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)

The experience with sacral anesthesia is reported on a total of 513 proctologic patients. From them, 105 cases were submitted to the sacral anesthesia without extradural morphine application, and 308 cases were anesthesized with simultaneous extradural administration of morphine. Easy in applicability, the sacral anesthesia is such an analgesic procedure which results in no complications and may be employed mainly in elder patients. The anesthetics prolonged in action (those similar in type with Bupivacain, Marcain) together with extradural morphine administration are also effective in respect with postoperative analgesia. An average time of postoperative analgesia represents 53 +/- 23.4 hrs. when 2 mg/kg Bupivacain, 0005% Epinephrine and 5 mg Morphinum hydrochloricum are applied, respectively.
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PMID:[Sacral anesthesia in proctology]. 226 11

Thirty-seven patients with advanced cancer requiring oral administration of strong narcotics for pain control have been treated with one or other of two commercially-available, sustained-release morphine preparations. Patients were followed up primarily at home, supervised by a local hospice care team, and received daily dosage ranging from 60 mg to 420 mg morphine administered as 30 mg sustained-release tablets delivered at intervals from 6 to 10 hours for 'Roxanol SR' and from 8 to 14 hours for 'MS Contin'. Duration of treatment ranged from 2 to 80 days, and 17 of 19 patients who received sustained-release morphine for 20 or more days achieved a stable dosage schedule. Thirty-five of the 37 patients obtained good to excellent analgesia and only 2 of them required intermittent 'rescue' doses of standard morphine between doses of the sustained-release preparation. From experience with the use of the two preparations it was considered that 'MS Contin' was preferable because of the smaller size of the tablets and because of the longer duration of analgesia provided. It is concluded that sustained-release morphine preparations offer a safe and efficacious alternative to immediate-release analgesics and can help to improve the quality of life for the patient and care-givers.
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PMID:The use of sustained-release morphine in a hospice setting. 365 62

The comparative metabolism of the natural (-)- and the unnatural (+)-morphine was studied in liver microsomes from phenobarbital-treated, morphine-treated and control rats. (-)-Morphine was glucuronidated only at position 3 with the formation of (-)-morphine-3-glucuronide [(-)-M3G] at an average rate of 2.19 nmol X mg protein-1 X min-1. In contrast, (+)-morphine was conjugated preferentially at position 6. The rate of formation of (+)-morphine-6-glucuronide [(+)-M6G] was 3.1 times higher than that of (+)-M3G (0.92 and 0.30 nmol X mg protein-1 X min-1, respectively). Natural morphine was N-demethylated at an average rate of 0.42 nmol X mg protein-1 X min-1, and this rate of N-demethylation was about twice as high as that of (+)-morphine (0.17 nmol X mg protein-1 X min-1). Phenobarbital treatment led to a 3- to 4-fold increase in the formation rate of (-)-M3G and (+)-M6G whereas the glucuronidation of (+)-morphine at position 3 was increased only marginally. No change in the N-demethylation of either enantiomer was observed. In contrast, pretreatment with (-)-morphine decreased the N-demethylation of both enantiomers by about 80% without any effect on the glucuronidation. The increased ratio of the rate of (+)-M6G/(+)-M3G formation after phenobarbital treatment indicates that different isozymes may be involved in the two reactions. This study demonstrates that there is an inherent substrate stereoselectivity and site selectivity for morphine in the rat hepatic uridine 5'-diphosphate-glucuronyltransferase although not as critical as for the opiate receptors mediating analgesia.
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PMID:Natural (-)- and unnatural (+)-enantiomers of morphine: comparative metabolism and effect of morphine and phenobarbital treatment. 392 76

The analgesic effects and bioavailability of a slow-release preparation of morphine (Duromorph) were studied in 12 patients with acute postoperative pain. Duromorph produced significant analgesia within 1-2 h of administration i.m., and there was a progressive decrease in the mean pain score for at least 8 h. None of the patients requested or received additional analgesia within 12 h, and the incidence of side-effects was similar to that associated with i.m. morphine. During the 8-h study, plasma concentrations of morphine slowly increased for 3 h, and then gradually declined. After 3 h, concentrations were invariably greater than those produced by conventional doses of morphine sulphate i.m. The study confirmed that Duromorph was an effective analgesic with a prolonged duration of action, which was suitable for the management of postoperative pain.
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PMID:Postoperative analgesia with Duromorph. 404 20

Heroin hydrochloride is approximately twice as potent as morphine sulfate, and acts slightly faster but for a shorter duration than morphine. Although patients with chronic pain due to advanced cancer differ from cancer patients with postoperative pain in terms of their degree of tolerance to the analgesic effects of morphine and heroin and their reports of various elements of mood, there is, thus far, no indication that heroin has any unique advantage over morphine in terms of side effect occurrence or effects on mood at equianalgesic doses. Both drugs improve mood provided they are administered in doses which result in analgesia. While there appears to be some slight difference in the spectrum of side effects observed after heroin as compared to morphine, heroin and morphine share the most common side effects. The incidence of side effects following both drugs appear to be highest among those effects which are primarily somatic and undesirable. The use of visual analog scales concurrent with categorical pain and pain relief scores provides a means for the finer estimation of relative analgesic potency and time action. The results of these studies are in general agreement with those of other investigators. Where apparent differences exist they can usually be explained on the bases of differences in methods and subject populations.
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PMID:Relative analgesic potency of intramuscular heroin and morphine in cancer patients with postoperative pain and chronic pain due to cancer. 678 35

MS Contin tablets and Oramorph SR tablets are two forms of oral controlled-release morphine sulfate available for the alleviation of pain. Our objective was to compare their analgesic effects in a relative potency assay. In this study, 151 patients undergoing caesarean section or abdominal hysterectomy and reporting moderate or severe postoperative pain received a 30 or 90 mg dose of either drug in a balanced, randomized, double-blind, parallel-group, single-dose experimental design. Patients provided self-ratings of analgesia. Relative potency for pain relief were calculated from log dose-effect curves. For total pain relief (rated by visual analog scales) over 12 hours, the log dose relative potency estimate for MS Contin tablets/Oramorph SR tablets was 1.9 (95% confidence limits, 0.89 to 11.1); for peak pain relief (visual analog scales) the relative potency estimate was 1.7 (95% confidence limits, 0.65 to 48.3). Overall, the 90 mg dose of MS Contin was more effective than 30 or 90 mg doses of Oramorph SR and the 30 mg dose of MS Contin at hours 6 to 12. Adverse experiences (mainly drowsiness) were mostly mild to moderate, with no significant differences in their overall incidence or severity between equivalent doses. MS Contin tablets provided greater peak, total, and duration of analgesia, without higher incidence of adverse experiences.
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PMID:Analgesic efficacy and potency of two oral controlled-release morphine preparations. 792 17

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

Kadian/Kapanol (K) is a capsule formulation of morphine designed for 12- or 24-hourly dosing. This double-blind study compared the efficacy and safety of K every 24 hr to K every 12 hr and MS Contin tablets (MSC) every 12 hr. One hundred fifty-two patients with cancer pain were titrated to adequate analgesia with immediate-release morphine (IRM) solution. Stabilized patients were randonized to one of the three treatments for 7 +/- 1 days. Rescue medication was IRM tablets. Efficacy and safety were assessed by time to first remedication and total dose of rescue medication, pain scores, global assessments, and incidence of morphine-related side effects. Fifty-four patients were treated with K every 24 hr. 45 with K every 12 hr. and 53 with MSC every 12 hr. Mean age was 61 years and mean total daily dose of morphine was 138 mg. Forty-six percent of the K every 24 hr patients, 51% of the K every 12 hr patients, and 55% of the MSC every 12 hr patients required rescue medication on the final day. Time to remedication was 16.0 hr for K every 24 hr, 9.1 hr for K every 12 hr and 8.7 hr for MSC every 12 hr (P = 0.0010). Patient global assessment significantly favored K every 24 hr over MSC every 12 hr (P = 0.018). There were no statistically significant differences among the treatments for any morphine-related side effects when adjusted for baseline. K had efficacy and safety profiles similar to MSC every 12 hr but had the advantage of 12- or 24-hourly administration.
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PMID:Comparison of a once-a-day sustained-release morphine formulation with standard oral morphine treatment for cancer pain. 926 35

This single-dose, double-blind, randomized, parallel-group study compared the analgesic efficacy and safety of MS Contin (MSC) and Oramorph SR (OSR), two controlled-release preparations of oral morphine sulfate, in patients following orthopedic surgery. One hundred patients received MSC 30 mg, MSC 60 mg, or OSR 60 mg (two 30-mg tablets) when postoperative pain became moderate or severe. Patients self-rated pain intensity and relief on categorical (CAT) and visual analogue scales (VAS) hourly for up to 12 hours. MSC 60 mg produced the greatest peak analgesic effect and was more efficacious than OSR 60 mg through the sixth hour, with statistical significance achieved at 1, 2, and 3 hours postdosage. Compared with OSR 60 mg, both MSC dosages provided significantly more rapid times to peak effect by CAT and VAS ratings. The OSR group experienced almost twice as many adverse events as did the two MSC groups and also reported somnolence and dizziness more frequently. MSC 60 mg provided more rapid and greater peak analgesia with fewer adverse effects than did OSR 60 mg.
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PMID:Analgesic efficacy and safety of two oral controlled-release morphine preparations in orthopedic postoperative pain. 1015 Feb 66

Avinza is a once-daily, extended-release oral morphine preparation. It has a pharmacokinetic profile that exhibits less peak-to-trough fluctuations in plasma concentration whilst providing analgesia statistically identical to that produced by MS Contin (controlled-release morphine sulfate), Oxycontin (oxycodone HCl controlled-release) and six doses of oral morphine sulfate administered every 4 h. Avinza improves quality of sleep by several measures but interestingly gives the best sleep improvement when given in the morning rather than at night. It causes the same side effects of other opioids: constipation, nausea, vomiting, somnolence and mood swings. Doses of 30 - 60 mg/day have been shown to be well tolerated by patients with osteoarthritis (even in the elderly), who have failed other medications.
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PMID:Avinza - 24-h sustained-release oral morphine therapy. 1499 42


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