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)

In a randomized, double-blind crossover study, 40 patients with postherpetic neuralgia were given single oral doses of clonidine, 0.2 mg, codeine, 120 mg, ibuprofen, 800 mg, or inert placebo. Pain relief and side effects were recorded for 6 hours. Patients reported significantly more relief after clonidine than after the other three treatments. Codeine and ibuprofen were ineffective. Sedation, dizziness, and other side effects were more frequent after clonidine (74%) or codeine (69%) than after placebo (36%) or ibuprofen (28%). Reported pain relief was greater during trials in which side effects were present. A single, mild side effect was associated with as much additional pain relief as multiple, severe side effects. Clonidine's superiority to codeine, which had a similar incidence of side effects, argues for a specific analgesic effect. In addition, side effects may have contributed to clonidine analgesia, perhaps by suggesting to patients that they had received a potent drug.
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PMID:Association of pain relief with drug side effects in postherpetic neuralgia: a single-dose study of clonidine, codeine, ibuprofen, and placebo. 328 74

A prospective, randomized study was performed in 87 patients to compare the safety, efficacy and dose requirements of two sedation techniques for stereotactic headframe application. Sedation administration and headframe application averaged 30 min. Fifty patients weighing 76 +/- 13 kg (mean +/- SD) received mean doses of 154 micrograms fentanyl plus 5.5 mg droperidol i.v. (FD group). An additional 37 patients weighing 76 +/- 19 kg received mean doses of 127 micrograms fentanyl plus 6.7 mg Valium (diazepam; FV group). Both treatments provided excellent hemodynamic stability and a low incidence of adverse side effects while providing adequate analgesia and sedation. The incidence of anesthetist-assessed patient anxiety and discomfort was more favorable in the FD group.
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PMID:Sedation for stereotactic headframe application: a randomized comparison of two techniques. 332 51

The effects of detomidine, a veterinary sedative analgesic, were studied in the horse. Novel objective techniques were employed to assess the analgesic and sedative potency of this compound. Intravenous doses of 0.010, 0.020 and 0.040 mg/kg were administered to eight adult Thoroughbred racehorses according to a double-blind crossover design. Analgesia was measured by determining the latency to onset of the skin twitch and hoof withdrawal reflexes following noxious thermal stimulation of the withers and fetlock, respectively. Sedation was assessed by quantifying spontaneous locomotor activity in horses confined to an activity chamber, and by electronic measurement of head ptosis. Linear, dose-related increases in the intensity and duration of analgesia were observed. However, dose-related increases in duration, rather than intensity of sedation were observed. In conclusion, detomidine is an effective analgesic in the horse, but it is more potent in producing sedation than analgesia.
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PMID:Objective assessment of detomidine-induced analgesia and sedation in the horse. 341 17

Ciramadol, an agonist-antagonist analgesic (in intramuscular doses of 30 and 60 mg) was compared with 10 mg of morphine and placebo in a double-blind, parallel study in 160 patients with postoperative pain. The patients were assigned randomly to one of the four treatment groups and could receive a dose of the medication every 3 hr as needed for 48 hr; a maximum of six doses was allowed in a 24-hr period. Formal efficacy assessments using standard pain intensity and pain relief scales were restricted to the initial dose period. The three active therapy groups had significantly (P less than 0.05) higher analgesia scores than the placebo group on all efficacy scales. The mean cumulative efficacy scores for the initial dose evaluation were highest for 60 mg of ciramadol; however, patients' overall evaluations of therapy were highest in the morphine group. Nausea and vomiting were the most frequent adverse experiences (15-25% incidence); however, there were no statistically significant differences between groups in their occurrence. A greater percentage (P less than 0.05) of patients reported skin reactions in the 60 mg ciramadol group (15%) than in the 30 mg ciramadol (0%) and placebo (0%) groups. Sedation was slightly higher with the active therapies than with placebo. Changes in vital signs were minimal. It is concluded that 60 mg of ciramadol compares favorably with 10 mg of morphine as a postoperative analgesic.
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PMID:A double-blind comparison of multiple intramuscular doses of ciramadol, morphine, and placebo for the treatment of postoperative pain. 390 21

A technique is described for the management of post-operative patients who have undergone major craniofacial surgery. Under supervision on the Intensive Care Unit, the patients breathe humidified, oxygen-enriched air through a naso-tracheal tube. Sedation and analgesia are provided by continuous infusions of etomidate (variable rate) and fentanyl (fixed rate), administered by volumetric infusion pumps (IMED 922). Six patients have been studied in detail and our results are presented. In conjunction with fentanyl, a mean infusion rate of 3.72 micrograms . kg-1 . min-1 of etomidate provided good sedation and analgesia, without clinically significant respiratory depression. The patients found the technique very acceptable and no side-effects were noted.
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PMID:Intravenous sedation for the intubated and spontaneously breathing patient in the intensive care unit. 644 33

The influence of diurnal variation and morbid obesity on the morphine requirements of patients using patient-controlled analgesia (PCA) was studied. Forty-six patients undergoing either elective (Group I) or gastric bypass (Group II) surgery composed the study group. Patients were allowed to use the PCA machine for 36 to 72 hours postoperatively to deliver 0.6 mg/sq m doses of morphine sulfate intravenously. Counters on the device indicating the number of doses received were monitored every two hours along with vital signs and a pain and sedation rating. Dosing rates were studied with regard to the time of day. Morbid obesity had no significant effect on dosing rate requirements. Analyses revealed a significant diurnal rhythm in morphine dosing rate requirements despite a 27-fold interpatient variability. Peak analgesic use was at 0900, and the nadir was at 0300. Patient pain rankings did not indicate any changes in pain status, demonstrating PCA's use of analgesia as an endpoint for dosing. Sedation status showed a higher degree of sedation at night when compared with the daytime values, documenting that sedation was not drug-induced. There is a circadian variation in narcotic analgesic need in the postoperative patient that is met appropriately by PCA.
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PMID:Morphine requirements using patient-controlled analgesia: influence of diurnal variation and morbid obesity. 668 12

Nitrous oxide analgesia was used prior to local anesthesia in over 200 outpatient implants and was very effective in reducing anxiety and pain of injections. Sedation by nitrous oxide is characterized by unique absorption, distribution, and elimination, which result in rapid onset and rapid recovery. The drug is widely accepted as a nontoxic conscious sedation modality, and simple machines permit easy and safe administration. The drug is particularly desirable in the elderly who may have respiratory or cardiovascular disease, and seems ideally suited to ambulatory surgicenters.
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PMID:Nitrous oxide analgesia for outpatient surgery. 673 94

Two groups of six patients who had undergone major maxillofacial surgery and who required intermittent positive pressure ventilation, analgesia and sedation for about 48 hours postoperatively were studied. Analgesia in the postoperative period was maintained by an infusion of fentanyl 0.034 micrograms/kg/minute. Sedation was maintained with an intravenous infusion of etomidate such that the patients slept but opened their eyes when addressed and obeyed commands. An assay method was developed which enabled the measurement of plasma concentration of etomidate for periods of up to 24 hours after stopping the infusion. The steady state plasma concentration associated with the technique which produced the required degree of sedation was found to be 158 micrograms/litre (SEM 36). Etomidate exhibited linear pharmacokinetics and the decrease in plasma concentration of etomidate after stopping the infusion was consistent with a three-compartment pharmacokinetic model. All the patients recovered within 1 hour of stopping the infusion. The use of results obtained from the first group of six patients enabled a dosage regimen to be calculated that used a two stage infusion. This regimen enabled a reduction in the time taken to establish the appropriate degree of sedation in the second group of six patients. The two-stage infusion technique provides a means of rapid sedation and of maintaining a suitable clinical response for the prolonged periods that may be necessary when patients are transferred to an intensive therapy unit.
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PMID:Plasma concentrations of etomidate during an intravenous infusion over 48 hours. 686 54

Patients with pain after operation received morphine hydrochloride intrathecally in doses of 0.02 mg kg-1 (n = 30) and 0.2 mg kg-1 (n = 30). The high-dose group showed slightly longer-lasting and more potent analgesia than the low-dose group. Sedation, decreases in heart rate and systolic arterial pressure, oliguria, nausea and urinary retention were more frequent in the high-dose group. Two patients of the high-dose group showed evidence of respiratory depression which appeared after a late change in posture (7 and 11 h). We conclude that postoperative analgesia with intrathecal morphine 0.02 mg kg-1 must be followed by a prolonged head-up posture and be performed in hospital units where the treatment of respiratory depression is competent.
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PMID:Postoperative spinal analgesia with morphine. 702 19

During a twelve-month period, 416 children with acute abdominal pain required emergency admission to Southampton General Hospital; 46% had operations. Appendicitis was the commonest organic cause of acute abdominal pain identified (31%). Constipation (9%) can present as acute abdominal pain simulating appendicitis. All children should have a urine sample examined microscopically and the finding of significant pyuria is suggestive, but not diagnostic, of a urinary tract infection (7%). Mesenteric adenitis, which can only be diagnosed with certainty at laparotomy, was less common (4%). Despite careful clinical assessment and follow up, 45% of children in this series remained undiagnosed. Sedation but not analgesia may assist in the diagnosis of the acute abdomen in children.
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PMID:Acute abdominal pain in children. 724 73


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