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)

Thirty-eight women having caesarean section under epidural anaesthesia received either lignocaine 2% or bupivacaine 0.5% both with adrenaline 1:200,000 in a double-blind, randomised study. The time to establish satisfactory surgical anaesthesia, the volume required and the quality of analgesia as assessed by the anaesthetist, patient pain and discomfort scales and patient approval, were not significantly different. Motor block assessed by the Bromage and RAM-test was greater in the lignocaine group but surgical opinion of abdominal wall relaxation was not significantly different between groups. The bupivacaine group had significantly longer durations of sensory and motor block while the lignocaine group had a higher incidence of maternal shivering, other complication rates being similar. Neonatal outcomes were uniformly good. Both local anaesthetics provided satisfactory epidural anaesthesia and neither proved to have a distinct advantage in the clinical setting of this study.
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PMID:Epidural anaesthesia for caesarean section: a comparison of 0.5% bupivacaine and 2% lignocaine both with adrenaline. 339 12

Once the determination has been made that the patient's fears are not psychiatrically related, the dentist has the initial responsibility of evaluating the degree of anxiety present and attempting to relate this to a method of alleviating it. The most frequently used methods are behavioral and consist of talking to the patient, explaining the procedure clearly, reassuring the patient, and accurately estimating the degree of discomfort that may be associated with the treatment. Prescribing adequate pain control methods suited to the patient's needs come next. It is not appropriate to shoehorn each patient into a preset method of treatment. If one is not skilled in advance forms of anxiety and pain control, the kindest service is to refer the patient to another dentist who may be better equipped. This is a far better practice than to make extravagant claims about one's capability with conscious sedation, nitrous oxide analgesia, and so forth. Patient's confidence in your ability is constantly tested against the treatment they receive and the success of that treatment.
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PMID:Anxiety. Dental overview. 346 7

Exposure of adult male mice to a magnetic resonance imaging (MRI) procedure has been shown to abolish the nocturnal analgesic responses observed following treatment with morphine. The field component(s) responsible for this inhibitory effect were examined by exposing mice to either the static, time-varying or rf magnetic field components associated with an MRI procedure. In the middle of the night portion of their day-night cycle, mice were exposed for 23.2 min to one of the above field components, intraperitoneally injected with morphine sulphate (10 mg/kg) and then exposed to the field conditions for another 23.2 min, after which analgesic responses were determined. Analgesia was quantitated by determining the length of time mice were content to be on a hot surface (50 degrees C) before they showed discomfort by licking their paws. It was observed that the time-varying magnetic field completely abolished, the rf field significantly reduced, while the static field component (0.15 T) had no evident effect on morphine-induced analgesia. These results indicate that the time-varying, and to a lesser extent the rf, fields associated with the MRI procedure inhibit morphine-induced analgesia in mice. These data also raise the possibility that exposure in humans to some of the magnetic field components associated with MRI may have clinically relevant effects on the actions of narcotic drugs such as morphine.
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PMID:Attenuation of morphine-induced analgesia in mice by exposure to magnetic resonance imaging: separate effects of the static, radiofrequency and time-varying magnetic fields. 358 76

Thirteen healthy women in active labour received an intrathecal injection of morphine 1.0 mg. Eighty-five percent (11 patients) experienced acceptable or good pain relief. Analgesia set in 15-45 min after injection and reached a maximum after 15-120 min and lasted until delivery. Eighty-five percent (11 patients) of the patients developed mild side-effects i.e., pruritus, nausea and emesis. The intrathecal injection of morphine did not adversely affect the condition of the infant. Venous blood samples from the patients and umbilical cords for estimation of plasma morphine showed extremely low concentrations. No patients experienced any discomfort during the injection of morphine. These results indicate that morphine 1.0 mg administered intrathecally decreases labour pains to an acceptable level.
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PMID:Intrathecal administration of morphine for the relief of pains in labour and estimation of maternal and fetal plasma concentration of morphine. 360 34

Forty-nine boys scheduled for day-case inguinal herniotomy were studied to compare ilio-inguinal nerve block and wound infiltration for postoperative analgesia. Both techniques were simple to perform and produced no complications. In the ilio-inguinal block group, 100% had either no pain or very mild discomfort when assessed 60 minutes after return to the day unit, compared to 95% in the infiltration group. Some children did appear to have pain following discharge but in all cases this responded well to simple analgesics. We conclude that both techniques provide satisfactory analgesia whilst the complications of narcotics are avoided, and suggest that simple infiltration of the wound with local anaesthetic solution should be encouraged in paediatric anaesthesia.
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PMID:Day-case herniotomy in children. A comparison of ilio-inguinal nerve block and wound infiltration for postoperative analgesia. 361 3

The safety and efficacy of a disposable, nonelectronic, patient-controlled-analgesia (PCA) device for alleviating postoperative pain were evaluated. Patients who were to undergo abdominal surgical procedures under general anesthesia were instructed in the use of the Travenol Infusor with Patient Control Module. Patients used the PCA device upon emerging from anesthesia in the recovery room. The PCA device delivered a 1-mg i.v. injection of morphine sulfate upon patient demand, with a relative delay of six minutes between allowable administrations. Nursing staff evaluated pain and sedation every four hours using a five-point scale. In the 50 patients evaluated, the highest analgesic use occurred during the first four to eight postoperative hours. After the immediate postoperative period, patients experienced either mild or no pain during approximately 90% of the evaluation periods. No patient suffered respiratory depression during self-dosing. Results of a poststudy self-assessment questionnaire showed that 90% of the patients reported experiencing mild to moderate pain overall, and 78% reported only mild discomfort throughout the postoperative period. Ninety-two percent of the patients strongly preferred PCA therapy over intramuscular injections. The Travenol Infusor with Patient Control Module represents a safe and effective device for PCA therapy of postoperative pain.
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PMID:Evaluation of a disposable, nonelectronic, patient-controlled-analgesia device for postoperative pain. 366 83

One hundred forty-eight adult patients having epidural anesthesia for cesarean section, postpartum tubal ligation, lower extremity orthopedic procedures, or lithotriptic therapy were assigned to five groups. Group 1 patients were given a commercially prepared 1.5% lidocaine solution with 1:200,000 epinephrine plus 1 ml of normal saline per 10 ml of lidocaine; the solution pH was 4.6. Group 2 patients were given commercially prepared 1.5% lidocaine solution plus 1:200,000 epinephrine, with 1 mEq (1 ml) NaHCO3 per 10 ml of lidocaine; the solution pH was 7.15. Group 3 patients received the commercial solution of 1.5% lidocaine with 1:200,000 epinephrine; the solution pH was 4.55. Group 4 patients were given a mixture of 18 ml of 2% lidocaine with 30 ml of 1.5% lidocaine, both commercially packaged with 1:200,000 epinephrine, plus 1 mEq (1 ml) of NaHCO3 added per 10 ml of solution; the solution pH was 7.2. Group 5 patients received 1.5% plain lidocaine to which epinephrine was added to a final concentration of 1:200,000; the solution pH was 6.35. Times of onset of analgesia (time between the completion of the anesthetic injection and loss of scratch sensation at the right hip (L-2 dermatome] and of surgical anesthesia (time between completion of injection and loss of discomfort following tetanic stimulation produced by a nerve stimulator applied to skin on the right hip) were significantly more rapid in the groups that received the pH-adjusted solutions (groups 4 and 2). Group 4 had the fastest mean onset time, 1.92 +/- 0.17 min, followed by group 2, 3.31 +/- 0.23 min.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of pH-adjusted lidocaine solutions for epidural anesthesia. 371 16

Osteoradionecrosis can involve the mandible following radical irradiation for treatment of oral cavity cancer. The radionecrosis of the mandible is often associated with severe intractable pain, local or extensive deformity, including pathologic fracture, orocutaneous fistula formation, and frequent loss of function. Treatment has ranged from analgesia and antibiotics to hyperbaric oxygen treatments to local or extensive sequestrectomies with partial or total mandibulectomy and restoration of tissue losses with unirradiated tissue. To our knowledge, this is the first report of the successful use of a free greater omental flap for immediate treatment of mandibular osteoradionecrosis and concomitant reconstruction. We found the omentum to be an excellent vascular bed that rapidly resolved the osteoradionecrosis and pain, promoted healing, and restored mandibular function with minimal discomfort to the patient.
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PMID:The free greater omental flap for treatment of mandibular osteoradionecrosis. 381 98

Descriptions of parturition are reviewed for 88 individuals in 29 species of captive and wild non-human primates. Mild or severe discomfort, in the form of straining, stretching, arching, grimacing, writhing, shaking, doubling up, eye closure and restlessness is reported in 69 cases. Silence and utterance of moderate-level vocalizations are reported in 21 and 43 cases, respectively. The overall pattern indicates that parturition in non-human primates is characterized by a significant degree of pain and discomfort, while vocal responses to pain are generally subdued. We suggest that analgesia is the mechanism, and concealment of the parturient female the adaptive significance behind this blocking of vocal pain responses.
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PMID:Parturition in non-human primates: pain and auditory concealment. 392 17

A therapeutic regimen is described for sedative, analgesic, and anti-emetic effect in patients receiving intra-arterial carmustine (BCNU) for malignant gliomas. This regimen consists of nalbuphine, 30 mg, i.v., and droperidol, 2.5 mg, i.v., given immediately prior to intra-carotid BCNU infusion. Droperidol, 2.5 mg, i.v., is then administered on four hour intervals for sixteen hours post-procedure. This combination provided excellent effect in nine patients treated for twelve intra-carotid infusions. None of the nine patients experienced vomiting, one experienced mild nausea several hours post-infusion, and non complained of severe pain or discomfort. Thirteen additional patients received diazepam, 10 mg, P.O., prior to the intra-carotid BCNU infusion, with fentanyl, 100 mcg, i.v., and prochlorperazine, 10 mg, i.m. at the onset of infusion. All thirteen patients suffered from severe nausea, vomiting, and orbital pain. The nalbuphine/droperidol combination is thought to provide a superior alternative to the traditional narcotic/pheonothiazine/benzodiazepine combination for carotid BCNU infusion. This combination has theoretical advantages for the patient with intracranial mass lesions by providing analgesia and sedation with minimal potential for respiratory depression and carbon dioxide retention.
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PMID:Nalbuphine and droperidol in combination for sedation and prevention of nausea and vomiting during intra-carotid BCNU infusion. 395 77


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