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)

1 In a controlled crossover study identical oral surgical procedures were performed on two separate occasions in six patients. 2 Two h after surgery, either 40 mg methylprednisolone (Solu-Medrol) or placebo (saline) was administered intravenously in a double-blind randomized fashion. 3 Five h after surgery, three patients received 4 mg naloxone (Nalonee) while 3. Five h after surgery, three patients received 4 mg naloxone (Nalonee) while three patients received placebo (saline) intravenously, followed by a crossover to alternative injections 1 h thereafter. 4 Several measurements/assessments were recorded for a paired comparison of the post-operative courses. 5 The mean pain assessment (VAS) was reduced by about 50% 45 min after the steroid injection (P = 0.03). 6 Neither increasement of the post-operative pain nor reversal of the steroid-induced analgesia could be demonstrated by injection of 4 mg naloxone. 7 Swelling was reduced by 46% on day 3 after the operation when the steroid was injected as compared to placebo (P = 0.06); on day 6 the reduction averaged 60% (P = 0.04). 8 According to overall assessments after the second operation all patients expressed clear preference for the post-operative course when the steroid was injected. 9 Present and previous results in this model with bilateral oral surgery suggest that short term corticosteroid administration deserves attention as an efficient means which may be of value in reducing pain and excessive inflammation in surgery and traumatology.
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PMID:Effects of naloxone on post-operative pain and steroid-induced analgesia. 684 55

The introduction of microdiscectomy to lumbar spine surgery has resulted in a significant decrease in postoperative pain and length of hospital stay. Intraoperative application of long-acting local anesthetic agents has been used for many general and neurosurgical procedures for the management of postoperative pain. In addition, many surgeons routinely use intraoperative corticosteroids during lumbar discectomy to reduce traumatic nerve root inflammation. However, the efficacy of intraoperative long-acting local anesthetic agents and corticosteroids for reduction of postoperative discomfort has not been reported for lumbar discectomy. This study evaluated 32 patients at a university-based Veterans Administration hospital undergoing lumbar microdiscectomy. All 32 patients presented with radicular symptoms and had radiographic confirmation of a herniated nucleus pulposus. These patients were divided into three groups. Group 1 (12 patients) received 160 mg intramuscular Depo-Medrol (methylprednisolone acetate) and 250 mg intravenous Solu-Medrol (methyl-prednisolone sodium succinate) at the start of the operation. A macerated fat graft soaked in 80 mg Depo-Medrol was placed over the affected nerve root following discectomy. In addition, 30 ml of 0.25% bupivacaine was infiltrated into the paraspinal musculature at skin incision and during closure. Group 2 (10 patients) received 30 ml of 0.25% bupivacaine infiltrated into the paraspinal musculature at skin incision and at closure. In this group of patients, a saline-soaked fat graft was placed over the affected nerve root. Group 3 (10 patients) acted as a control group, undergoing lumbar microdiscectomy without corticosteroids or bupivacaine. Patients receiving bupivacaine and corticosteroids (Group 1) had a statistically significantly shorter hospital stay (1.4 days) compared to the control group (4.0 days) (p = 0.0004, Mann-Whitney U-test). Patients in Group 1 required less postoperative narcotic analgesia than the other groups. Finally, a larger percentage of patients in Group 1 reported complete relief of back and radicular pain on postoperative Day 1 compared to other groups. Postoperative complications and functional outcome were not different between the groups. These results indicate that the combination of long-acting anesthetic agents and corticosteroids can reduce postoperative discomfort and subsequently the length of postoperative hospital stay.
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PMID:The perioperative use of corticosteroids and bupivacaine in the management of lumbar disc disease. 843 38

The purpose of this study is to present several years experiences in using of epidural analgetic blockade in patients with a substantial exacerbation of radicular pain syndrome in the course of discopathy resistant to traditional treatment. The observation of 61 non-surgical patients, who were given epidurally an analgetic (Bupivacainum hydrochloricum or Morphinum hydrochloricum) and a steroid antiphlogistic (Depo-Medrol) simultaneously, using a stationary catheter, confirms the efficacy of the method. Taking advantages of local analgesia in order to break the pain arc, the possibility of sustaining it for an extended period of time, as well as its local antiphlogistic activity, even while using minimal doses of the drugs, show evident therapeutic effects.
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PMID:[Continuous epidural blockade as a method of treatment of low back pain syndrome in the course of disk pathology. Introductory research]. 896 75

We investigated clinical effects of steroid during perioperative management of 40 patients undergoing extensive radical surgery for esophageal cancer. Methylprednisolone 500 mg was administered in 20 patients preoperatively (the steroid group). The non-steroid group received no steroid. Clinical parameters checked were pre- and postoperative changes of P/F ratio, fluid balance and postoperative epidural analgesia in the two groups. The steroid group had significantly more optimal P/F ratio postoperatively. Fluid balance was significantly more favorable, and postoperative period was significantly less painful in the steroid group. We assumed that steroid had prevented enhancement of vascular permeability and also had suppressed secretion of inflammatory mediators. We conclude that preoperative administration of steroid is beneficial for the perioperative management of patients undergoing extensive surgery.
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PMID:[Clinical effects of steroid in the perioperative management of patients undergoing extensive esophagectomy]. 1216 75