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

Astra 2337 ketocaine-soaked pads applied to the skin surface produced analgesia adequate for split skin graft cutting 85 out of 86 patients. In 86 per cent, the analgesia was completely satisfactory; a few had some discomfort or pain but all could tolerate this. Application for 1 hour is time enough, but the effect lasts for at least 8 hours and probably longer. Apart from occasional redness and oedema of the skin, no adverse effects wer noted and the blood levels of absorbed ketocaine were far below the toxic level. This simple effective technique is of great value, particularly in such cases as burns who require multiple grafting operations and in whom repeated general anaesthetics can have such adverse effect.
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PMID:Skin surface application of ketocaine to provide local anaesthesia for cutting split skin grafts. 33 67

In a double-blind, cross-over, clinical study with nine probands, the efficiency parameters of four commonly used local analgesics were evaluated: 2% Carbocain with adrenaline 1:200,000, 3% Citanest with Octapressin 0.03 iu/mul, 3% Carbocain Dental, and 2% Xylocain with adrenaline 1:80,000. It was found that 3% Carbocain Dental (no vasoconstrictor content) demonstrated significantly shorter duration of analgesia than the other solutions in the soft tissues as well as in the dental pulp. 3% Citanest with Octapressin exhibited the longest soft tissue duration, but as far as duration of tooth analgesia was concerned there was no significant difference between 3% Carbocain Dental and 2% Carbocain with adrenaline. The longest duration of tooth analgesia was shown with 2% Xylocain with adrenaline; this solution also possessed the highest frequency of analgesia and extent of analgesia. All probands personally preferred injections with 3% Carbocain Dental as injection with this solution resulted in the least discomfort.
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PMID:A comparison of four commonly used local analgesics. 40 25

Three hundred fifty-seven groin hernia repairs were performed under local anesthesia using a long-lasting local anesthetic agent. An ilioinguinal, iliohypogastric, and twelfth intercostal nerve block was carried out initially, followed by regional infiltration of the agent, using a technic first described by Ponka [8] with several modifications. This technic can be employed suffessfully in the majority of groin hernia repairs. It requires careful attention to detail in the administration of preoperative sedation and analgesia and the use of sharp dissection only and greater gentleness in the handling of tissue. We have observed a significant reduction in postoperative discomfort and the virtual elimination of urinary retention, urinary sepsis, atelectasis, and phlebitis in these cases. All patients are fully ambulatory, without assistance immediately after surgery and the majority are discharged the same day or the following morning. This results in a marked reduction in the total cost of repairing a groin hernia.
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PMID:Change in the management of adult groin hernia. 41 25

A description is given of 22 patients, with a spontaneous forward subluxation of the sternal end of the clavicle, seen over a 5-year period. The majority were middle-aged women presenting with a lump at the root of the neck, which was usually associated with little or no discomfort. There was no history of injury and no interference with shoulder function. The diagnosis was obvious on clinical examination and no treatment was required other than explanation, reassurance and simple analgesia. In no case was the correct diagnosis made by the referring physician and many of the patients were unduly concerned by the nature of the swelling. The sterno-clavicular joint is a synovial articulation and consequently it may be involved in rheumati arthropathy. A condition of non-infective subacute arthritis of the sterno-clavicular joint has been described and is similar to that reported here but in contrast to the previous report we believe that the changes which occur in the joint are secondary to its subluxation.
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PMID:Spontaneous dislocation of the sterno-clavicular joint. 47 98

Intravenous regional anesthesia for the treatment of fractures and dislocations of the upper extremity is a very effective, consistent and safe form of analgesia which requires low doses of lidocaine and can be performed in an emergency room using a regular blood pressure cuff. Dosage should be related to body weight and the blood pressure cuff should be maintained at higher than systolic pressure for a minimum of 15 minutes after the lidocaine is injected. Release of the tourniquet should be staged as described. Ninety-one per cent of 77 patients had excellent analgesia following the IVRA. Eight per cent had fair results, but this was still adequate to perform the reduction with only minimal but definite discomfort to the patient. Only one patient failed to respond to the IVRA technique. Other advantages such as muscle relaxation during the anesthetic and rapid full return of sensation after cuff release, permit ease of reducion and early anticipation of cast discomfort or pressure pain from sharp edges of plaster. Unpleasant long term side effects of axillary block anesthesia, such as persistent paresthesia have not been seen.
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PMID:Intravenous regional anesthesia for closed treatment of fractures and dislocations of the upper extremities. 95 82

The efficacy of postoperative pain control with two doses of transdermal fentanyl were compared to a fixed-interval intramuscular (i.m.) morphine regimen in 21 patients undergoing orthopedic surgical procedures. The two transdermal fentanyl patches with delivery rates of 70-80 micrograms/hr and 90-100 micrograms/hr, groups one and two, respectively, were compared to an i.m. morphine regimen of 150 micrograms/kg every 6h, group three. Transdermal patches were applied one hour prior to surgery and removed after 24h. Analgesia, safety scores, side effects, and a global postoperative evaluation were recorded by a blinded physician at frequent intervals up to 36h. No significant difference in pain intensity, evaluated by the visual analog scale, were found between the three groups. Group two had the lowest discomfort score. Groups one and two had a significantly lower respiratory rate than group three. Although there were isolated significant differences in peripheral hemoglobin saturations, these differences were not consistent. This is the first study in which transdermal fentanyl was compared to a fixed-interval i.m. morphine protocol without supplementation with other narcotics. The results show that fentanyl by a transdermal route can provide analgesia comparable to i.m. morphine. No clinically important adverse side effects were found in any of the study groups.
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PMID:Postoperative pain control by transdermal fentanyl. Preliminary comparison of two dosages to a fixed-interval i.m. morphine regimen. 129 19

There is no consensus amongst physicians about the need for analgesia when a woman undergoes ablative therapy of the cervix. Many doctors believe that the discomfort felt during such procedures is insubstantial. By means of a randomised double-blind placebo-controlled trial, we have shown that patients experience considerable pain during cold-coagulation treatment of the cervix. We found that intracervical lignocaine leads to a significant (p < 0.01) reduction in this pain.
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PMID:Efficacy of lignocaine analgesia during treatment to the cervix. 135 50

Epidural administration of hydromorphone was evaluated using a patient-controlled analgesia (PCA) delivery system in 170 healthy women undergoing elective cesarean delivery with epidural bupivacaine who were randomly assigned to one of four epidural PCA treatment groups: group I, hydromorphone alone by bolus administration; group II, hydromorphone, with a continuous (basal) infusion; group III, hydromorphone in combination with 0.08% bupivacaine by bolus administration; or group IV, hydromorphone and bupivacaine, with a concurrent infusion of both drugs. Patients in group I required significantly less opioid medication (2.1 +/- 1.1 mg [mean +/- SD]) during the first 24 h than patients in group II (3.3 +/- 1.3 mg). Similarly, patients in group III self-administered significantly less hydromorphone (2.0 +/- 1.0 mg) and bupivacaine (23.3 +/- 11.4 mg) during the first 24 h of PCA therapy, compared with patients in group IV (hydromorphone [2.7 +/- 1.1 mg] and bupivacaine [31.5 +/- 11.6 mg]). The concomitant use of a local anesthetic or basal opioid infusion with hydromorphone via epidural PCA did not decrease the number of PCA demands or delivered doses. In addition, patients in all four groups had similar pain, sedation, discomfort, fatigue, and anxiety scores. The frequency of awakening at night to self-administer analgesic medication was not decreased when a basal infusion was used.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidural patient-controlled analgesia: influence of bupivacaine and hydromorphone basal infusion on pain control after cesarean delivery. 138 97

Obstetrician-gynecologists at St. James's University Hospital in Leeds, England, compared various cervical ripening agents in 64 18-39 year old women presenting for first trimester abortion. The women either received oral administration of a placebo or RU-486 or had a laminaria tent or gemeprost vaginal suppository inserted into the endocervical canal or the posterior fornix, respectively. All cervical ripening agents dilated the cervix better than the placebo (p .02). They also greatly diminished the force needed (50-65%) to dilate the cervix to 8 mm Hegar (p .001). The laminaria tent resulted in greater initial cervical dilatation than gemeprost or RU-486, regardless of parity (p .05), but the total force was not significantly different between the 3 groups. 71% of the women who received the gemeprost vaginal suppository had pelvic pain and regular painful uterine contractions. The pain was so intense in 33.3% of them (20% of all gemeprost patients) that health workers had to inject opiate analgesia intramuscularly. 81% of laminaria tent patients experienced menstrual type pains. A significantly lower percentage of RU-486 patients (33%) suffered mild pelvic discomfort than the gemeprost (p = .03) and laminaria tent groups (p = .001). None of the women in the placebo, laminaria tent, and RU-486 groups received analgesia. 40-41% of women in the 3 treatment groups experienced preoperative vaginal bleeding. Since RU-486 patients suffered minimal side effects and insertion of laminaria tents is inconvenient and potentially damaging (e.g. iatrogenic complications of fistulas, dumb belling, and tent fracture), the physicians concluded that RU-486 is the easiest cervical priming agent to administer and is as effective as the other agents.
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PMID:Should we use prostaglandins, tents or progesterone antagonists for cervical ripening before first trimester abortion? 145 95

During a five-year period, 324 epidurals were performed by a general practitioner anaesthetist in an isolated rural hospital. Of these 160 were for obstetric purposes, 72% in primagravida patients, the majority in early and established labour (median cervical dilatation of 3.0 cm). The median epidural insertion time was seven minutes: 80% were free of all complications, there were no dural taps and there was a failure rate of 2%. The median visual analogue pain score (VAPS) was 8.3 prior to insertion and at peak of epidural blockade it was reduced to 0.5. Ten per cent of patients had unblocked segments, half of these were corrected and 90% of patients had even blocks. Despite higher pain scores in the 6-10 cm cervical dilatation group, epidural analgesia was just as effective when compared to the 0.5 cm group. Seventy-seven percent of women interviewed the day after delivery were fully satisfied with the epidural: 19% said it was considerable help, 2% some help and 2% said no help at all. During epidural caesarean section (n = 72), 75% of patients were comfortable, 17% had some discomfort and 7% required general or spinal anaesthesia. The incidence of hypotension (systolic blood pressure less than 90 mmHg), was 24.6% with a median ephedrine dose of 10 mg; however, with a greater than 20% drop in systolic blood pressure, the dose of ephedrine required to maintain blood pressure increased in a log-dose fashion. For women who received epidurals in labour, the caesarean section rate was 25%, instrumental vaginal delivery 34% and spontaneous vaginal delivery 41%. There were no adverse neonatal outcomes.
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PMID:A five-year prospective analysis of the efficacy, safety and morbidity of epidural anaesthesia performed by a general practitioner anaesthetist in an isolated rural hospital. 152 77


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