Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oxygen regimen, hemodynamics, hemocoagulation, vegetative status, and immune status of patients subjected to multiple surgical interventions under anesthesia are analyzed. Three premedication schemes are considered. Routine fluothane anesthesia with nitrogen oxide + oxygen or calypsol after standard premedication is inadequate in children when used repeatedly. Tramal, a new analgesic, used in premedication, is highly effective, causes no side effects, and ensures sufficiently deep and prolonged analgesia. Use of neurovegetative blocking for premedication is a new and most physiological method of analgesia to be used in multiple minor surgical interventions in patients with burns.
 ...
PMID:[Comparative analysis of different premedication methods in minor surgery in children]. 760 33

The active morphine metabolite, morphine-6-glucuronide (M-6-G), may contribute to both the analgesia and the adverse effects observed during morphine (MOR) therapy. To evaluate the relationship between M-6-G and adverse effects, we measured steady-state plasma concentrations of MOR and M-6-G and concurrently noted the presence or absence of moderate to severe cognitive impairment or myoclonus in 109 cancer patients who were receiving either oral (n = 71) or parenteral (n = 38) morphine. MOR and M-6-G plasma concentrations were determined by HPLC with electrochemical detection. The presence of cognitive impairment or myoclonus was analyzed in relation to molar M-6-G/MOR ratio, age, morphine dose, the use of other centrally acting drugs, renal function (blood urea nitrogen (BUN) and serum creatinine), hepatic function (serum bilirubin, serum glutamic oxalacetic transaminase (SGOT), and alkaline phosphotase) and serum lactate dehydrogenase (LDH). The patient population consisted of 60 women and 49 men. The mean age was 51.5 years (range: 10-85 years). The mean morphine dose (total dose-prior 48 h) was 486 mg (range: 40-4800 mg) for the oral group and 931 mg (range: (10-9062 mg) for the parenteral group. The mean molar M-6-G/MOR ratios were 6.1 (SD: 18.2; range: 0.01-153.3) for the oral treatment group and 2.7 (SD: 4.16; range: 0.05-23.8) for the parenteral treatment group. Overall, the M-6-G/MOR ratio demonstrated a moderate but significant correlation with BUN (r = 0.4; P < 0.001) and creatinine (r = 0.45; P < 0.001) levels, but not with the other clinical variables examined.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Morphine-6-glucuronide concentrations and opioid-related side effects: a survey in cancer patients. 764 48

Xenon is a more potent anesthetic than nitrous oxide, and give more profound analgesia. This investigation was performed to assess the potential of xenon for becoming an anesthetic inspite of its high manufacturing cost. Seven ASA I-II patients undergoing cholecystectomy (n = 4), hernia repair (n = 2), or mammoplasty (n = 1) were studied. Denitrogenation by 15-20 min of oxygen breathing under propofol anesthesia was followed by fentanyl-supplemented xenon anesthesia administered via an automatic minimal flow system which held the oxygen concentration at 30%. Xenon anesthesia lasted 76-228 min and 8-14 l of xenon (ATPD) was used, of which 5.6-8.1 l was expended during the first 15 min. Anesthesia appeared to be satisfactory, and the patients woke up rapidly after xenon was discontinued. The automatic system made minimal flow xenon anesthesia easy to administer, but nitrogen accumulation is still a problem. Assuming a xenon price of 10 US$ per litre, the average cost for xenon was about 65 US$ for the first 15 min and then about 25 US$ for each subsequent hour of anesthesia.
 ...
PMID:Clinical experience with minimal flow xenon anesthesia. 790 41

Rat experiments have revealed that gradual increases in atmospheric pressure up to 1.1 MPa progressively alters the vocalization threshold in electrical stimulation of the tail root. Substitution of air for heliox (79.1% helium and 20.9% oxygen) leads to attenuation of the analgesic effect of hyperbarism. It is postulated that hyperbaric analgesia is due mainly to the elevated partial pressure of nitrogen. Morphine and promedol in doses of 2.5 mg/kg and clofeline in a dose of 0.1 mg failed to change analgesic effects when atmospheric pressure was increased up to 0.7 and 1.1 MPa. The analgesic effect of morphine and promedol in doses of 5 mg/kg and buprenorphine in a dose of 0.035 mg/kg under similar conditions increased during the whole period of isopression, while that of clofeline in a dose of 0.5 mg/kg increased only in the first few minutes of isopression. The analgesic action of morphoeceptine in a dose of 5 mg/kg decreased during isopression. The possible mechanisms of hyperbaric analgesia and the specific features of the analgesic action of different drugs at elevated atmospheric pressure are discussed.
 ...
PMID:[The anodyne action of narcotic analgesics and clofelin under increased atmospheric pressure]. 810 60

Seventeen infants were treated with inhaled nitric oxide for critical pulmonary artery hypertension after operations for congenital heart defects. In all 17 patients conventional medical therapy consisting of hyperventilation, deep sedation/analgesia, and correction of metabolic acidosis had failed. All children were monitored with a transthoracic pulmonary artery catheter inserted at operation. Pulmonary artery hypertension was defined as an acute rise in pulmonary pressure associated with a decrease in oxygen arterial or venous saturation. After failure of conventional medical therapy, 20 ppm of inhaled nitric oxide was administered to the patient. In all patients the pulmonary pressures decreased (mean pulmonary arterial pressure decreased by -34% +/- 21%) without significant change in systemic arterial pressure, whereas the oxygen arterial saturation and oxygen venous saturation increased by 9.7% +/- 12% and 37% +/- 28%, respectively. Fifteen children were discharged from the intensive care unit at 10 +/- 6 days (range 3 to 26 days) and two died. This study demonstrates that inhaled nitric oxide exerts a selective pulmonary vasodilation without decreasing systemic arterial pressure in children with congenital heart disease. The increased values of mixed venous oxygen saturation and urinary output suggest that this selective lowering of pulmonary vascular resistance improved the overall hemodynamics. The potential toxic effects of nitric oxide and nitrogen dioxide necessitate careful consideration of the risks and benefits of inhaled nitric oxide therapy.
 ...
PMID:Inhaled nitric oxide as a therapy for pulmonary hypertension after operations for congenital heart defects. 815 35

The metabolic effects of continuous intravenous (IV) application of the alpha 2 agonist clonidine were evaluated by assessment of nitrogen economy and postaggression endocrine patterns. Twenty-four patients undergoing abdominothoracic esophageal cancer resection were studied. Thirteen of these patients with alcohol abuse were treated postoperatively with IV clonidine for prevention of alcohol withdrawal syndrome. Eleven patients who were not treated with clonidine served as controls. All patients were treated in a standardized manner in regard to surgical technique, balanced anesthesia, and postoperative intensive care treatment, including thoracic epidural analgesia with bupivacaine and fentanyl. Isonitrogenous and isocaloric nutrition was comparable in all patients. A significantly improved cumulated 6-day nitrogen balance was found in clonidine-treated patients (-1.5 +/- 4.9 g nitrogen) compared to the control group (-17.6 +/- 4.2 g nitrogen) (P < 0.05). The main reason for improved nitrogen economy may be clonidine-induced growth hormone (GH) release. The pattern of insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) concentrations could support this hypothesis.
 ...
PMID:Postoperative alpha 2-adrenergic stimulation attenuates protein catabolism. 889 12

To evaluate the influence of anesthesia on postoperative nitrogen balance after upper abdominal surgery, twenty-seven patients undergoing the surgery were investigated. They were allocated randomly to three groups receiving different anesthetic methods, i.e., epidural anesthesia, general anesthesia or balanced anesthesia. In the epidural anesthesia group, anesthesia was maintained with 0.5% isoflurane, nitrous oxide and oxygen supplemented with epidural analgesia extending from Th 1 to L 3. In general anesthesia group, anesthesia was maintained with isoflurane, nitrous oxide and oxygen. In balanced anesthesia group, anesthesia was maintained with 0.5% isoflurane, nitrous oxide, oxygen and intravenous fentanyl. Epidural fentanyl was used for postoperative analgesia in all groups. There was no significant difference in the cumulative nitrogen balance for three days among the three groups. Postoperative values of IL-6 and CRP also did not differ significantly among the three groups. Postoperative WBC was significantly higher in the balanced anesthesia group than in other two groups. The results suggest that the difference in anesthetic methods does not influence postoperative nitrogen balance.
 ...
PMID:[Does the difference in anesthetic methods influence postoperative nitrogen balance?]. 886 11

Sixty-seven children aged 5-15 years were induced to narcosis and narcotized with diprivan. The patients were operated on for appendicitis, peritonitis, osteomyelitis, phlegmons of different localization, and craniocerebral injuries. For induction, diprivan was intravenously injected in a dose of 3-4 mg/kg. During the main narcosis (central analgesia with fentanyl in a total dose of 0.008 mg/kg/h) diprivan was infused by microjets in a dose of 6-9 mg/kg/h in combination with nitrogen oxide and oxygen in 1:1 ratio. Control group consisted of similar age-matched patients, to whom central analgesia without diprivan was administered. Respiration rate, heart rate, systolic and diastolic arterial pressure, mean arterial pressure (MAP), SaO2, and clinical course of anesthesia were examined at different stages of analgesia and surgery. During induction anesthesia the respiratory rate decreased by 27% and SaO2 decreased to 92.75 +/- 1.2% due to the specific effect of diprivan. MAP decreased by 4.8%. During the traumatic moment of surgery, respiratory rate increased by 20.1%, SaO2 was 98.25 +/- 0.24%, and heart rate increased by 22.6%. In the controls this period of surgery was associated with a more expressed reaction of the cardiovascular system, presenting as tachycardia (114.5 +/- 3.6) and increase of MAP by 10.1%. After anesthesia pain sensitivity returned earlier, due to which tachycardia and negligible hypertension were observed.
 ...
PMID:[Diprivan as a component of the anesthesia in emergency surgical interventions in children]. 955 51

Analgesia of children operated on the lumbosacral segments is discussed. Balanced total anesthesia was used with caudal epidural blocking by a combination of alpha 2-agonist clofelin, local amide anesthetic bupivacaine, and narcotic analgesic promedol. Injection of a combination of clofelin (0.01% solution) in a dose of 1 microgram/kg, standard dose of 0.25% bupivacaine solution with adrenaline (1:200,000) in a dose of 0.3 ml/kg, and promedol in a dose of 0.2 mg/kg into the epidural space via the caudal approach in the presence of superficial anesthesia with halothane (0.2-0.4 vol/%), nitrogen oxide and oxygen in 2:1 ratio ensured adequate analgesia and effective neurovegetative protection both during the operation and the first 25 h after it.
 ...
PMID:[Caudal epidural anesthesia in children operated on in the area of the lumbosacral segments]. 955 53

Fentanyl citrate analgesia attenuates the excess nitrogen excretion in the urine and glucose production induced by trauma. On the other hand, intracerebroventricular injection of morphine stimulates excretion of stress hormones, such as catecholamines and corticosterone. Furthermore, morphine levels in the brain are increased during fasting and sepsis. The aims of this study were to determine whether intracerebroventricular injection of tumor necrosis factor-alpha (TNF-alpha) elevates morphine levels in the rat brain and whether prophylactic administration of fentanyl blocks metabolic responses induced by intracerebroventricular injection of TNF-alpha because of a reduction of morphine levels in the brain. Morphine levels in the brain were increased from 648 to 1,134 fmol/g at 30 min after intracerebroventricular injection of TNF-alpha (P < 0.05 vs. control). This increase was associated with an increase in stress hormones (corticosterone: 416.1 +/- 69.1 ng/ml, P < 0.05 vs. control; epinephrine: 3,778.3 +/- 681.3 pg/ml, P < 0.01 vs. control) and an enhancement of proteolysis (254.2 +/- 45.7 micromol Leu . kg-1 . h-1, P < 0.01 vs. control) and glucose production (7.5 +/- 0. 7 mg . kg-1 . min-1, P < 0.05 vs. control). Fentanyl reduced morphine levels in the brain to 624 fmol/g (not significant vs. control), resulting in a reduction of stress hormone levels in the plasma and blunted metabolic responses. In conclusion, prophylactic administration of fentanyl prevented an increase in morphine levels in the brain induced by intracerebroventricular injection of TNF-alpha, leading to a reduction in stress hormone levels and subsequent metabolic responses.
 ...
PMID:Effect of fentanyl on morphine levels in the brain in rats receiving intracerebroventricular injection of TNF-alpha. 975 82


<< Previous 1 2 3 4 5 6 7 Next >>