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)

We previously determined that a single dose of metoclopramide could significantly reduce the patient-controlled analgesia (PCA) morphine requirements of women undergoing prostaglandin-induced termination of pregnancy. In the present study, we evaluated whether repeated doses of metoclopramide would further reduce pain and accelerate expulsion of the fetus. After intraamnionic injection of prostaglandin, patients were randomly allocated to receive either 10 mg of intravenous metoclopramide (n = 17) or saline (n = 15), concurrent with the initiation of PCA. A second, identical dose was administered 4 h later. Data included visual analogue scale scores for pain 45 min after each administration of metoclopramide or saline and visual analogue scale and sedation scores every 2 h for the first 10 h, amount of morphine delivered by PCA pump, time of fetal and placental passage, and hospital discharge. Metoclopramide-treated patients experienced significantly earlier fetal and placental passage (P < 0.05). This was associated with a 66% reduction in PCA morphine received by the time of fetal delivery (P < 0.05). In addition, patients in the metoclopramide group were discharged from the hospital significantly sooner (P < 0.05). This difference included fewer second-day hospital stays (P < 0.05). Visual analogue scale scores measured 45 min after each infusion of the study agent were reduced from baseline in the metoclopramide group only (P < 0.05). No significant intergroup differences were noted with respect to pain or interval morphine usage. We conclude that repeated doses of metoclopramide significantly reduce the duration of induced labor and therefore the total PCA morphine requirements.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Metoclopramide-enhanced analgesia for prostaglandin-induced termination of pregnancy. 141 31

Metoclopramide has in previous studies been found to be synergic with acupuncture analgesia both in the laboratory and in the clinics. In the present study no synergism could be shown when patients with chronic pain were treated with acupuncture.
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PMID:No synergism between metoclopramide and acupuncture in chronic pain. 288 Apr 74

A double blind trial was conducted in 477 mothers in labour to compare the antiemetics metoclopramide 10 mg and promethazine 25 mg and placebo when added to the first dose of pethidine. Metoclopramide and promethazine were equally effective, and both better than placebo, in reducing the incidence of nausea and vomiting after the administration of pethidine. Seventy seven per cent of mothers were drowsy, and 8% slept in the hour after the pethidine injection, with no difference between the groups. The sedative effect was more persistent in the promethazine group, 66% of whom were still drowsy after delivery. One third of the mothers in each group needed further analgesia, with 77% of these ultimately requesting an epidural. The reduction in pain half an hour and one hour after pethidine, assessed by a visual analogue scale, were, respectively, 22% and 22% for placebo; 26% and 23% for metoclopramide; 13% and 9% for promethazine. Analgesia after metoclopramide was significantly better than that after promethazine in terms of pain score, duration of first injection, and need for Entonox. Metoclopramide is therefore to be preferred to promethazine as an antiemetic in labour.
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PMID:Comparison of the antiemetics metoclopramide and promethazine in labour. 392 Nov 42

Animal experiments revealed that the activity of the cholinergic system in certain brain areas enhanced acupuncture analgesia (AA) while that of the dopaminergic system attenuated it. Metoclopramide, having antidopamine and anticholinesterase actions, was found to be synergic with AA both in the laboratory and in the clinics. Patients having taken metoclopramide reported better analgesic effect during thyroidectomy under acupuncture anesthesia. The results suggest that metoclopramide can be used as an adjuvant to improve AA.
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PMID:Synergism between metoclopramide and electroacupuncture analgesia. 614 3

This placebo-controlled, randomized, double-blind trial was designed to evaluate the efficacy of three prophylactic antiemetic regimens on postoperative nausea and vomiting (PONV) during patient-controlled analgesia (PCA) with morphine. We studied 286 elective surgical patients for 36 h postoperatively. Group 1 was saline control. In Groups 2 and 3, metoclopramide or droperidol was administered as an intravenous (i.v.) bolus and then added to morphine in the PCA device. In Group 4, tropisetron, a long-acting investigational 5-hydroxytryptamine subtype 3 (5-HT3) antagonist was given as a single i.v. dose. We assessed the frequency and severity of PONV, as well as the need for rescue, frequency of side effects, and overall patient satisfaction. Severity of PONV was measured with a symptom-severity score (STS) which was based on both intensity and duration. The average total doses of antiemetics were metoclopramide 53.8 +/- 2.2 mg, droperidol 5.99 +/- 0.3 mg, and tropisetron 6.1 +/- 0.2 mg. Control patients had a 54% incidence of PONV. Droperidol reduced both the incidence (P < 0.001) and severity (P < 0.01) of PONV for the entire 36 h. Tropisetron reduced incidence and severity (P < 0.05), but the effect of the single bolus dose lasted only 18 h. Metoclopramide had a marginally significant effect under these conditions. Only droperidol decreased the need for rescue medication (P < 0.01), although rescue with tropisetron was highly effective. Side effects and patient satisfaction were comparable among the groups, but patients receiving droperidol were sleepier (P < 0.05) than control patients and recalled somewhat more anxiety (P = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prophylactic antiemetic therapy with patient-controlled analgesia: a double-blind, placebo-controlled comparison of droperidol, metoclopramide, and tropisetron. 816 Oct 1

The efficacy and side effects of epidural bolus injection of 4 mg of morphine in a volume of 2 ml, 10 ml, or 20 ml (groups I, II and III) for postoperative analgesia after caesarean section (60 patients) were evaluated. All patients had epidural anaesthesia established up to T4 level with 0.5% bupivacaine 18-20 ml, supplemented with 2% lidocaine with adrenaline, when necessary. Morphine 4 mg in either of the three volumes was injected through the epidural catheter in random order after delivery of the baby. Six patients in each group reported no pain during the 24-h follow-up period. No additional pain medication during the 24 h after surgery was required in 11, 14 and 10 patients in groups I, II and III, respectively. Most of the others managed with the addition of a single dose of rectal ketoprofen. There were no differences in analgesic therapy between the groups. Pruritus was the most common adverse effect (18/20, 19/20 and 18/20 in groups I, II and III, respectively). 10/20, 12/20 and 14/20 (N.S.) patients had nausea and vomiting in groups I, II and III, respectively. Metoclopramide, prescribed for persistent nausea, was given to 4/20 patients in group I, 6/20 patients in group II and 9/20 patients in group III (N.S.). After removal of the urinary catheter 7/20 patient in group III required carbachol for urinary retention compared to 3/20 and 4/20 patients in groups I and II (N.S.).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Epidural analgesia with 4 mg of morphine following caesarean section: effect of injected volume. 827 52

Metoclopramide may enhance opioid analgesia, but it is not known if the drug is analgesic itself. This question was examined in a double-blind, randomized study of 38 patients undergoing knee arthroscopy with opioid-free anaesthesia comprising propofol, isoflurane and nitrous oxide in oxygen. At the end of surgery, patients received either metoclopramide 0.5 mg kg-1 or placebo i.v. After operation, they received patient-controlled analgesia with pethidine for 3 h, during which period, pain score was assessed on a visual analogue scale (VAS). There were no significant differences between the groups in the patterns of pethidine consumption. However, the VAS-pain scores tended to be smaller in the metoclopramide group; this difference was significant 30 min after operation. These results do not demonstrate conclusively a clinically relevant analgesic action of metoclopramide.
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PMID:Evaluation of the analgesic effect of metoclopramide after opioid-free analgesia. 825 Dec 99

In patients with advanced non-small cell lung cancer, cachexia is an important cause of morbidity and mortality. The pathogenic mechanism of this finding, usually referred to as "cancer anorexia and cachexia syndrome" (CACS), is complex and far from completely understood, but a disturbed equilibrium between possible food intake and metabolic needs seems to be fundamental. The literature data on the treatment options in advanced non-small cell lung cancer (NSCLC) with cachexia are reviewed. Based on the clinical studies on cancer cachexia, some recommendations for the therapeutic approach of this disorder in patients with advanced NSCLC can be given. Metoclopramide is easily administered, can alleviate gastric disturbances, but probably does not correct the catabolic spiral of CACS. There are not enough data to advise the use of parenteral nutritional support, hydrazine, cyproheptadine, tetrahydrocannabinol or nandrolone decanoate. Corticosteroids are useful in additional analgesia and fast palliation of very weak and debilitated patients in the final episode of their disease. Recent data in non-small cell lung cancer patients are in favour of the use of high-dose progestagens to improve both appetite and weight.
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PMID:Hormonal treatment in advanced non-small cell lung cancer: fact or fiction? 886 99

The analgesic properties of 2 antiemetic agents--metoclopramide and ondansetron--were investigated in studies which showed that metoclopramide may decrease postoperative opioid requirements, but the analgesic effect of ondansetron is controversial. The postoperative effects of metoclopramide and ondansetron on pain in patients undergoing laminectomy were evaluated. Forty six patients were randomized into 3 groups: group M, which consisted of 15 patients who received intravenous (IV) metoclopramide 0.5 mg 30 minutes before surgery; group O, which consisted of 16 patients who received ondansetron IV 0.1 mg 30 minutes before surgery; and group C, which consisted of 15 patients who received the same volume of saline IV 30 minutes before surgery. The efficacy and duration of analgesia were assessed using a visual analogue scale (VAS) at 0, 0.5, 1, 3, 6, and 24 hours after surgery. Hemodynamic parameters, additional analgesic requirements, and adverse effects were recorded for the study groups. Diclofenac 75 mg was administered intramuscularly as a rescue analgesic during the postoperative period. VAS scores were lower in the metoclopramide group than in the ondansetron and control groups (P<.05, each). The patients in the ondansetron and control groups required much more diclofenac than the patients in the metoclopramide group (P<.05). Metoclopramide administered preoperatively provided postoperative analgesia in patients undergoing elective laminectomy.
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PMID:Can antiemetics really relieve pain? 1641 40

Metoclopramide (MTCL) can abort attacks of migraine headache. I report swift resolution of cough-induced headache as well as suppression of cough in six male patients following parenteral administration of MTCL. A similar unexpected rapid antitussive action of MTCL was also observed in 12 of 14 other patients (13 male and 1 female) with severe paroxysmal cough without headache. Use of MTCL primarily for analgesia is reviewed, and the pharmacological basis for its antinociceptive action is proposed. As a nonopiate agent with potential to stimulate endogenous opiate-mediated mechanisms, MTCL appears to have additional valuable roles in clinical practice. This is the first report of an antitussive action of MTCL. Further controlled studies are required to confirm the therapeutic role of MTCL in cough-induced headache as well as its potential antitussive and general analgesic actions.
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PMID:Metoclopramide aborts cough-induced headache and ameliorates cough--a pilot study. 1678 37


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