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)

A 28-year-old woman, G3P3, who was otherwise healthy and had taken no medication and had no known allergy, was admitted to our hospital for delivery after a normal pregnancy. An epidural catheter was inserted for analgesia and labour was induced with oxytocin. Two hours later, she suffered a sudden cardiac arrest. She was immediately treated and, since a normal cardiac rhythm and a blood pressure of 90 mmHg has been obtained 30 minutes later, a 3750 g child was delivered by caesarean section. Soon after delivery, a life-threatening uterine haemorrhage appeared, due to DIC. Evolution was favourable, after bilateral uterine arteries embolization had been performed. The diagnosis of amniotic fluid embolism was established by the clinical course, the absence of local cause and the presence of a large number of amniotic cells in the mother's peripheral blood. Tryptase blood concentration was normal in the mother's blood.
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PMID:[Amniotic fluid embolism: successful evolution course after uterine arteries embolization]. 1207 39

Serine proteases such as thrombin, trypsin and mast cell tryptase can act on different cell types through protease-activated receptors (PARs). These receptors have been shown to be implicated in several phenomena such as inflammation, platelet activation, immune response and atherosclerosis. Several studies recently reported PARs expression on neurons and some of them demonstrated that these receptors could interfere with nociception. The contribution of PAR(1) to inflammatory pain and the mechanism involved in this phenomenon were investigated. Intraplantar injection of PAR(1) agonist increased withdrawal latency and reduced response frequency to von Frey filaments, thus inhibiting nociceptive response to both mechanical and thermal stimuli in mice. PAR(1) agonist also reduced carrageenan-induced inflammatory hyperalgesia. The anti-nociceptive effects of PAR(1) agonist were mediated by endogenous opioids, as this effect was inhibited by local injection of naloxone methiodide, and because intraplantar injection of PAR(1) agonist increased mRNA expression of the endogenous opioid precursor proenkephalin. However, PAR(1) agonist was not able to inhibit calcium signals in isolated sensory neurons exposed to pro-nociceptive agents. Finally, despite similar inflammatory parameters, PAR(1)-deficient mice showed a strong potentiation of inflammatory hyperalgesia induced by the intraplantar injection of either formalin or carrageenan, or in the chronic model of collagen-induced arthritis, compared to wild-type mice. This study highlights a previously unknown endogenous mechanism of analgesia, showing a central role for the thrombin receptor PAR(1) in the regulation of inflammatory pain and as an activator of opioid pathways.
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PMID:Thrombin receptor: An endogenous inhibitor of inflammatory pain, activating opioid pathways. 1967 41

We report a 39-year-old woman who showed intraoperative anaphylactic shock during elective cesarean section in the 38th week of pregnancy. She underwent cesarean sections under general anesthesia at 33 years of age, and under spinal anesthesia at 37 years without any complication; other past history was unremarkable. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine 2.5 ml and analgesia level up to T2 was obtained 12 minutes later. The operation was uneventful at the birth of a neonate weighing 2700 g delivered with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Drip infusion of oxytocin was started after the delivery and uterine contraction was good. Five minutes later, blood pressure decreased abruptly to 70/40 mmHg, heart rate increased to 130 beats min(-1) and the patient complained of chest discomfort. Bolus injections of ephedrine and phenylephrine were ineffective, and continuous infusion of adrenaline was started to maintain blood pressure. The operation was finished and the patient was intubated for artificial ventilation to prevent airway obstruction. The tracheal tube was removed the following day and the postoperative course was uneventful thereafter. Plasma tryptase levels at 1 and 6 hours after the episode of hypotension were 9.0 and 1.3 ng x ml(-1). Postoperative blood tests revealed an increase in latex-specific immunoglobulin E, suggesting that anaphylactic shock was induced by latex.
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PMID:[A case of anaphylactic shock induced by latex during cesarean section]. 2096 Sep 7