61-91) produced strong long-lasting analgesia when infused in a dose of 10 or 20 mug; on a molar basis the potency was between 90 and 180 times that of morphine. The following morphine-like effects were also produced: shivering leading to fever, vasodilatation of the pinnae, mydriasis, opening of the palpebral fissures, tachypnoea with bouts of panting, vocalization, hyperexcitability, restlessness and catalepsy. All the effects, including analgesia, were abolished by an intraperitoneal injection of naloxone (1 mg/kg).4 Hyperglycaemia, another central effect produced by morphine, was obtained with C-fragment infused in a dose of 60 mug.5 On intravenous injection, C-fragment produced analgesia with a dose of about 200 mug/kg. Administered by this route, C-fragment was again more potent than morphine.6 C'-fragment (LPH 61-87), LPH 61-78 and LPH 61-69, either had no analgesic effect or produced weak short-lasting analgesia when infused in doses up to 100 mug.7 Methionine enkephalin (LPH 61-65) either produced very weak short-lasting analgesia or had no analgesic effect when infused in doses of between 30 and 400 mug.8N-methyl methionine enkephalin amide in which both termini of methionine enkephalin were protected against degradation by exopeptidases produced long-lasting analgesia when infused in doses of 150 to 180 mug; its analgesic potency was approximately 100 times less than that of C-fragment. Blocking only one terminus of methionine enkephalin did not appear to endow the peptide with analgesic properties. The N-methyl pentapeptide amide produced other morphine-like effects of which the most striking was catalepsy. All the effects were abolished by intraperitoneal naloxone (1 mg/kg).
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PMID:C-fragment of lipotropin--an endogenous potent analgesic peptide. 56 Aug 94

During seven operations with acupuncture analgesia in the People's Republic of China, recordings were made with a self-developed device for telemetric transmittance of the ECG. Among others, the amplitude of the QRS complex as well as the period of time between two cardiac cycles were electronically measured and registered for evaluation. Through comparison of the values from China with our own material, the following statements can be made: (1) All patients were in conditions ranging from restlessness and slight excitation to weariness and drowsiness. A condition similar to narcosis must be excluded. (2) In a large number of cases a preoperatively performed strong psychological sedation through pharmacological agents can be excluded with certainty. (3) The massive reaction to events such as the cleansing of the operative field refutes-at least partly-our concept of "Asiatic indifference". (4) Acupuncture cannot depress reflexes. (5) Finally, the hypothesis that acupuncture has a stabilizing effect on the circulation is invalid.
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PMID:Telemetric ECG data (biorhythms) in operations with acupuncture analgesia in the People's Republic of China. 111 37

On an educational journey to China, we were able to record and accumulate electrocardiograms during operations under acupuncture analgesia with the aid of a self-developed apparatus. To elaborate this among others the amplitude of the QRS-complex as well as the time period between two cardiac cycles were electronically measrued and registered. With examples from the comprehensive material it is possible to draw the following conclusions: 1. The patients were in conditions ranging from restlessness and irritation to weariness and drowsiness. A condition similar to that resulting from narcosis must be excluded. 2. A pre-operatively undertaken strong psychological sedation by means of drugs can be excluded with certainty. 3. The massive reaction to events such as the washing out of the operative field refutes, at least partly, our concept of "Asiatic indifference". 4. Acupuncture is not able to depress reflexes. 5. Finally, the hypothesis that acupuncture has a stabilizing effect on the circulation is not valid.
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PMID:[Telemetric ECG data (biorhythms) during operations under acupuncture analgesia in the People's Republic of China (author's transl)]. 113 Jun 38

In 70 patients (maxillo-facial-, neurosurgical-, abdominal- and gynaecological operations) the technique of "analgetic anaesthesia" using high doses of fentanyl (0.025 mg/kg body weight) and naloxone as its antagonist (0.02 mg/kg body weight) has been employed. All patients were artificially ventilated with N2O/O2 in a 3:1 ratio. Muscle relaxation was achieved with pancuronium-bromide (0.08 mg/kg). The patients had no apparent heart or lung disease. The youngest patient was 4 years of age, the oldest 82 years of age (average age 48.9). The necessity for a reinjection of fentanyl (half the initial dose) was determined by continously monitoring heart rate. This variable appeared to be the most subtle index indicating a reduction in analgesia. Sufficient analgesia was maintained once the heart rate stayed 20% below preanaesthetic levels. At the end of the operation naloxone reversed the respiratory depression. There was no evidence indicating postoperative pain, which may have required administration of additional analgesics. If deep analgesia was maintained up to the last surgical procedures no emesis appeared in the post operative period. The incidence of emesis was higher 10% compared to the classical neuroleptanalgesia with droperidol this was often noted in cases where blood accumulated in the stomach (maxillo-facial operations) (70%). In 3% of all cases psychomotor agitation with delirium appeared right after the injection of naloxone. This lasted for about 15 minutes. We suspect that due to the sudden and powerful effect of naxolone, in replacing fentanyl from its receptor site, acute withdrawal symptoms may be precipitated.
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PMID:[High doses of fentanyl as the sole anaesthetic agent and naloxone as its antagonist (author's transl)]. 113 60

Four pharmacologic actions of intravenous ketamine (30 mg/kg) were studied in the rat. To elucidate the mechanism(s) terminating the pharmacologic effects, animals were pretreated with ketamine and agents anticipated to modify hepatic microsomal metabolism, including phenobarbital and SKF 525A. SKF 525A pretreatment markedly prolonged ataxia, analgesia and agitation, in addition to significantly elevating brain and plasma ketamine levels subsequent to the initial 10 minutes following injection; thus hepatic metabolism appeared to play a prominent role in the termination of the posthypnotic effects of the drug. While significantly shortening the durations of the three posthypnotic events, phenobarbital and ketamine pretreatments also lowered the brain and plasma levels of ketamine. With all pretreatments, brain ketamine levels were almost identical at the cessation of hypnosis (25 mug/g of tissue) and ataxia (8-10 mug/g of tissue). No pretreatment altered either the duration of loss of righting reflex (hypnosis) or brain and plasma ketamine levels during the initial 10 minutes after injection. Approximately 70% of the injected drug was recovered from four tissues, skeletal muscle, gut, skin and liver, at 10 minutes after injection; thus redistribution from brain to other tissues appeared to play a major role in the cessation of hypnosis. Ketamine pretreatment caused a 2-fold increase in the rate of its in vitro hepatic microsomal metabolism. Brain and plasma ketamine levels 30 minutes after injection were nearly identical in rats pretreated with ketamine and phenobarbital, although phenobarbital pretreatment resulted in a 4-fold increase in in vitro ketamine hepatic metabolism.
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PMID:Biodisposition of ketamine in the rat: self-induction of metabolism. 127 Dec 78

A 32-year-old female patient was operated on for a residual colonic stricture occurring after hemicolectomy. A right internal jugular central venous catheter was inserted during the anaesthetic for postoperative parenteral feeding. The anaesthetic combined both general and epidural anaesthesia, the latter being continued for postoperative analgesia (10 ml.h-1 of 0.125% bupivacaine). Two days later, the patient complained of sudden chest pain, with restlessness, tachycardia, cyanosis, resulting in ventricular tachycardia and cardiac arrest. When admitted to the surgical intensive care unit, the patient was in deep coma and had nonsustained ventricular tachycardia, a left haemopneumothorax and a pneumopericardium. The patient died before a definitive diagnosis was made. Postmortem examination revealed an ulcerated anterior pillar of the tricuspid valve, as well as a perforation of the right ventricle and a communication between the pericardium and the left pleural cavity. The diagnosis and treatment of this rare life-threatening complication may be very difficult. It prevention consists in using short catheters for internal jugular venous access, and checking the tip's position radiologically by opacifying the catheter.
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PMID:[Cardiac tamponade and central venous catheterization]. 150 94

Attitudes and beliefs of physicians and nurses have shifted during the past decade, resulting in more frequent administration of analgesics and sedatives to neonates. However, nurses caring for critically ill newborns have difficulty in determining appropriate interventions because of the lack of clear and complete knowledge related to the use of analgesia and sedation in this patient population. This chapter presents current information on six key issues related to the use of analgesia and sedation in neonates. An algorithm for determining appropriate intervention for neonates with pain, distress, or agitation is proposed to provide a more systematic approach to the use of analgesics and sedatives.
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PMID:Issues regarding the use of analgesia and sedation in critically ill neonates. 168 45

In a pilot study involving eleven terminal tumor patients suffering pain, the effect of monotherapy with oral, slow-release morphine on analgesia, somatogenic components, depression and state of psychic health was investigated. A significant decrease in pain intensity was observed. A significant correlation was found between analgesia and changes in depression. Individual assessment on the basis for the Hamilton Depression Scale revealed a significant association between the treatment of pain and sleep disturbances, depressive states, restlessness and suicidality. In addition, analgesia led to an improvement in general psychic health as indicated by the v. Zerssen scale. A reactive-depressive symptomatology in tumor patients suffering pain can be positively influenced by selective opiate therapy.
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PMID:[Pain therapy and depression in cancer patients]. 169 57


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