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)

Fentanyl is commonly used as an adjunct to general anaesthesia for day-surgery procedures. We have prospectively studied the effect of this practice on postoperative analgesia in 304 day-surgery patients, 164 undergoing termination of pregnancy and 140 having various other minor gynaecological procedures. Approximately half the patients received fentanyl, the mean dose being 50 mcg. Fentanyl given during anaesthesia had no effect during recovery on analgesic requirements or on nausea or vomiting in either pregnant or non-pregnant patients.
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PMID:Is fentanyl effective for postoperative analgesia in day-surgery? 160 39

Neurolept analgesia in ambulatory nasal endoscopies has been gaining widespread use recently. Scrupulous selection of patients and careful preoperative evaluation and premedication are essential. Excellent surgical block is a prerequisite to good neurolept analgesia. Versed (midazolam) is particularly suitable for outpatient surgery, since it provides superior operative condition to Valium (particularly less venoirritation) and rapid recovery in the postoperative period associated with a low incidence of nausea and vomiting. When used in combination with fentanyl (Sublimaze) or alfentanil, Versed is suitable for the provision of total neurolept analgesia. Careful intraoperative vigilance and monitoring, including pulse oximetry, cannot be overemphasized.
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PMID:Neurolept analgesia in ambulatory (nasal) endoscopies. 168 34

Fentanyl/diazepam anesthesia is an appropriate combination for surgical operations on the guinea pig, since it ensures definitive anesthesia and analgesia without respiratory depression. Comparative investigations with pentobarbital and urethane were carried out to check their applicability for electrocochleographic recordings. We found that fentanyl/diazepam combination anesthesia is more suitable for electrocochleographic investigations than pentobarbital. We were thereby able to prove that pentobarbital has an attenuating effect on electrocochleographic recordings in contrast to the findings reported in the available literature. For this reason, and because the lowest rates of animal morbidity occurred with fentanyl/diazepam, this combination anesthesia should be used preferentially for electrophysiological experiments in guinea pigs.
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PMID:The value of fentanyl/diazepam anesthesia for experimental operations and recordings of compound action potentials in the guinea pig cochlea. 174 48

The maternal and umbilical concentrations of fentanyl were measured after epidural analgesia for cesarean section, using a highly sensitive radioimmunoassay method. Sixteen parturients were anesthetized with a single epidural injection of a mixture of 85 mg bupivacaine 0.5%, 60 mg etidocaine 1%, and 100 micrograms fentanyl with epinephrine 1:200,000. Apparent maternal individual maximum peak concentration (Cmax) of fentanyl was 0.38 +/- 0.16 ng/ml (mean +/- SD) (range 0.12-0.59 ng/ml) and the time to reach Cmax (Tmax) was 24 +/- 14 min (range 5-60 min). Infants were born 19 to 42 min after epidural administration of fentanyl (mean 27 min). Fentanyl concentrations in neonates was 0.13 +/- 0.04 ng/ml for the umbilical vein and 0.06 +/- 0.03 ng/ml for the artery. The fetus extraction ratio was 53 +/- 19% (range 20-83%). The large difference between arterial and venous concentrations of fentanyl may be due to a metabolization by the fetus and/or an uptake of the drug in the fetal tissues. Thus, even if fentanyl levels reaching the fetus after cesarean section under epidural anesthesia, using local anesthetics with 100 micrograms of fentanyl, are within safe range values, the likelihood of fentanyl uptake by fetal tissues calls for a cautious use of repeated fentanyl administration.
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PMID:Maternal and umbilical cord concentrations of fentanyl after epidural analgesia for cesarean section. 176 14

Analgesia and hemodynamic parameters during epidural anesthesia with trimecaine (2% solution) in combination with fentanyl (200 micrograms) have been studied in 56 patients aged 28-84 years. During premedication 34 patients were, in addition to atropine, dimedrol and relanium, administered galanthamine (15 mg); 22 patients were not given galanthamine. Fentanyl was administered with the first doses of the anesthetic. It has been established that premedication with galanthamine reduced the time of anesthesia onset by 19.6% and decreased the initial anesthetic dose by 10.7%. The initial period of anesthesia was characterized by a 23% increase in the number of cases with retained baseline BP level, a 1.6-fold decrease in the value of BP lowering, a 2.4-fold slowing of the time of hypotonic reaction development and a 31% shortening of the time of bradycardia onset.
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PMID:[The use of galanthamine in epidural anesthesia with trimecaine and fentanyl]. 178 88

The purpose of this retrospective study was to evaluate the combined use of intravenous analgesia, with a potent opiate alone, supplemented by local anaesthesia as an alternative to general anaesthesia for medically compromised patients. Sixty-two in-patients, aged between 32 and 80 years, with an ASA physical status of III and IV, were involved in this study. The local anesthetic used was 4% articain with epinephrine (1:200,000) and narcotic analgesics were Fentanyl or Alfentanil. Surgical procedures included multiple dental extractions, cystectomy and the removal of impacted teeth. All patients completed the surgery without deeper anaesthesia and mostly enjoyed a comfortable intraoperative period. Only one respiratory depression was observed, but quickly reversed. Other adverse effects were few and without consequences, hemodynamic changes remained in tolerable limits. In conclusion this anaesthetic technique can be a suitable alternative to general anaesthesia in oral surgery for high-risk patients.
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PMID:Local anaesthesia with intravenous analgesia as an alternative to general anaesthesia for medically compromised patients undergoing oral surgery. A retrospective study of sixty-two cases. 183 35

The pharmacokinetics, pharmacodynamics, and clinical uses of fentanyl, sufentanil, and alfentanil are reviewed. The fentanyl derivatives have reduced or eliminated many of the disadvantages of opioid anesthetics, such as incomplete amnesia and undesirable hemodynamic responses to surgery. Fentanyl is 50-100 times as potent as morphine and was the first of the three to be marketed. Sufentanil is even more potent than fentanyl. Alfentanil has the fastest onset of action, followed by sufentanil and then fentanyl. Alfentanil also has the shortest duration of action of the group. Most studies of these agents have been done to assess their role as anesthetics in cardiac surgery. All three provide cardiovascular stability when administered before noxious surgical stimuli, except when given as a single bolus during the induction of anesthesia. All seem to produce adequate anesthesia, particularly when used in combination with nitrous oxide. Because of its short duration of action, alfentanil is preferred for brief procedures or when rapid changes in the level of consciousness are desired. All three agents have also been used for analgesia; epidural administration provides adequate relief of pain. Fentanyl has been formulated as a transdermal patch that seems to provide the same degree of analgesia as a continuous i.v. infusion. Fentanyl has also been formulated as an investigational lozenge that has shown advantages as a preoperative sedative in children. As more is learned about these agents, their perioperative uses for anesthesia, analgesia, and sedation will continue to be refined.
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PMID:Clinical uses of fentanyl, sufentanil, and alfentanil. 183 93

Fentanyl is an attractive agent for analgesia in the emergency department. Its use in this setting has been limited to IV bolus administration. We report successful sedation, muscle relaxation, and analgesia of a multiple trauma patient with fentanyl IV bolus and continuous infusion in the ED.
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PMID:Continuous intravenous infusion fentanyl for sedation and analgesia of the multiple trauma patient. 185 80

Two groups of primiparous women with single fetus in cephalic presentation were prospectively randomized at the end of pregnancy to receive epidural analgesia with 0.25% bupivacaine, either single (n = 102) or associated with 0.05 mg of phentanyl (n = 102). Phentanyl significantly reduces the period of development of analgesia and increases the interdose period. The quality of analgesia is significantly better when fentanyl is associated with bupivacaine. The evolution of delivery (dilatation and expulsion) and the perinatal results (cord pH and vitality of the newborn as assessed by the Apgar test) were similar in both groups. We conclude that the association of phentanyl with bupivacaine has advantages for epidural analgesia during delivery, as the quality of analgesia is improved, its duration is prolonged and there are no adverse effects on the evolution of delivery or on the newborn.
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PMID:[Comparative study of peridural anesthesia with bupivacaine alone and combined with fentanyl during vaginal delivery]. 187 42

To determine the suitability of the rhesus monkey as a model for investigation of opioids, we examined the analgesic, respiratory, and cardiovascular effects of fentanyl in six adult male rhesus monkeys. Fentanyl was administered in sequential bolus injections of 2, 4, 16, 64, and 128 micrograms/kg, with 10 min between each dose. Arterial plasma fentanyl concentrations and blood gas tensions were measured 3 and 9 min after each dose and 1, 2, 5, 20, 60, and 120 min after the final dose. At the same time periods, mean systemic arterial, pulmonary arterial, central venous, and pulmonary capillary wedge pressures, cardiac output, heart rate, and respiratory rate were measured. Analgesia was quantified as the time required for tail withdrawal from a standardized noxious stimulus. Tail latency response time increased significantly after the 4-microgram/kg dose (plasma fentanyl concentration = 2.7 +/- 0.9 ng/mL). Maximum tail latency response time was attained after the 64-micrograms/kg dose (43.4 +/- 26.0 ng/mL). Respiratory rate decreased significantly after the 2-microgram/kg dose, and PaCO2 increased significantly after the 4-microgram/kg dose. All animals became apneic, requiring tracheal intubation and controlled ventilation, after the 64-micrograms/kg dose. Also, mean arterial pressure and cardiac output decreased significantly after the 64-micrograms/kg dose. There were no other significant cardiovascular changes. Peak plasma fentanyl concentration after the 128-micrograms/kg dose was 117.0 +/- 49.6 ng/mL. It appears that plasma concentrations of approximately 40 ng/mL are sufficient to reach the full cardiovascular, respiratory, and analgesic effects of fentanyl in the rhesus monkey. Significant respiratory and analgesic effects are evident at concentrations as low as 3 ng/mL.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cardiovascular, respiratory, and analgesic effects of fentanyl in unanesthetized rhesus monkeys. 189 88


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