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)

7,500 deliveries occurred from the date of opening of the Maternity Hospital Jean-Rostand. 3,500 of these were conducted under epidural anaesthesia. At different stages prospective studies were carried out to recall the effect of adding fentanyl to bupivacaine when the epidural injection was made. A pharmacokinetic study. This shows that the levels in the mother and the fetus begin to coincide more with the number of doses that are given and pass from 0.3 after 50 micrograms have been administered to 0.5 after 100 micrograms have been administered and 0.7 after 150 micrograms have been administered. The fetal levels are far lower than those required to depress respiration. The half life of distribution through the circulation has been worked out at 4 minutes and the half for elimination of the drug at 460 minutes. The maternal levels show great fluctuations and late alterations. Analgesia is earlier, more complete and more prolonged when fentanyl is added. Fentanyl also masks irregularities. Undesirable effects such as tiredness, pruritus, nausea, vomiting and urinary retention occur infrequently and last only for short periods of time. No mother had respiratory depression. The doses of bupivacaine that had to be given were as a whole less when fentanyl was added. In 40% of cases it only required one injection to achieve analgesia throughout the whole labour. The length of labour and the number of caesarean operations carried out did not change.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fentanyl in peridural obstetrical analgesia. Evaluation after 4 years' use]. 358 62

Epidural fentanyl (Sublimaze; Janssen) in the management of postoperative pain, with particular attention to efficacy and safety, was investigated. A treatment group (group 1) of 31 patients and a control group (group 2) of 30 patients were used. Group 1 received epidural fentanyl 100 micrograms postoperatively, while in the control group pain was treated with intramuscular pethidine 1.5 mg/kg 4-6-hourly as required during the 11 hours in the recovery room. Epidural fentanyl started working within 20 minutes and provided excellent analgesia for 8 hours or more postoperatively, comparable to repeated doses of intramuscular pethidine. Of the patients in group 1 13% experienced tolerable pruritus and the incidence of nausea and vomiting was small relative to that recorded in group 2.
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PMID:Epidural fentanyl in the management of postoperative pain. 375 Jan 35

Fentanyl is a synthetic narcotic which, when administered intravenously, has a rapid onset and short duration of action. It produces less cardiovascular depression than either meperidine or morphine. Experience with 100 examinations performed using intravenous fentanyl and diazepam for analgesia and sedation in adults is reviewed. There were no complications, and effective analgesia was obtained in all cases. Fentanyl has distinct pharmacologic advantages over both morphine and meperidine for use in radiologic special procedures.
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PMID:Fentanyl and diazepam for analgesia and sedation during radiologic special procedures. 378 61

Tramadol-N2O anaesthesia as recommended by Stoffregen was studied in 40 patients (ASA I-II) undergoing elective orthopaedic or lower abdominal surgery. Fentanyl and droperidol (Thalamonal)/atropine were given as i.m. premedication, induction was performed using methohexitone, succinylcholine and pancuronium, ventilation was controlled by means of a Takaoka respirator (N2O/O2 79:21, 4 breaths/min). Intraoperative analgesia was provided by a biphasic tramadol infusion. However, half the patients were given placebo infusion (0.9% NaCl) instead of tramadol in a randomized and double-blind manner in order to evaluate tramadol efficacy as one component of balanced anaesthesia. Whenever anaesthetic depth appeared to be insufficient enflurane (0,5-1.5 vol.%) was administered for short periods. Blood pressure, pulse rate as well as cumulative enflurane dose were documented; postoperative analgesic requirement and awareness of intraoperative events (tape recorder music offered via earphones) were further used to assess tramadol effects. Anaesthesia proved to be quite comparable in both groups; patients felt satisfied without exception. Relative cumulative enflurane times (vol.% . min, related to duration of anesthesia) did not differ significantly (tramadol 5.9%, placebo 4.9%). When enflurane had not been necessary (tramadol n = 13, placebo n = 10), mean percentage rises of blood pressure or pulse rate, related to preoperative values, were found to be slightly higher in the tramadol group. Postoperative analgesic requirement was reduced significantly after tramadol. Striking differences between the two groups, on the other hand, were shown with respect to intraoperative awareness: while patients receiving placebo proved to be amnaesic, 65% of tramadol patients were aware of intraoperative music.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The significance of tramadol as an intraoperative analgesic. A randomized double-blind study in comparison with placebo]. 388 43

The effects of intravenously administered fentanyl (25 micrograms/kg, n = 9; 50 micrograms/kg, n = 5) and alfentanil (12.5 micrograms/kg, n = 5; 25 micrograms/kg, n = 7) on the noxiously evoked, single-unit activity of cells in the nucleus reticularis gigantocellularis (NRGC) were studied in decerebrate cats. Only cells of the NRGC excited exclusively by supramaximal electrical stimulation of A delta fibers (noxious stimulation) of the superficial radial nerve were studied. The noxiously evoked activity of all cells in the NRGC was suppressed by the administration of opioids (by 58 and 88% for fentanyl, 25 micrograms/kg and 50 micrograms/kg, respectively; by 35 and 78% for alfentanil 12.5 micrograms/kg and 25 micrograms/kg, respectively). Fentanyl and alfentanil effects were antagonized by the intravenous administration of naloxone. These results indicate that opioid suppression of noxiously evoked activity is seen in neurons located in the brainstem, and thus suppression of brainstem neurons may be important in the production of fentanyl and alfentanil analgesia.
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PMID:Fentanyl and alfentanil suppress brainstem pain transmission. 392 68

To identify the opioid antagonist activity of nalmefene and to determine its duration in man, six healthy male subjects were pretreated on separate days with a saline placebo, 0.5 mg, 1 mg, or 2 mg nalmefene intravenously in a randomized double-blind fashion. Opioid challenges with fentanyl, 2 micrograms/kg, then were administered 1, 2, 4, 6, and 8 h afterward. Respiratory depression was monitored by ventilatory and occlusion pressure responses during CO2 rebreathing, while analgesia to experimental pain was identified with the submaximal effort tourniquet ischemia test. One hour following placebo pretreatment, the initial fentanyl dose produced marked respiratory depression. Minute ventilation and occlusion pressure at a PCO2 60 mmHg during rebreathing (VE60 and P(0.1)60) were reduced to 29 and 41% of control, respectively. The slopes of the ventilatory and occlusion pressure responses also decreased significantly to 51 and 55% of control. Respiratory effects were similar with all subsequent fentanyl doses. Pretreatment with 2 mg nalmefene completely prevented the subjective and respiratory effects of fentanyl for the entire 8 h of the experiment. Nalmefene, 1 mg, significantly blunted the fentanyl effects for the same period, but VE60 values at 6 and 8 h were depressed significantly (P less than 0.05) to 66 and 61% of control. The antagonist effects of the lowest nalmefene dose, 0.5 mg, persisted for about 4 h, at which time VE60 was 64% of control. Fentanyl administration produced consistent increases in pain tolerance (44-55% above control) throughout the experiment. Nalmefene pretreatment abolished this analgesic response in a dose-related time course that mirrored the respiratory effects almost exactly.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prolonged antagonism of opioid action with intravenous nalmefene in man. 394 4

Pain perception and its alteration by analgesic drugs is difficult to measure in the horse. The latency to onset of flexion of a limb in response to a noxious thermal stimulus has been used as a nociceptive end point for analgesic studies in many species. While this method has been employed in the horse, it may be confounded by the spontaneous locomotor activity observed after administration of narcotic analgesics. Consequently, an alternative method of assaying narcotic analgesia that did not involve the equine locomotor apparatus was developed. This report describes the use of the heat-evoked skin-twitch reflex as a reproducible measure of pain threshold and its alteration by the narcotic analgesic fentanyl. This method is compared with the heat-evoked hoof-withdrawal reflex, and the apparatus necessary to elicit both reflexes in the horse is described. Fentanyl, administered at intravenous doses of 0.010, 0.005, and 0.0025 mg/kg, produced a dose-related prolongation of the skin-twitch reflex but failed to alter the latency to hoof withdrawal following noxious thermal stimulation. The skin-twitch reflex is therefore a more sensitive assay of narcotic analgesia in the horse than is the hoof-withdrawal reflex.
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PMID:A method for studying cutaneous pain perception and analgesia in horses. 399 60

The dose-related effects of intravenously administered fentanyl (0.010, 0.005, 0.0025 mg/kg) and saline were studied in mature performance horses using a rigorous experimental protocol. Fentanyl produced a dose-related prolongation of the skin twitch reflex latency but did not increase the hoof withdrawal reflex latency. Dose related increases in stepping frequency, cardiac and respiratory rats were observed following fentanyl, while changes in rectal temperature and pupil area were not. These data indicate that fentanyl, a prototypic mu-agonist, produces a syndrome characterized by analgesia, locomotor and sympathetic stimulation in the horse.
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PMID:Dose-related effects of fentanyl on autonomic and behavioral responses in performance horses. 401 40

The authors present a study of 20 cases of epidural obstetrical analgesia. A Bupivacaine-Fentanyl mixture was given by continuous flow to bring about this analgesia. After an initial injection of 10 ml (9 ml of 0.25% Bupivacaine and 0.05 mg Fentanyl), a mixture of 45 ml of 0.25% Bupivacaine and 0.25 mg Fentanyl was perfused into the epidural space using an electronic pump syringe, delivering at a rate of 5 ml/hr. The mean time of analgesia until the delivery is 4 h 40 mn and the women in labour received a mean of 31.14 ml of 0.25% Bupivacaine (77.85 mg) and 0.173 mg Fentanyl. It took only 5 1/2 minutes to set up this form of analgesia. Not a single patient had any pain the first stage of labour nor in the second stage, and 95% of them were able to push efficiently. There are no detectable changes in the haemodynamic parameters in either the mothers or the fetuses and no depression of maternal respiration was found. In each case the Apgar score was 10 after 5 minutes. In summary, the use of an electronic pump syringe to deliver a Bupivacaine-Fentanyl mixture in obstetrical labour is a great improvement in analgesia without any secondary effects in the mother and child.
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PMID:[Peridural obstetrical analgesia using an electronic syringe]. 402 54

Fentanyl, a synthetic analgesic narcotic, was used in 2,000 cases of pediatric facial trauma between 1981 and 1984. A dose of 2 to 3 micrograms per kilogram of body weight was administered slowly intravenously to provide sedation and analgesia to facilitate the repair. The drug has advantages ideal for outpatient use, namely rapid onset, brief duration, and short recovery time. The major possible complication is that of apnea, which requires that resuscitation equipment be available. Three apneic episodes occurred in this series and all were successfully reversed with naloxone with no untoward effects.
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PMID:Use of i.v. fentanyl in the outpatient treatment of pediatric facial trauma. 405 97


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