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)

Role of the subsequently excited receptors elicited by tetanic muscular contraction in electro-acupuncture analgesia was examined. Conditioning stimulation of the nerve (CPN) as well as electro-acupuncture induced a significant delay of the tail flick latencies of the rat with weak intensity of stimulus (1.0-1.5 x DFT), and this effect was abolished after section of the nerve at a point distal to the stimulating electrode. Electrophysiological data indicate that a small amplitude of the A large fiber group's potential was recorded with the intensity range of 1.0-1.5 x DFT. These facts suggest that the analgesic effect induced by weak stimulation is not the result of direct excitation of afferent fibers but the result of subsequent activation of receptors provoked by tetanic muscular contraction. The possible receptors are proposed and their participation in acupuncture analgesia also discussed. CPn = the common peroneal nerve; DFT = dorsal flexion threshold (1.0 x DFT = 1.15 x Ta).
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PMID:Role of the subsequently activated receptors in electro-acupuncture of the rat. 734 21

Pain in pancreatic cancer is often a major problem of treatment. Administration of opioids is frequently limited by side effects or insufficient analgesia. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) represents an alternative for the palliative treatment of visceral pain in patients with pancreatic cancer. This review focuses on the indications, technique, outcomes of EUS-CPN and predictors of pain relief. EUS-CPN should be considered as the adjunct method to standard pain management. It moderately reduces pain in pancreatic cancer, without eliminating it. Nearly all patients need to continue opioid use, often at a constant dose. The effect on quality of life is controversial and survival is not influenced. The approach could be done in the central position of the celiac axis, which is easy to perform, or in the bilateral position of the celiac axis, with similar results in terms of pain alleviation. The EUS-CPN with multiple intraganglia injection approach seems to have better results, although extended studies are still needed. Further trials are required to enable more confident conclusions regarding timing, quantity of alcohol injected and the method of choice. Severe complications have rarely been reported, and great care should be taken in choosing the site of alcohol injection.
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PMID:Celiac plexus neurolysis in pancreatic cancer: the endoscopic ultrasound approach. 2441 63

Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely: morphine-based drugs on step three of the WHO analgesic ladder (as opposed to the weak opioids: codeine and tramadol). The presence of pain is associated with reduced survival. This article reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. The online literature review was conducted through: PubMed, Clinical Key, Uptodate, and NICE Evidence. There are two principal mechanisms for pain: pancreatic duct obstruction and pancreatic neuropathy which, respectively, activate mechanical and chemical nociceptors. In pancreatic neuropathy, several histological, molecular, and immunological changes occur which correlate with pain including: transient receptor potential cation channel activation and mast cell infiltration. Current pain management is empirical rather etiology-based and is informed by the WHO analgesic ladder for first-line therapies, and then endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with resistant pain. For EUS-CPN, there is only one clinical trial reporting a benefit, which has limited generalizability. Case series report pancreatic duct stenting gives effective analgesia, but there are no clinical trials. Progress in understanding the mechanisms for pain and when this occurs in the natural history, together with assessing new therapies both pharmacological and endoscopic, will enable individualized care and may improve patients' quality of life and survival.
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PMID:Pain in Patients with Pancreatic Cancer: Prevalence, Mechanisms, Management and Future Developments. 2822 52