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 analgesic effect of subarachnoid administration of tetracaine combined with low dose morphine or nalbuphine for spinal anesthesia was evaluated in 60 ASA physical status class I or II patients. Dextrose solution (10%) was added to 0.4 mg morphine or 0.4 mg nalbuphine to make a total volume of 2 ml, which was injected intrathecally with tetracaine in a double-blind, randomized fashion. Vital signs, sensory level, motor block, pain score, and side effects were recorded every 2 min for the first 15 min and then at 15, 30, 45, and 60 min and at 30-min intervals until the patient complained of pain. Side effects and opioid requirements were recorded for the first 24 h. Complete analgesia (time from injection to first report of pain) lasted 180 +/- 51.6 min in the control group and increased to 238 +/- 71 min in group with addition of 0.4 mg nalbuphine, 250 +/- 74 min in group with addition of 0.4 mg morphine (p less than 0.05). The effective analgesia (time from injection to first opioid requirement) also increased in groups of nalbuphine and morphine than the control group. No differences in complete or effective analgesia was found between groups in the presence of nalbuphine or morphine. Results indicate that the addition of 0.4 mg nalbuphine or morphine to hyperbaric tetracaine for spinal anesthesia improves the quality of intraoperative analgesia and can last into the postoperative period. Side effects were less in nalbuphine group than with morphine group.
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PMID:[The analgesic effect of subarachnoid administration of tetracaine combined with low dose morphine or nalbuphine for spinal anesthesia]. 152 93

Epidural analgesia and anaesthesia are more and more commonly used in modern obstetrical anaesthesia practice leading to the frequent use of fluid infusion and vasopressors. Fetal and neonatal effects of these treatments are reviewed here and may be summarized as follows: 1) Prolonged and/or severe maternal arterial hypotension may induce fetal hypoxia and acidosis, especially when fetal status is already compromised (uteroplacental insufficiency). 2) Preventive fluid hydratation with crystalloids associated with left uterine displacement are always useful to avoid maternal hypotension. 3) Dextrose-containing solutions are undesirable for the prevention of treatment of maternal hypotension as they may induce delayed neonatal hypoglycemia. 4) When the parturient is correctly hydrated, the rapid use of intravenous ephedrine is efficient in restoring normal maternal arterial pressure and has no deleterious effect on the fetus and the newborn. Finally, rapid, repetitive and non-invasive monitoring of maternal arterial pressure is the prerequisite to a rapid management of maternal hypotension which is essential to avoid any deleterious effect to the fetus and the neonate.
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PMID:[Vascular filling and vasopressors: effects on the fetus and the newborn infant]. 849 Jul 49

Dextrose-free anesthetic medications are commonly used to provide subarachnoid anesthesia and analgesia. Hypobaricity has been proposed as a mechanism to explain postural effects on the extent of sensory block produced by these drugs. Densities of dextrose-free solutions of local anesthetics and opioids, and commonly used anesthetic/opioid mixtures were determined at 37.00 degrees C for comparison with the density of human cerebrospinal fluid (CSF). Measurements accurate to 0.00001 g/mL were performed using a mechanical oscillation resonance frequency density meter. All undiluted solutions tested are hypobaric relative to human lumbar CSF with the exception of lidocaine 1.5% and 2.0% with epinephrine 1:200,000. All mixtures of local anesthetics and opioids tested are hypobaric. We observed good agreement between measured densities and calculated weighted average densities of anesthetic mixtures. While the influence of baricity on the clinical effects of dextrose-free intrathecal anesthetics remains controversial, attempts to attribute postural effects to the baricity of these drugs requires establishment of accurate density values. These density data may facilitate elucidation of the mechanisms underlying the behavior of dextrose-free intrathecal anesthetics.
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PMID:Densities of dextrose-free intrathecal local anesthetics, opioids, and combinations measured at 37 degrees C. 898 7