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

Nitrous oxide analgesia was introduced into obstetrics by a young Polish-Russian physician who manufactured the gas himself, mixed it with oxygen, humidified the mixture with water vapor, and devised a mouthpiece for self-administration. After assessing the results on himself, he evaluated the effects on pain relief, maternal emotion, and maternal and fetal heart rates, as well as on the frequency, duration, and strength of uterine contractions in 25 parturients. He recognized that, in contrast to chloroform, nitrous oxide did not alter uterine activity. He concluded that the advantages of nitrous oxide administration far outweighed its disadvantages.
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PMID:The introduction of nitrous oxide analgesia into obstetrics. 140

Labour pain is very real to expectant mothers. Untreated it can give rise to hypocarbia, hypoxia and fetal acidosis. Pain relief during labour dates back to Queen Victoria who was given chloroform for the birth of Prince Leopold. Since then many techniques and drugs have been used. Epidural analgesia was introduced in 1942 and since then has been regarded as a very effective method for labour pain relief. This article deals with the technique of epidural catheter insertion as well as discussing some of the common complications that can occur and their management.
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PMID:Epidural analgesia for patients in labour. 239 6

Pain is a primary component of normal childbirth as evidenced by the behavior of parturients in primitive societies. Methods of pain relief such as the use of herbs and plant extracts were described in ancient writings. Modern obstetric analgesia employing ether began in 1847, three months after the first successful surgical anesthetic. Administration of chloroform and nitrous oxide followed. Twilight sleep, a combination of morphine and scopolamine, became popular in the beginning of the twentieth century as did regional analgesia, first single injection and later continuous blockade via catheter. Simultaneously, psychologic methods were propagated, but were not uniformly successful. Continuous lumbar extradural analgesia has evolved as the optimal method of bsotetric pain relief, both subjectively and objectively, and its combination with childbirth education is considered to be complementary. The increasing utilization of obstetric analgesia and the recognition of marked physiologic and pharmacologic differences between pregnant and nonpregnant patients has led to the development of the subspecialty of obstetric anesthesia as well as to the foundation of obstetric anesthesia societies.
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PMID:[Historical development of obstetrical anesthesia]. 331 45

A selective high-performance liquid chromatographic method for the determination of bupivacaine in human serum is described. The technique is based on a single extraction of the drug from alkalinized serum with a mixture of hexane-isopropanol-chloroform. Desmethyldoxepin is used as internal standard. The chromatographic system consists of a home-packed Nucleosil C8 (10 microns) column; the mobile phase is acetonitrile--0.05 M potassium phosphate buffer (pH 3.3) (28:72, v/v). The method can accurately measure serum bupivacaine concentrations down to 20 micrograms/l using 500 microliters of sample. The coefficient of variation for intra-assay variability of bupivacaine is 2.1% (n = 13) and for inter-assay variability of bupivacaine 5.7% (n = 11) at 1.00 mg/l. The calibration graph is linear over the range 0.02-5.00 mg/l and the extraction efficiency is 91.8 +/- 3.8% (+/- S.D., n = 7). The method is accurate and sensitive for both clinical and pharmacokinetic studies on bupivacaine in man. The method is applied to the analysis of serum samples obtained from orthopaedic patients during both spinal and epidural analgesia.
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PMID:High-performance liquid chromatographic determination of bupivacaine in human serum. 648 Jul 88

The terms 'analgesia' and 'anaesthesia' have been defined by emphasizing differing aspects of their effects. The distinction between these interventions has not been clarified by their definitions. The historical remedies for pain were similarly unclear. This lack of clarity is apparent in the introduction of chloroform in childbirth, which has much in common with the introduction and effects of epidural analgesia. The reasons for and benefits of this lack of clarity are examined.
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PMID:Analgesia and anaesthesia in childbirth: obscurantism and obfuscation. 968 34

This historical review of obstetric analgesia-anesthesia in Spain covers the first half of the twentieth century. Following usual practice for researching medical history, we have performed an exhaustive review of Spanish medical literature published during the study period, followed by classification, study and critical analysis. We found that the first half of the century saw considerable change in the application of analgesic-anesthetic techniques for childbirth and obstetric procedures, indicating that practitioners were far from apathetic as had been obstetricians of the second half of the nineteenth century, who generally rejected any type of analgesia for use during labor and birth. The numerous techniques in vogue during that period under study are described, although analgesia-anesthesia by inhaled ether and chloroform was undoubtedly the most widely used by obstetricians until well into the 1950's.
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PMID:[Obstetric anesthesia/analgesia in Spain. Study notes on its historical evolution during the 1st half of this century]. 1037 94

Volatile anesthetics produce safe, reversible unconsciousness, amnesia and analgesia via hyperpolarization of mammalian neurons. In molluscan pacemaker neurons, they activate an inhibitory synaptic K+ current (IKAn), proposed to be important in general anesthesia. Here we show that TASK and TREK-1, two recently cloned mammalian two-P-domain K+ channels similar to IKAn in biophysical properties, are activated by volatile general anesthetics. Chloroform, diethyl ether, halothane and isoflurane activated TREK-1, whereas only halothane and isoflurane activated TASK. Carboxy (C)-terminal regions were critical for anesthetic activation in both channels. Thus both TREK-1 and TASK are possibly important target sites for these agents.
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PMID:Inhalational anesthetics activate two-pore-domain background K+ channels. 1032 Dec 45

It was already known that Professor Naguib (Bey) Mahfouz (1882-1974) whas the first staff anesthetist at Kasr El-Ainy Hospital (KEAH) in Cairo between the years 1904-1906. It is not well established why he changed his specialty. In a pursuit of this story, a very relevant account was discovered in his books published in 1935 on medical education and in 1966, a biography. Interesting revelations in his biography were revealed: First, he was not the first anesthetist at KEAH, and he was appointed to replace a retired anesthetist called Amin Naseem; second, chloroform was introduced to Egypt by Herbert Milton, the British surgeon at KEAH, toward the end of the last century; third, the reason why he changed his specialty was a fatal case of obstructed labor whom he has been giving anesthesia to- an incident that turned him toward obstetrics; fourth, he used chloroform, ehter and spinal analgesia with stovaine even when he was practicing as a surgeon; fifth, he revealed in his medical education book the names of pioneer doctors working in anesthesia in Egypt.
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PMID:Essay on modern history of anesthesia in Egypt as reflected in Naguib (Bey) Mahfouz books. 1112 1

Pain associated with Herpes Zoster (HZ) and Post-herpetic Neuralgia (PHN) has been a challenging task to manage with ease. Topical aspirin dissolved in chloroform is an effective means of reducing pain due to HZ and PHN in most patients. The locus of pain origin and analgesia induced by topical aspirin is supposed to be at cutaneous free nerve ending pain receptors. The present study was conduced in fifty two patients of HZ and PHN. Pain intensity before and after the application of drug was measured with help of Sort Form McGill Pain Questionnaire (SE-MPQ). Most of the patients experienced relief of pain within 1-5 minutes after the aspirin-chloroform application. Maximum relief was achieved in about 30-40 minutes and persisted for 5-6 hrs. In the beginning 3-4 applications were required but frequency decreased gradually as the pain abated.
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PMID:Herpes zoster and post-herpetic neuralgia--a clinical trial of aspirin in chloroform for anodyne. 1077 45

There is a long history of attempts to alleviate the pain of childbirth, particularly in Asian and Middle Eastern civilisations. In the UK, it was the administration of chloroform to Queen Victoria by John Snow in 1853 that is widely credited with popularizing the idea that labour pain should and could be treated. Medical analgesia is now well established around the globe with a wealth of research evidence describing methods, efficacy and complications. In this article, we define 'primary breakthrough pain' as the moment when a woman first requests analgesia during labour. The management of this can include simple emotional support, inhaled analgesics, parenteral opioids and epidural analgesia. 'Secondary breakthrough pain' can be defined as the moment when previously used analgesia becomes ineffective. We concentrate our discussion of this phenomenon on the situation when epidural analgesia begins to fail. Only epidural analgesia offers the potential for complete analgesia, so when this effect is lost the recipient can experience significant distress and dissatisfaction. The best strategy to avert this problem is prevention by using the best techniques for epidural catheterisation and the most effective drug combinations. Even then, epidurals can lose their efficacy for a variety of reasons, and management is hampered by the fact that each rescue manoeuvre takes about 30 minutes to be effective. If the rescue protocol is too cautious, analgesia may not be successfully restored before delivery, leading to patient dissatisfaction. We therefore propose an aggressive response to epidural breakthrough pain using appropriate drug supplementation and, if necessary, the placement of a new epidural catheter. Combined spinal epidural techniques offer several advantages in this situation. The goal is to re-establish analgesia within 1 hour. The primary aim of pain management during labour and delivery is to provide the level of comfort determined as acceptable to each individual woman. Some require little or no analgesia, while others demand complete abolition of pain. Whatever the individual's personal point of breakthrough pain is, supporting clinicians should respond logically and rapidly to re-establish analgesia using locally agreed protocols. This approach will maximize patient satisfaction and hopefully increase the pleasure and satisfaction of childbirth.
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PMID:The management of breakthrough pain during labour. 1959 96


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