Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Propofol (2,6, di-isopropylphenol) was given by continuous intravenous infusion to provide sedation following coronary artery bypass surgery. The need for additional sedation, analgesia and hypotensive agents was assessed at two propofol infusion rates (10 or 25 micrograms/kg/min). Both rates provided clinically satisfactory conditions. There were no differences in the requirements for analgesia or vasodilators between the groups. The higher infusion rate of 25 micrograms/kg/min was associated with a lower requirement for additional sedation but a more frequent need to stop the infusion temporarily to prevent hypotension.
 ...
PMID:Propofol to provide sedation after coronary artery bypass surgery. A comparison of two fixed rate infusion regimens. 130 Aug 57

Patients about to undergo a suspension laryngoscopy were randomly assigned to one of two groups (n = 10). They were given either etomidate 1 mg kg-1 followed by 1 mg kg-1 h-1, or propofol 2.5 mg kg-1 followed by 9 mg kg-1 h-1. Alfentanil 10 micrograms kg-1 was given to provide analgesia with a further half dose if necessary. Duration of apnoea, quality of anaesthesia, times between stopping hypnotic administration and the moment when the patients opened their eyes, gave their name, date of birth and the day's date were noted. Heart rate, blood pressures, respiratory frequency and blood gases were noted before induction, before suspension and when hypnotic infusion was stopped. Clinical tolerance was good, the duration of surgery, apnoea and quality of anaesthesia were the same for both groups. Blood pressure was less depressed by etomidate, but ventilatory frequency was higher. Recovery was significantly faster after propofol. Propofol is recommended for patients who require good post-operative cooperation (chronic obstructive pulmonary disease) and etomidate for those who are haemodynamically compromised.
 ...
PMID:Etomidate vs. propofol to carry out suspension laryngoscopies. 176 51

Fifty patients of both sexes, aged between 37 and 60 years old and belonging to ASA classes I, II, III and IV, underwent urological surgery lasting more than two hours under general anesthesia using a continuous infusion of propofol, N2O/O2, vecuronium bromide 0.02% infusion. Patients were divided into two groups of 25, group A and group B, according to whether they received fentanyl or buprenorphine as an analgesic. Propofol and fentanyl consumption in group A were 5.43 +/- 0.7 mg/kg/hour and 10.53 +/- 1.7 micrograms/kg respectively, whereas those of propofol and buprenorphine in group B were 5.71 +/- 1.08 mg/kg/hour and 6.05 +/- 0.06 micrograms/kg; there was a statistically non-significant difference for propofol consumption (p greater than 0.005). During the induction and maintenance phases of anesthesia, hemodynamic parameters decreased significantly (p less than 0.001) in comparison to starting values in both groups, but no statistically significant differences were observed. Buprenorphine prolonged reawakening from anesthesia by a few minutes but at the same time extended postoperative analgesia by several hours, thus improving the overall quality of the immediate postoperative period. The most frequent side effect (32% in group A and 52% in group B) was sinusal bradycardia.
 ...
PMID:[The use of propofol in combination with fentanyl or buprenorphine in long-duration anesthesia]. 192 59

Pharmacologic advances in anesthesia over the last decade have focused on drug safety, shorter durations of action, reversibility, and ease of administration. This is reflective of major changes in the focus of patient care from inpatient to outpatient settings as well as from available risk management data that support the investigation of these new drugs. The pharmacologic advances discussed included those drugs in current practice as well as experimental drugs yet to be released for general clinical use. Inhaled agents, such as isoflurane and perhaps the experimental agent, desflurane, will maintain or achieve their popularity because of the relative ease of administration and wide margins of safety. Propofol, the most recent intravenous anesthetic available for clinical use, has already gained wide acceptance because of its dual function as an induction and maintenance agent and its appropriateness for use in the ambulatory surgical population. The role of midazolam in anesthesia practice has increased to such an extent that it has largely supplanted the use of diazepam (Valium). The introduction of the antagonist, flumazenil, will undoubtedly enhance the safety and efficacy of midazolam as well as broaden its applicability of use across various patient populations. Several of the newer synthetic narcotics, such as alfentanil and sufentanil, have replaced other narcotics formerly used in anesthesia practice, such as meperidine and morphine, primarily because of their short action and lack of significant side effects. The use of muscle relaxants as a critical component of anesthetic management has led to the development of a number of new drugs in this classification. Pharmacologic management of patients under anesthesia will at some future date likely include the administration of alpha 2 agonists. Administration of these drugs can reduce anesthetic requirements of traditional agents by as much as 50%. As research continues, new drugs will be incorporated into the practice of anesthesia, ones that will promote rapid uptake, low toxicity, intense analgesia, easy reversibility, shorter durations, and fewer side effects. One measure of success relative to pharmacologic development in anesthesia is the recent and dramatic decreases in patient morbidity and mortality figures over the last decade. This attests to the rapid growth and development of not only improved patient monitoring systems but also newly improved "agents of sleep."
 ...
PMID:New advances in anesthesia. 204 91

Propofol (Diprivan), a modern intravenous hypnotic, produces a reduction in both cardiac index (CI) and mean arterial pressure (MAP). Ketamine (Ketanest), a potent analgesic, in contrast, causes an increase in MAP and CI. The aim of the present study was to investigate whether the combination of propofol and ketamine can give better hemodynamic stability during the induction and maintenance of general anesthesia than propofol used with fentanyl, whose cardiodepressant actions may cumulate. METHODS. For induction of general anesthesia 10 patients (ASA I and II) each received 3-5 boluses of propofol (0.5 mg.kg-1 during 35 s until predetermined level of anesthesia was reached (stage D2/E0 according to [20]) followed by a continuous propofol infusion (0.120 mg.kg-1.min). Fentanyl 0.1 mg was administered to each patient in group A for induction of anesthesia and again if evident pain was present. In group B ketamine was given following a pharmacokinetic model based on computer-simulated calculation. After an initial bolus of 38 mg injected within 2 min further doses of 42 mg, 35 mg, 32 mg and 28 mg ketamine were administered over 30 min at a time. Signs of evident pain were treated by means of supplementary doses of 0.5 mg.kg-1. RESULTS. In both groups a moderate drop of MAP was observed after the induction of general anesthesia. Two patients in each group showed a distinct decrease in MAP (-32%). The heart rate dropped slightly (-9%) in group A, but did not change in group B. Following intubation the MAP rose by less in group A (+8%) than in group B (+21%). After the beginning of the operation the group treated with propofol/fentanyl showed major hemodynamic changes; in particular, bradycardia with less than 40 bpm was observed in more patients than in the propofol/ketamine group. Postoperatively, fewer patients in group B required rescue doses of analgesics (1 of 10) than these in group A (7 of 10), though vigilance was better in group B. DISCUSSION. The dose of ketamine administered during the induction of general anesthesia may have been not high enough to neutralize the cardiodepressant effect of propofol. But during the maintenance of anesthesia there was in fact better hemodynamic stability in group B than in group A as a result of the neutralization of opposing actions. Fentanyl even intensified the fall in MAP after propofol. Patients in group B showed better vigilance as well as better pain relief postoperatively. The population of the fentanyl group was obviously more deeply sedated and analgesia was still inadequate. In our study general intravenous anesthesia with propofol and ketamine offered the advantages of better analgesia, a higher state of vigilance and the absence of respiratory depression during the postoperative phase compared with the combination of propofol and fentanyl.
 ...
PMID:[The effect of propofol-ketamine anesthesia on hemodynamics and analgesia in comparison with propofol-fentanyl]. 207 45

Anesthesia of the tracheobronchial (TB) pathways during laser therapy (LT) faces a variety of problems including analgesia and sedation in patients with respiratory difficulties or who continue to breathe spontaneously while the airways are occupied by operating instruments. During the course of the study, two methods of anesthesia were compared in 36 patients undergoing LT of the TB pathways. The first method (Group A, n = 16) involved the use of Diazepam as an hypnotic starter and Fentanyl as an opioid analgesic in continuous infusion. Propofol was used both as an inducer and as the main drug in the second method (Group B, n = 20) in order to reduce the opioid dose required. The following variables were studied: heart rate, systolic and diastolic blood pressure, blood gas analytic parameters, side-effects such as cough and intraoperative movement, and disturbances of heart rhythm and conduction; in addition, the duration of operations and the time taken to regain consciousness were recorded, together with the total dose of Fentanyl used. An improved hematosis was observed in patients treated with Propofol during the operation and on regaining consciousness, and the time taken to regain consciousness was significantly reduced. No significant differences were observed between the two groups with regard to cardiocirculatory variables or undesirable effects.
 ...
PMID:[Use of propofol during laser therapy of the tracheobronchial tract]. 208 86

Thirty-seven patients with a wide range of illnesses were studied during mechanical ventilation of the lungs in an intensive care unit. Fifteen were sedated with a continuous propofol infusion, with analgesia provided by bolus doses of papaveretum. Twelve received a continuous infusion of papaveretum, supplemented by bolus doses of midazolam. The level of sedation was assessed every four hours and measurements were made of haemodynamic and respiratory variables. Levels of sedation were generally satisfactory in both groups. Six patients who received propofol required the use of muscle relaxants, because of their strong respiratory drives, to achieve synchronisation with the ventilator. There was no significant difference in respiratory or haemodynamic variables between the groups, but several patients required inotropic support because of their disease. There was no evidence of inhibition of adrenal steroidogenesis in the propofol group. Propofol can be a useful sedative agent in the intensive care unit, but sedative regimens should be tailored to individual patient requirements.
 ...
PMID:Propofol for long-term sedation in the intensive care unit. A comparison with papaveretum and midazolam. 219 70

Propofol was assessed for eye surgery in 20 children. ASA group I or II, 2-14 year-old, randomly assigned to 2 equal groups. Premedication, analgesia and muscle paralysis were similar in both groups. Group P patients were given an induction dose of 4 mg.kg-1 propofol, followed by an infusion of 15 mg.kg-1.h-1 for the first half hour, and then 10 mg.kg-1.h-1 to maintain anaesthesia. Group C patients were given 10 mg.kg-1 thiopentone for induction and halothane for maintenance. The quality of anaesthesia was assessed by monitoring adverse effects, heart rate, blood pressure, the length of anaesthesia, the delay of the first spontaneous breath and eye opening, and extubation. Intraocular pressure was measured before and 3 min after intubation, and 5 min after extubation. The quality of anaesthetic induction and maintenance were very similar in both groups. Pain occurred more frequently at the injection site with propofol (p less than 0.01). Children in group P recovered more quickly, and extubation was possible much earlier in this group (p less than 0.05). However, restlessness was significantly more frequent in group P (n = 9) than in group C (n = 1) (p less than 0.01). Systolic, diastolic blood pressure and heart rate were significantly lower in group P (p less than 0.05; 0.001; 0.001 respectively). No significant decrease in intraocular pressure in both groups was observed. The use of propofol for eye surgery in children is acceptable, despite some restlessness during recovery.
 ...
PMID:[Effects of propofol on intraocular pressure in surgery of strabismus in children]. 233 Oct 82

101 critically ill patients admitted to five intensive-care units were allocated randomly to receive a continuous intravenous infusion of either propofol or midazolam for sedation for up to 24 h. In addition, morphine was given to provide analgesia. The mean duration of infusion was 20.2 h (range 3.0-24.5) in the propofol group and 21.3 h (4.0-47.0) in the midazolam group and infusion rates were 1.77 mg/kg/h (range 0.40-5.00) and 0.10 mg/kg/h (0.01-0.26), respectively. The infusion rates were adjusted as necessary, and the desired level of sedation was achieved easily in most patients in both groups. There were slight falls in arterial pressure, but there were no significant differences between the groups. Heart rate was lower in patients who received propofol. Some small changes occurred in biochemical and haematological variables in both groups, but they were not clinically significant. There was no indication that either drug substantially impaired adrenal steroidogenesis. When the infusion was discontinued, there was less variability in recovery of consciousness in patients who had received propofol. In a subgroup of patients, weaning from mechanical ventilation was achieved significantly faster after discontinuation of propofol than of midazolam. Propofol proved to be a satisfactory agent for sedation of these critically ill patients and compared favourably with midazolam.
 ...
PMID:Comparison of propofol and midazolam for sedation in critically ill patients. 257 Sep 58

Thirty-two patients (14 women and 18 men) whose age ranged between 15 and 76 were admitted on an emergency and anesthetized with propofol in view of various surgical interventions (9 appendectomies, 9 fractures, 5 wound healing, 6 abscess incisions, 2 corneal grafts and one complex trauma surgery) undergone 24 hours after their admission. Premedication included hydroxyzine 1.5 mg.kg-1, atropine sulfate 0.5 to 0.75 mg and pethidine 1 mg.kg-1 according to pain intensity and initial pathology. Narcosis was induced by 2.5 mg.kg-1 propofol injected intravenously. Propofol was then administered continuously at a dose of 9 mg.kg-1 in the first hour and of 4.5 mg.kg-1.h-1 in the following hours for 28 of the patients. Four patients undergoing short operations were given additional injections of one third of the initial dose. Analgesia and myorelaxation were obtained with fentanyl (0.16 +/- 0.06 mg) and vecuronium (9.3 +/- 4 mg). Narcosis proved to be very efficient. The side effects observed (13% myoclonia, 6% rash, 6% bradycardia, 0.3% pains at the time of injection) were similar to those quoted in the literature. Blood pressure stabilized after a short slight depression (13% to 18% of the standard values). Pulse remained regular. We can thus say that propofol is a good hypnotic drug for emergency anesthesia provided that its contra-indications especially shocks of cardiac or septic origin and hypovolemia, are carefully respected.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Propofol in emergency anesthesia]. 278 40


1 2 3 4 5 6 7 8 9 Next >>