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)

Bupivacaine (Marcaine) is being used increasingly in obstetrics for epidural analgesia, by virtue of the good sensory block obtained and the minimum of side-effects on the mother and newborn infant. At a concentration of less than 0.5 p. 100, analgesia is excellent with a minimal effect on motor fibres. Side-effects and toxicity are limited by the use of fractionated doses from the beginning of labour or of a single dose during or at the end of labour calculated in relation to the effect sought. Any action on the newborn infant would appear to be exceptional, if dose recommendations are respected, the high percentage of Marcaine bound to proteins limiting its transplacental passage.
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PMID:[The use of Marcaine in obstetrical analgesia]. 2 48

A new long-acting local anaesthetic, etidocaine (Duranest) has been compared to mepivacaine (Carbocaine) in retrobulbar anaesthesia in a double-blind trial including 45 patients. Solutions used were etidocaine 0.5% and 1% and mepivacaine 1%, all without adrenaline. The onset time was short and no difference was found between the solutions. The duration of analgesia and motor block was significantly longer with etidocaine 1% compared to mepivacaine 1%. In a following open study with etidocaine 1% and mepivacaine 1% about 80% of the the patients in the etidocaine group never experienced any post-operative pain compared to about 50% in the mepivacaine group. No signs of local or systemic toxicity were noted in the studies.
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PMID:Etidocaine in retrobulbar anaesthesia. A comparison with mepivacaine. 79 Aug 88

Nine uterine artery segments were obtained during Caesarean hysterotomy. The amount of isometric tension developed by each segment when exposed to 3, 6, 10, 20, 50, 100, 1000 and 2000 microng/ml of lignocaine hydrochloride (Xylocaine) was measured. All nine segments contracted in response to the 1000- and 2000-microng/ml concentrations. Eight of nine, six of nine, and three of nine responded to the 100-, 50- and 20-microng/ml concentrations, respectively; one segment contracted in response to all concentrations. A dose-response curve indicated that maximum responses were obtained at the 1000-microng/ml concentration (0.1%). Although local anaesthetics are usually considered vasodilators, this study indicates that lignocaine causes the uterine artery to constrict in concentrations in excess of 20 microng/ml. Such concentrations might occur after paracervical block or accidental intravascular injection, but would not be expected in association with extradural analgesia.
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PMID:Response of arterial segments from gravid human uterus to multiple concentrations of lignocaine. 86 Nov 6

The influence of epidural block with bupivacaine (Marcaine-adrenalin) on fetal heart rate, uterine activity, and the frequency and intensity of contractions was studied in twenty-five nulliparae at term. Uterine activity was found to decrease during the first 30 minutes following epidural block. In the time interval 30 to 40 minutes after epidural block uterine activity increased again and attained the same level as during the last 10 minutes before analgesia. The frequency of uterine contractions did not decrease after the block. The lower levels of uterine contractility were due only to a lower amplitude of the contractions. The regularizing effect of epidural analgesia on incoordinate uterine action was noted. The recording of fetal heart rate in the time interval studied revealed no pathological findings. Mode of delivery, mean labour duration and Apgar scores after epidural block were comparable with earlier studies of a larger patient population. This study suggest that epidural analgesia does not induce any important changes in fetal heart rate but temporarily decreases uterine activity.
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PMID:Epidural analgesia in labour. IV. Influence on uterine activity and fetal heart rate. 97 61

A report is given on 170 orthopedic operations performed under hemi-spinal anaesthesia. The anaesthetic agent used was hyperbaric bupivacaine 1% (Marcaine, Carbostesine). Of these cases 92 were total hip joint replacements and 78 other operations of the lower extremities. Generally, the patients were classified as category three risks (A.S.A.) Their average age was 63 years. The anaesthetics and postoperative courses were smooth. In the total prosthetic hip joint operations hypotension during the implantation of acelabulum--or femur--cement was not observed. With doses of 1 ml of the local anaesthetic the average duration of analgesia was 3 hours and 10 minutes, and with added vasoconstrictor 4 hours.
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PMID:[Hyperbaric Bupivacaine 1% (Marcaine, Carbostesine heavy) for hemi-spinal anaesthesia in orthopedic (author's transl)]. 119 Apr 22

The clinical effects of three lidocaine-containing solutions with and without frigen (freon-113) as a propellant, after different waiting periods, and with different dosages applied were investigated in 130 outpatients who were undergoing dental treatment in the maxilla under local anesthesia. They were divided randomly into five groups (A through E): (A) Xylocaine spray with frigen, two applications (20 mg lidocaine); (B) Xylestesin spray with frigen, two applications (14 mg lidocaine); (C) Xylestesin spray with frigen, three applications (21 mg lidocaine); (D) Xylestesin pump spray without frigen, two applications (14 mg lidocaine); and (E) no topical anesthesia. They were further divided into 12 subgroups to evaluate waiting periods between the application of the topical anesthesia and the injection (1, 2, or 3 minutes). Patients assessed the pain of the injection, intensity of numbness, and intensity of the taste on a visual analog scale; they also assessed the pain of the injection compared to former injections. Pain during injection was reduced by topical application of lidocaine. A waiting period of 2 minutes proved to be sufficient and can be justified to avoid impatience and increased numbness in patients. However, a 3-minute waiting period may be appropriate for sensitive patients. An increase in the dosage failed to show better analgesia. The pump spray without frigen proved to be effective.
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PMID:Clinical investigation of potency and onset of different lidocaine sprays for topical anesthesia in dentistry. 139 79

Children with cancer experience a great deal of anxiety concerning their treatment and invasive tests such as bone marrow aspirations (BMAs) and lumbar punctures (LPs). Responses of pain, fear, and anxiety are well documented and may cause regression, developmental delay, sleeping and eating problems, nausea and vomiting, nightmares, and depression. Diagnostic and treatment procedures need not cause such adverse effects if sufficient pharmacological sedation, analgesia, and anesthesia are used. However, studies show that inappropriate interventions such as underdosing and limited use of medications occur because of certain myths, beliefs, and lack of pharmacological knowledge on the part of health professionals. Studies that specifically address premedication for painful procedures in children with cancer have shown that only a small percentage of children receive premedications and that there is no clear consensus or standard for either drugs or dosages. The issue of premedicating children before procedures remains controversial and deserves further investigation. This study explored the attitudes and perceptions of oncology physicians and nurses concerning medicating children before procedures. Findings showed that most pediatric oncology specialists medicate their patients before invasive procedures and that the most common premedications used are Versed; Demerol, Phenergan, Thorazine; chloral hydrate; Ativan; fentanyl; Demerol; and Xylocaine. Most pediatric oncology specialists believe that premedication is necessary for children for BMAs and LPs.
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PMID:Premedicating children for painful invasive procedures. 149 58

The following results were obtained in an experimental study in the dogs in general pentobarbital anaesthesia: Lidocaine type antiarrhythmics (lidocaine, Xylocaine ASTRA, Ethmozin USSR) administered shortly before artery ligation have a pro-fibrillation effect. This effect is indirectly proportional to the ischaemic focus development. A 3rd-generation beta blocker with intrinsic sympathetic activity (celiprolol, Selectol Chemie-Linz) had the same electrostabilizing effect on the ventricles in the acute phase of ischaemia as a 1st-generation beta blocker (metipranolol, Trimepranol SPOFA). The 3rd-generation blocker, however, stopped short of provoking a drop in the heart rate invariably associated with the 1st-generation beta blocker. The analgesic fentanyl (G. Richter) in combination with benzodiazepine (m,idazolam, Dormicum Hoffmann-La Roche) inducs analgosedation. In this way the dose of the analgetic can be reduced and yet the analgesia and electrostability of the heart remain the same. Due to the lower dose of the analgesic there is a lesser decrease in the heart rate and blood pressure. Analgosedation can be discontinued by administering an antagonist-agonist of benzodiazepines (flumazenil, Anexate Hoffmann-La Roche) or an antagonist of potent analgesics (butorphanol, Beforal SPOFA) without the risk of eliminating, at the same time, the electrostabilizing effect of analgosedation on the ischaemically damaged ventricles of the heart. For the prevention of sudden coronary death due to ventricular fibrillation in the acute phase of local myocardial ischaemia we can, on the basis of our experimental results, recommend analgosedation and the use of beta blockers with intristic sympathetic action. The use of lidocaine antiarrhythmics may lead to a reduction in the electric stability of the heart ventricles the ischaemic focus is developing under a certain "critical" blood level of the antiarrhythmics.
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PMID:Prevention of sudden coronary death. 167 65

The aim of the present study was to investigate whether obstetric analgesia with an epidural blockade (Marcaine, bupivacaine hydrochloride, 141.5 +/- 56.8 mg) and pethidine (95.0 +/- 30.7 mg) influenced neonatal myocardial function following vaginal delivery. Left ventricular output and other left ventricular function indices were measured 5.6 +/- 4.3 h postpartum with Doppler and M-mode echocardiography in a group of healthy, full-term, appropriate-for-gestational-age infants (n = 10) whose mothers had received both bupivacaine and pethidine during delivery, and in a similar group of newborn infants (n = 10) whose mothers had received only nitrous oxide/oxygen analgesia. In 7 of the 10 infants in each groups, a second assessment of myocardial function was performed 21.7 +/- 4.6 h post partum. There were no significant differences in any of the variables used to assess left ventricular function at either of the measurement points between the group of infants whose mothers had received bupivacaine/pethidine during delivery, and the group of infants whose mothers had received nitrous oxide/oxygen analgesia only.
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PMID:The influence of epidural blockade and pethidine administered during delivery on neonatal myocardial performance. 174 56

The incidence, character and treatment of backache associated with epidural anesthesia (EA) using 3% chloroprocaine (2-CP, Nesacaine-MPF) were observed in ten volunteers undergoing a study of the effects of EA upon plasma catecholamines. Three levels of epidural analgesia were sequentially sought, T10, T4 and C8, in ascending order. Each block was allowed to fully dissipate prior to the next injection. For the first, second and third injections, 15-20 ml, 25-35 ml and 52-60 ml, respectively, of 3% 2-CP were injected via an epidural catheter. Mean total volume of 2-CP injected was 103 ml (range, 92-115 ml) over seven hours. Back pain was first reported after as little as 15 ml (mean +/- SEM, 24.0 +/- 3.9 ml; range, 15-45 ml). The pain was described as a dull ache deep in the lumbar back, ranging in severity from mild to severe. No profound spasm of the erector spinae muscles was observed. Mean verbal analog scale pain scores after regression of the first, second and third blocks were 2.2, 4.3 and 6.5, respectively. Epidural fentanyl (100-200 micrograms) was effective in providing rapid relief of the pain. Large doses or possibly repeated injections of epidural Nesacaine-MPF are associated with an increased incidence and severity of postanesthesia lumbar back pain.
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PMID:Back pain after epidural anesthesia with chloroprocaine in volunteers: preliminary report. 183 45


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