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

The pKa's, partition coefficients and drug distribution coefficients (apparent partition coefficients) have been investigated for a number of narcotics and where possible for their congener narcotic antagonist. These studies were carried out by a novel microelectrometric titration technique as a function of temperature and pH. This method enables one to determine not only the dissociation constants to deconvolute overlapping pKa's, but also to determine the solubilities and oil-water distribution of these various drugs. The drug distribution coefficients displayed marked sensitivity to pH at values which span the range of attainable human physiological pH values. This has significant pharmacological implications for proper choice and scaling of drug dosages under various clinical situations among which are cited hyperventilation under a general anesthetic while concomitantly under a narcotic analgesic, obstetetrical analgesia, and medical and anti-abuse usage of narcotic antagonists. The partition coefficients and drug distribution coefficients were noticeably different at 20degreesC (where such measurements are customarily made) from those at 37degreesC (body temperature). Furthermore, various drugs exhibit very non-equivalent increases in drug distribution coefficients with increasing temperature, ranging from 21% for naltrexone. This non-regularity indicates that it will not be valid to extrapolate by any constant factor the measurements made at lower temperatures. Even the true partition coefficients increase with temperature from 20degrees to 37degreesC.
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PMID:Narcotic and narcotic antagonist pKa's and partition coefficients and their significance in clinical practice. 1 83

At the present time, it is rarely necessary to operate after a digestive perforation complicating the ingestion of a caustic fluid. By contrast, cancer surgery progresses. Anaesthesia requires protection with a high degree of analgesia and curarisation. The use of a Carlens tube during oesophagectomy via a thoracic approach facilitates the surgeon's task. Compensation for blood and water losses should be generous. Insertion of a gastric tube through the plasty makes it possible to avoid gastrostomy. Finally, postoperative artificial ventilation is necessary in these individuals who often suffer from some form of respiratory pathology.
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PMID:[Anesthesia for esophageal surgery]. 2 77

Salpingectomy by laparoscopy in 200 healthy outpatients employed local analgesia and "pentazepam" (pentazocine 90 mg and diazepam 30 mg in 250 ml of 5% D/W) as anesthesia. Patients received no premedication, ventilated spontaneously, without tracheal intubation, but were given nasal O2 at 3 L/min throughout the procedure. N2O was used for abdominal insufflation, and the abdominal pressure and Trendelenburg position were restricted to less than 20 cm H2O pressure and 30 degrees, respectively. Changes in arterial blood gases measured in 12 patients were unremarkable. Prolonged recovery, unsatisfactory surgical conditions, tachycardia, nausea and vomiting were infrequent.
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PMID:"Pentazepam" (pentazocine + diazepam) supplementing local analgesia for laparoscopic sterilization. 13 Aug 13

Effects of drugs that modify catecholaminergic or tryptaminergic mechanisms were determined in experimental animals regarding the analgesic action of difenamizole, morphine, and aminopyrine. Analgesia was assessed by the hot plate method in mice and the hot water induced tail withdrawal reflex in rats. Both 5-hydroxytryptophan (5-HTP) and L-dopa potentiated the analgesic action of morphine, but antagonized the action of difenamizole in the hot plate test. p-Chlorophenylalanine (pCPA), alpha-methyl-p-tyrosine (alpha-MT), and reserpine antagonized the effect of morphine as assessed by this same test. alpha-MT potentiated the analgesic action of difenamizole. The analgesic action of aminopyrine was hardly modified in the hot plate method by pretreatment with 5-HTP, pCPA, L-dopa, and alpha-MT. In rats, 5-HTP antagonized the effect of morphine, while pCPA, L-dopa, and alpha-MT caused no appreciable change in the analgesic action of morphine in the hot water induced tail withdrawal reflex. The effect of difenamizole was not modified by pretreatment with these monoamine-related drugs. On the other hand, brain 5-hydroxytryptamine content was increased by pretreatment with 5-HTP in both tests. These results suggest that the analgesic action of difenamizole and morphine, as measured in the hot plate test in mice, may be mediated by catecholamines and 5-hydroxytryptamine, but that other mechanisms may be involved in the hot water induced tail withdrawal relfex in rats. In addition, the biogenic amines may play a different role depending on the type of analgesic.
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PMID:[Relationship between biogenic amines and analgesic action of difenamizole in heat induced reflexes]. 13 90

In addition to the well-known activation of the pituitary-adrenal axis, acute exposure to severe stressors includes a temporary analgesia in rats. Thus, the present study investigates whether the pituitary was involved in the mediation of analgesia induced by severe cold-water swim (CWS) stress. Flinch-jump thresholds were measured 30 min following 3.5-min swims in water temperatures ranging from 2-35 degrees C. Compared with untreated normal rats, hypophysectomized rats, receiving corticosterone and thyroxin, displayed significantly less CWS-induced analgesia, while similarly-supplemented normal rats exhibited significantly more CWS-induced analgesia. In a second experiment, operant liminal escape pain thresholds were determined following acute and chronic CWS. Whereas normal rats exhibited profound analgesia following the initial swims, the hypophysectomized rats never displayed any CWS-induced operant escape shifts. Stress-induced alterations in general activity levels and/or thermoregulation were shown to be unrelated to the diminished effectiveness of CNS to produce analgesia in hypophysectomized rats. These data imply that the pituitary is involved in the mediation of CWS-induced analgesia.
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PMID:Analgesia induced by cold-water stress: attenuation following hypophysectomy. 22

Water intoxication during or following oxytocin induced labor, albeit a rare event, can nevertheless cause potentially fatal complications or risk of neurological damage. Large doses of oxytocin plus large volumes of electrolyte-free solutions are the prime factors associated with water intoxication. Suggested treatment consists of hypertonic saline. Although circulatory overload and pulmonary oedema can occur from saline treatment it is believed that the risk of cerebral oedema is greater than risk from saline treatment. Prevention of water intoxication includes: 1) restriction of fluid intake; 2) monitoring of analgesia given; 3) interruption of continuous infusion; 4) fluid balance with control of serum electrolytes and osmolality; and 5) use of electrolyte-containing fluid as a vehicle for the oxytocin.
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PMID:Water intoxication after oxytocin-induced midtrimester abortion. 28 25

Analgesic and antipyretic activities of 2-(4-(2-imidazo-[1,2-a]pyridylphenyl)propionic acid (Y-9213) were studied with various experimental models. The analgesic activity of Y-9213 was found to be more potent than that of indometacin and morphine in the silver nitrate, Randall-Selitto, and phenylquinone writhing tests. Y-9213 also showed an analgesia in the tail pinch and electric stimulation test. On the warm water induced foot withdrawal reflex, Y-9213 was more effective in spinal-sectioned mice than in intact mice similarly to mephenesin and diazepam. Y-9213 was also proved to possess antipyretic activity as potent as indometacin and to be devoid of morphine-like property. Y-9213 exhibited little effect on the respiration and cardiovascular system in dogs. Y-9213 was found to be rapidly absorbed and eliminated from the blood with a half-life of about 2.5 h in rats. These findings indicate that Y-9213 may be an effective and well tolerated antipyretic and analgesic agent.
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PMID:The analgesic activity of imidazopyridine derivatives. 31 30

A quantitative method for measuring pain threshold by the use of ultrasonic stimulation in man was designed and the possibility of clinical application in assessing analgesics was investigated. Ultrasonic stimulus was given to Japanese subjects on the palmer distal part of the 2nd, 3rd and 4th fingers of both hands. The latent time between start of the stimulation and withdrawal of the hand when perceiving pain was considered the pain threshold. The ultrasonic evoked pain was a sharp pin-prick type, without sensations such as thermal and mechanical. The pain threshold lowered with increasing either stimulus intensity or water bath temperature when the hand of the subject was immersed during measurement. Normal threshold to ultrasonic stimulation measured in both 50 men and 50 women gave nearly normal distribution curves; women being more sensitive to ultrasonics than men. Analgesia with codeine phosphate (20 mg p.o.), aspirin (1.5, 1.0, 0.5 g p.o.), aminopyrine (100 mg p.o.) and mefenamic acid (500 mg p.o.) in volunteers of both sexes was demonstrated significantly using this method under double blind circumstances. Pentobarbital, diazepam, butylscopolamine, bromelain and placebo each in the usual dose used clinically failed to alter the pain threshold. Humans were at least 25 fold more sensitive than mice to the analgesics used herein.
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PMID:Clinical assessment of analgesics using ultrasonic stimulation. A new method. 33 41

Fourteen patients with a variety of neoplasms not responsive to standard forms of therapy underwent whole body hyperthermia for a maximum 4 h at 41.8 degrees C. This was a phase-I cancer trial designed to develop whole body hyperthermia as an adjuvant to systemic chemotherapy. Intravenous analgesia was used to sedate patients, obviating the need for general endotracheal anesthesia. Hyperthermia was induced by means of a high-flow water perfusion suit. Cardiovascular performance was evaluated using a flow-directed pulmonary artery catheter. Patients developed a twofold mean increase in cardiac index without evidence of cardiac damage by ECG or creatine phosphokinase (CPK) isoenzymes. An acute fall in serum magnesium and phosphate and an acute rise in arterial pH, serum CPK values, and granulocyte count occurred in all patients. There were no clotting abnormalities. Toxicity included fatigue, diarrhea, nausea, and transient elevations in liver enzymes. Four patients were febrile for 36 h after initial defervescence. Peripheral neuropathy developed in four. These results show that with carefully monitored conditions whole body hyperthermia is feasible.
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PMID:Whole body hyperthermia: a phase-I trial of a potential adjuvant to chemotherapy. 42 99

A review is presented of work on envenomation by stonefish (Synanceja spp.), which represent not only a danger for the inhabitants of tropical coasts but also for tourists. Stonefish are common in shallow water of reef areas by the shores of the Indian and Indopacific Ocean. The bizarrely shaped fish is often taken for a weed-covered stone and accidents occur when swimmers, divers or fishermen step on the stings of the dorsal fin. These stings are provided with poison glands. The venom has neurotoxic, myotoxic and hemorrhagic effects. The case of a 39-year-old diver is cited who suffered a stonefish stab which lasted for several weeks. Generally envenomations by Synanceja cause severe local pain and enormous swelling of the limb; systemic symptoms as usually found with neurotoxins are common; death may occur by shock, by paralysis of the diaphragm or cardiac arrest. For first aid bathing of the limb in hot water is recommended. Clinical measures are local analgesia, local neutralization of the venom, if possible antiserum therapy and intensive care with symptomatic treatment of systemic complications. The most effective prevention is adequate foot protection when wading in the sea.
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PMID:[Overview of the epidemiology of stonefish poisonings, their treatment and preventive measures]. 44 11


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