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

It would be wrong to draw firm conclusions in this paper, because the methodology was highly subjective. However, the authors are of the opinion that certain conclusions can be drawn: Autistic individuals, even those with wildly aberrant behavior, can frequently receive dental treatment in a routine manner, if adequately sedated. Various sedative drugs may be effective. Combinations of drugs may be successful, where individual drugs have failed. The authors found the combination of Nisentil and Phenergan, supplemented with Vistaril when needed, to be especially effective. N2O-O2 analgesia appears to be beneficial, either alone or as an adjunct to other medications.
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PMID:Sedation of the autistic patient for dental procedures. 28 61

Children with cancer experience a great deal of anxiety concerning their treatment and invasive tests such as bone marrow aspirations (BMAs) and lumbar punctures (LPs). Responses of pain, fear, and anxiety are well documented and may cause regression, developmental delay, sleeping and eating problems, nausea and vomiting, nightmares, and depression. Diagnostic and treatment procedures need not cause such adverse effects if sufficient pharmacological sedation, analgesia, and anesthesia are used. However, studies show that inappropriate interventions such as underdosing and limited use of medications occur because of certain myths, beliefs, and lack of pharmacological knowledge on the part of health professionals. Studies that specifically address premedication for painful procedures in children with cancer have shown that only a small percentage of children receive premedications and that there is no clear consensus or standard for either drugs or dosages. The issue of premedicating children before procedures remains controversial and deserves further investigation. This study explored the attitudes and perceptions of oncology physicians and nurses concerning medicating children before procedures. Findings showed that most pediatric oncology specialists medicate their patients before invasive procedures and that the most common premedications used are Versed; Demerol, Phenergan, Thorazine; chloral hydrate; Ativan; fentanyl; Demerol; and Xylocaine. Most pediatric oncology specialists believe that premedication is necessary for children for BMAs and LPs.
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PMID:Premedicating children for painful invasive procedures. 149 58

While instituting a new program in fetoscopy, the authors explored the effects of sedation with meperidine (Demerol) and promethazine HCl (Phenergan) during fetoscopy conducted on 10 mothers at 14 to 18 weeks' gestation. Each received 100 mg of meperidine and 50 mg of promethazine HCl approximately 30 minutes before the procedure. In 3 instances, a repeat half-dose injection was made at 30 minutes for adequate analgesia. Sex of the fetus was determined accurately in 9 instances. In 9 of 10 cases, visualization was satisfactory; technical problems in 1 case precluded visualization. Complications included 2 superficial fetal limb hematomas and 2 instances of minimal fetal bleeding from an unknown site. Three patients required perforation of anterior placentas. Amniotic fluid was invariably clear but became progressively turbid. Sedation allowed a longer period for clear amniotic fluid by decreasing fetal movements progressively over the first hour; fetal activity showed a prompt return thereafter. The clarity of the amniotic fluid was adversely influenced by external manipulation of the fetus. The authors conclude that sedation has obvious benefits for the mother and may facilitate evaluation of the fetus during fetoscopy.
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PMID:Effects of maternal sedation during fetoscopy. 739 15

Persistent occipital neuralgia can produce severe headaches that are difficult to control by conservative or surgical approaches. We retrospectively describe a series of six patients with severe occipital neuralgia who received conservative and interventional therapies, including oral antidepressants, membrane stabilizers, opioids, and traditional occipital nerve blocks without significant relief. This group then underwent occipital nerve blocks using the botulinum toxin type A (BoNT-A) BOTOX Type A (Allergan, Inc., Irvine, CA, U.S.A.) 50 U for each block (100 U if bilateral). Significant decreases in pain Visual Analog Scale (VAS) scores and improvement in Pain Disability Index (PDI) were observed at four weeks follow-up in five out of six patients following BoNT-A occipital nerve block. The mean VAS score changed from 8 +/- 1.8 (median score of 8.5) to 2 +/- 2.7 (median score of 1), while PDI improved from 51.5 +/- 17.6 (median 56) to 19.5 +/- 21 (median 17.5) and the duration of the pain relief increased to an average of 16.3 +/- 3.2 weeks (median 16) from an average of 1.9 +/- 0.5 weeks (median 2) compared to diagnostic 0.5% bupivacaine block. Following block resolution, the average pain scores and PDI returned to similar levels as before BoNT-A block. In conclusion, BoNT-A occipital nerve blocks provided a much longer duration of analgesia than diagnostic local anesthetics. The functional capacity improvement measured by PDI was profound enough in the majority of the patients to allow patients to resume their regular daily activities for a period of time.
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PMID:Botulinum toxin occipital nerve block for the treatment of severe occipital neuralgia: a case series. 1798 66