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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study combined the use of preinjection laminaria, intravenous oxytocin, and 15 mg of intra-amniotic prostaglandin (PG) F2alpha in order to demonstrate a potentially improved procedure for 2nd trimester abortion. 20 patients, aged 18-27, were between the 16-20 weeks gestation, and were free of intercurrent medical or obstetrical problems. 7 of the 20 were nulliparae. A laminaria was inserted into the cervix the evening before the injection of PG. In the morning an intravenous infusion was begun using 50 units of oxytocin in 500 ml of 5% dextrose and 0.9% sodium choloride at a rate of 150 ml/hour. The amniocentesis was performed and when a free flow of clear amniotic fluid was obtained 15 mg. of PGF2alpha was injected into the amniotic cavity. Different concentrations of oxytocin were administered if contractions were increasingly painful or not. Results of the experiment were that: 1) all patients aborted within 24 hours of the prostaglandin injection, 2) the median injection-to-abortion interval was 7 hours and 25 minutes; primigravidae aborted with a median time of 15 hours 20 minutes; and multiparous patients aborted in 6 hours 20 minutes; 3) only 9 patients requested analgesia medication; 4) the average blood loss was 150-200 nl; 1 patient had a postabortion hemorrhage greater than 500 ml; 5) 3 patients underwent sharp curettage for suspected retained secundines; 6) vomiting occurred in 6 patients, 3 of whom had emesis once; and 7) no diarrhea was encountered during the study. This study demonstrates that this procedure fulfills 3 strict criteria for success, as follows: 1) single injection technic, 2) consistent abortion within 24 hours, and 3) minimal side effects.
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PMID:Midtrimester abortion using prostaglandin F2alpha, oxytocin, and laminaria. 471 13

Previous data in rats indicate that while dopamine receptor blockers like haloperidol (HAL) potentiate opiate analgesia, dopamine receptor stimulants like apomorphine reduce cold-water swim (CWS) and 2-deoxy-D-glucose (2-DG) analgesia. Yet recently, HAL and chlorpromazine (CBZ) have been shown to reduce heat and immobilization analgesia. To address these differences, the present study investigated whether HAL (10, 50, 100 microgram/kg) or CPZ (1, 3, 5 mg/kg) would potentiate or reduce the effects of morphine (MOR), CWS, 2-DG and chlordiazepoxide (CDP) upon analgesia and activity. While HAL increased jump thresholds in a dose-dependent manner, CPZ doses exerted erratic effects. MOR analgesia was potentiated by the two higher CPZ doses and by the highest HAL dose. 2-DG analgesia was potentiated by only the highest HAL dose while CDP analgesia was potentiated by the moderate CPZ dose. While all CPZ doses potentiated CWS-induced increases in jump thresholds, the lowest HAL dose reduced this effect. These effects are considered in terms of the analgesic manipulation and its magnitude of effect, the neuroleptic and its dose, the pain test, and possible concurrent effects upon activity.
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PMID:Neuroleptic and analgesic interactions upon pain and activity measures. 612 17

Modifications of early endoscopes have overcome problems of uterine bleeding and maintenance of distention and have provided high-intensity light sources and lenses of great resolution and clarity to permit wider use in clinical diagnosis. The hysteroscope is a modified cystoscope with similar components. The 3 media most commonly used for uterine distention in panoramic hysteroscopy are dextran 32% weight volume in dextrose 10%, which offers excellent vision and minimal spillage but may harden around the instrument; CO2 gas, which permits excellent visualization because it does not interfere with the view or mix with the blood; and dextrose 5% in water which mixes less readily with blood than normal saline. In general, no one of the methods is better than the others as long as the operator is experienced and knows the properties and possible side effects of each. Some type of analgesia or anesthesia is required for the procedure. The present indications for hysteroscopy include abnormal uterine bleeding, diagnosis and possible removal of submucus leiomyomas or endometrial polyps, location and removal of lost IUDs, evaluation of infertile patients with abnormal hysterograms, diagnosis and treatment of uterine adhesions, and division of small uterine septa. Hysteroscopy is contraindicated by pregnancy, infection, profuse uterine bleeding, and cervical malignancy. With proper technique and patient selection few complications arise, but uterine perforation, infection, and bleeding are possible. Other complications related to the medium or to intrauterine operation may occur.
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PMID:Hysteroscopy for gynecologic diagnosis. 618 55

Neonatal administration of monosodium glutamate (MSG) produces neurotoxic degeneration of the retina and medial-basal hypothalamus, including the arcuate nucleus. Since this hypothalamic area contains the only neuronal cell bodies in brain which contain adrenocorticotrophic hormone (ACTH) and beta-lipotropin (beta-LPH) and beta-endorphin, destruction of these cells by MSG may interfere with pain responses mediated by nerve fibers arising from these perikarya. The present study examined whether MSG-treated rats, as compared to littermate controls, exhibited concomitant changes in the immunocytochemical distribution of ACTH and beta-LPH, and their reactivity to several analgesia-inducing manipulations. Although MSG-treated rats did not differ from control rats in their baseline reactivity to electric shock, they displayed an inability to exhibit analgesia following acute exposure to cold-water swim stress. In addition, MSG-treated rats showed an attenuated analgesic response following morphine administration. However, the analgesia elicited by either abrupt food deprivation, or the glucoprivic stress of 2-deoxy-D-glucose, was unaffected by neonatal MSG treatment. Concomitant with these selective analgesic deficits, MSG-treated rats displayed a marked immunocytochemical reduction in ACTH/beta-LPH perikarya and terminals in brain, but not pituitary. These data indicate that multiple pain-inhibitory systems exist, and that some rely upon an intact medial-basal hypothalamus to produce analgesia.
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PMID:Neonatal monosodium glutamate. Effects upon analgesic responsivity and immunocytochemical ACTH/beta-lipotropin. 624 67

Recent studies have shown that while the analgesic responses induced by certain stressors appear to be related to morphine analgesia, the analgesic responses to other stressors do not. Para-chlorophenylalanine (PCPA), a potent tryptophan-hydroxylase inhibitor has been shown to decrease both basal pain thresholds and morphine analgesia on the flinch-jump test. To assess further the relationship between morphine and stress-induced analgesia, PCPA's effect upon the analgesic responses to cold-water swims, 2-deoxy-D-glucose, inescapable foot shock and morphine were determined using the flinch-jump and tail-flick tests. PCPA, which produced an 85% depletion of brain serotonin, significantly decreased jump thresholds while significantly increasing tail-flick latencies. Similarly, while morphine analgesia was decreased by PCPA on the flinch-jump test, it was not affected on the tail-flick test. The analgesic jump thresholds induced by cold-water swims and 2-deoxy-D-glucose as well as the increase tail-flick latencies induced by foot shock were unaffected by PCPA. These results are discussed in terms of PCPA's differential effects upon basal nociception and morphine analgesia and in terms of further dissociation between morphine and stress-induced analgesia.
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PMID:Stress and morphine analgesia: alterations following p-chlorophenylalanine. 645 44

The comparative efficacy of two solutions of bupivacaine, 0.5% plain (isobaric-specific gravity 1.010), and 0.4% bupivacaine (hyperbaric-specific gravity 1.027) in 4% dextrose, for spinal anaesthesia was studied in 67 patients. Both solutions were clinically satisfactory (94% completely successful neural blockade). Hyperbaric bupivacaine blocks a greater number of spinal segments (p less than 0.01), causes a more rapid fall in blood pressure (p less than 0.05), and is more predictable in effect with regard to the number of segments blocked and to the lateralisation of the block. The duration of perioperative analgesia with the hyperbaric preparation is, however, shorter-3.8 hours as opposed to 5.8 hours (p less than 0.01)--but this was likely to be due to the smaller total dosage of bupivacaine used in the hyperbaric group. It is concluded that either solution may be used satisfactorily in clinical practice. The isobaric solution, however, despite its ready availability, is less satisfactory than the hyperbaric because its effect with regard to the extent of blockade is less predictable.
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PMID:A comparison of hyper- and isobaric solutions of bupivacaine for subarachnoid block. 647 42

Intrathecal ketamine, which has not previously been described in man, has been administered to 16 patients with war injuries of the lower limbs. The first five received varying doses from 5 to 50 mg in a volume of 3 ml of 5% dextrose, to determine a dose-response curve (Group 1). The optimal dose was then administered to a further 11 patients who received ketamine 50 mg in a volume of 3 ml in 5% dextrose with the addition of adrenaline 0.1 mg (Group 2). A distinct sensory level was obtained in all patients. In Group 2, nine of the eleven patients obtained satisfactory surgical analgesia and two required supplementation with local anaesthetic. Central effects (drowsiness, dizziness, and nystagmus) also occurred in nine patients, but they remained conscious throughout; one patient experienced no central effects, and one patient developed dissociative anaesthesia. Central effects were more intense the higher level of block. There were no significant changes in mean systolic arterial blood pressure, pulse, or respiratory rates. Surgical analgesia for the blocked dermatomes lasted for a mean of 58 minutes (range 45-90), and recovery was complete and uncomplicated; mild generalised analgesia persisted for a further one to three hours following return of sensation. Ketamine alone did not produce motor block, but addition of adrenaline resulted in complete motor block, and may have intensified sensory blockade. Motor loss persisted for the same duration as surgical analgesia. Adrenaline neither delayed the onset of central effects, nor reduced their intensity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intrathecal ketamine for war surgery. A preliminary study under field conditions. 649 99

Thirty healthy women in active labour received an intrathecal injection of morphine 0.5 mg (n = 12) or 1 mg (n = 18) in 7.5% dextrose. Both doses provided excellent analgesia for labour, 93% of patients obtaining at least 50% pain relief. Analgesia began 15-60 min after injection and did not decrease until 6-8 h after injection. Analgesia was satisfactory until distension of the perineum, either by forceps or the infant's head. The intrathecal injection of morphine did not adversely affect the condition of the infant. Eighty per cent of patients developed pruritus; 53%, nausea or vomiting, or both; 43%, urinary retention; and 43%, drowsiness. These side effects were decreased by naloxone, which did not affect the degree of analgesia. There was no significant depression of ventilation in any patient. These results suggest that morphine 0.5 mg or 1 mg, administered intrathecally, effectively decreases the pain of labour, and that i.v. administration of naloxone can alleviate the common side effects.
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PMID:Intrathecal administration of hyperbaric morphine for the relief of pain in labour. 654 39

Injection of 2-deoxy-D-glucose (2DG) elicits both analgesic and hyperphagic responses in rats. While pituitary dysfunction, decreased dopamine availability, or neonatal monosodium glutamate treatment decreases 2DG hyperphagia, they increase 2DG analgesia. In contrast, 2-DG analgesia alone is decreased by repeated 2-DG injections, while 2-DG hyperphagia alone is decreased following naloxone pretreatment. The present four experiments examined further mechanisms subserving these two induced responses. In the first experiment, rats were deprived of food for 6 h following 2-DG (600 mg/kg). While 2-DG hyperphagia persisted in the absence of glucoprivation, 2-DG analgesia failed to occur after this delay. In the second experiment, acute exposure to inescapable foot shock (4 mA, 0.5 s/5 s for 1 h) preceded administration of 2-DG (600 mg/kg). While 2-DG hyperphagia was eliminated by this procedure, 2-DG analgesia was significantly potentiated. In the third experiment, repeated morphine (10 mg/kg) injections over 14 days eliminated 2-DG analgesia on the fifteenth day, but failed to affect 2-DG hyperphagia. In the fourth experiment, lesions placed in either the lateral hypothalamus or zona incerta decreased 2-DG hyperphagia, but failed to affect 2-DG analgesia. These results are discussed in terms of common and dissociative mechanisms mediating both responses.
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PMID:Dissociation of analgesic and hyperphagic responses following 2-deoxy-D-glucose. 658 11

Capsaicin modulates animal pain perception, increasing chemosensitive and pressure thresholds following systemic administration, increasing thermal thresholds following intrathecal administration, and decreasing electric shock thresholds following intracerebroventicular (ICV) administration. Since morphine analgesia is decreased in a dose-dependent manner following ICV capsaicin, the present study examined whether ICV injections of capsaicin (0, 25, 50, 100 micrograms) would alter other analgesic responses as well. Experiment 1 demonstrated that the analgesic response to a 450 mg/kg dose of 2-deoxy-D-glucose was significantly reduced by the 25 and 50, but not the 100 micrograms capsaicin dose. Further, while analgesia induced by cold-water swims (CWS) in a 2 degrees C bath was significantly attenuated by the 25 micrograms capsaicin dose, the entire dose range eliminated analgesia induced by CWS in a 15 degrees C bath. Experiment 2 indicated that the capsaicin-induced alterations in CWS analgesia were not attributable to parallel changes in CWS hypothermia. Experiment 3 demonstrated that capsaicin failed to alter both the non-opioid analgesic response induced by 20 inescapable foot shocks (FS) and the opioid analgesic response induced by 80 FS. These data are discussed in terms of the similarities to and/or dissimilarities from capsaicin-induced effects upon morphine analgesia.
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PMID:Capsaicin treatment and stress-induced analgesia. 668 8


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