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

Extracorporeal shock waves lithotripsy is a new procedure discovered and applied in the present decade to treat urinary and biliary stones. Shock waves are acoustic waves similar to sonic waves which follow the acoustic laws and therefore the shock waves can be refracted or reflected depending on the medium interface. Due to the high water content, the human body can be crossed by shock waves which eventually may be focused on the target stone. There are several commercially available shock waves generators, i.e. the spark gap emisors which were the first ones, and the piezoceramic and electromagnetic emisors. To focus the shock waves on a biliary stone the machines are provided with fluoroscopic or ultrasound devices or with both in the most advanced machines. Using an electromagnetic emisor (Lithostar plus) our group has treated 78 patients with biliary stones without analgesia or anesthesia. Total stone fragmentation was achieved in 85% of the cases. In patients with cholesterol gallstones who undergo lithotripsy, an adjuvant treatment with oral cholesterol solvent is mandatory. Extracorporeal biliary lithotripsy is free of mortality, and the morbidity is less than 5%.
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PMID:[Extracorporeal shockwave biliary lithotripsy. Physical basis and clinical application]. 227 Mar 72

More than 20 second-generation lithotriptors have been introduced for extracorporeal shock-wave lithotripsy. Despite great technical progress, each machine still has its specific short-comings. In cooperation, Storz Medical (Kreuzlingen, Switzerland) and the Department of Urology (Klinikum Mannheim, FRG), have developed a new lithotriptor designed to overcome these drawbacks. Energy source: Electromagnetic cylinder with paraboloid reflector (40 cm) for focusing, providing a wide range of pressure (190-1,000 bar) and a focal zone of 28 x 6 mm. The focal depth is maximally 15 cm. Coupling and positioning: Water cushion with patient lying on a specially designed 'acoustic cradle' consisting of an impedance-adapted foil. This is integrated in either a manually or automatically operated table. Localization: Coaxial ultrasound probe for real-time scanning and integrated C arm with pulsed fluoroscopy using a virtual focus (moved along x-axis) for stone localization. In 1989, we commenced with the first treatment based on our own in vitro and in vivo studies to determine the range of energy required for safe application. We treated 137 stones (100 caliceal, 19 pelvic and 18 ureteral) in 88 patients. The mean generator voltage was 16 kV (10-18 kV). Successful disintegration was achieved in 83 patients (95%) employing an average of 2,359 impulses (940-3,500). Thirteen percent of the treatments were performed without any anesthesia on lower generator voltage (10-15 kV), whereas the majority of calculi were treated under intravenous analgesia. The 5 failure cases included 2 stones in a caliceal diverticulum. Moreover, 12 patients with biliary calculi (11 gallstones and 1 bile duct stone) were successfully treated; 1 of these cases required a second treatment session.
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PMID:Modulith SL 10/20--experimental introduction and first clinical experience with a new interdisciplinary lithotriptor. 228 15

In June 1988, the new type of the lithotripter MPL 9000 (Dornier), which was the first interdisciplinary lithotripter for treatment of urinary and biliary calculi, was installed at the Shakai Hoken Chukyo Hospital. MPL 9000 has some features which enable one to treat with low range of shock wave energy and without anesthesia due to the enlarged aperture of the ellipsoid (210 mm), and locate the stone by computerized two ultrasound probes (coaxial, lateral). Unlike HM-3, the water bath is not used: shock wave is shot through the water cushion. From June to November 1988, 35 patients suffering from 64 urinary calculi were treated. The majority represented caliceal (75%) and pelvic (17%) stones, whereas 5 calculi were treated in the upper and lower ureter. Twenty-four patients were treated in one session and 11 patients needed additional sessions. The given number of shock waves was between 1337 and 3050 per one session and averaged 2403 with low generator voltage (15-18 kv). Twenty sessions (42%) were given without any medication and other 28 sessions (58%) were under analgesia (Pentazocine, i.v.) for the pain complained during the treatment. The rate of successful disintegration (less than 5 mm) was 88%. After the 1-month followup, 47.1% were free of stone, and 62.1% were free after the 3-month. Four patients had arrhythmia and one patient was with a subcapsular renal hematoma. We have concluded that this lithotripter is useful to treat upper and lower urinary tract calculi, in particular radiolucent ones in high risk patients because it is applicable without anesthesia.
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PMID:[Clinical experience with ESWL with new Dornier lithotripter MPL 9000]. 232 21

The demonstrated existence of opioid and nonopioid forms of pain control has raised questions as to how they interact. Previous indirect evidence suggests that activation of one system inhibited the activation of the other. The present study assessed this directly using morphine as an opiate form of analgesia and continuous cold-water swims (CCWS, 4 degrees C, 2 min) as the nonopioid form. A significant reduction in morphine (8 mg/kg, SC) analgesia on the tail-flick test was observed if rats were acutely exposed to CCWS immediately prior to morphine administration. The inability of naloxone (10 mg/kg, SC) to reduce CCWS analgesia verified its nonopioid nature. The antagonism of morphine (3 mg/kg, SC) analgesia was greater following preexposure to 2 min of CCWS than 1 min of CCWS. CCWS was also more effective in antagonizing analgesia induced by the 3 mg/kg than the 8 mg/kg dose of morphine. The antagonism of morphine analgesia by CCWS was dependent upon the temporal patterning of stimulus presentation: exposure to CCWS 20 or 60 min prior to morphine failed to alter subsequent morphine analgesia. A significant reduction in analgesia induced by intraperitoneal administration of morphine (10 mg/kg) was also observed when CCWS was presented immediately prior to injection, suggesting that pharmacokinetic factors such as altered drug absorbance by CCWS-induced vasoconstriction do not appear to explain these effects. These data provide direct support for the existence of collateral inhibitory mechanisms activated by CCWS and morphine, and suggests that these opioid and nonopioid forms of analgesia do not function synergistically, but instead involve some form of hierarchical order.
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PMID:Antagonism of morphine analgesia by nonopioid cold-water swim analgesia: direct evidence for collateral inhibition. 232 40

Eight adult female cattle (6 Holstein, 1 Jersey, 1 Brown Swiss) were used to determine the antagonistic effects of tolazoline, and alpha 2-adrenoceptor antagonist, on xylazine-induced (via caudal epidural administration) depression of CNS, respiratory, and cardiovascular activity and rumen motility. A 2% solution of xylazine HCl was injected into the epidural space at the first coccygeal interspace, using a dosage of 0.05 mg/kg of body weight, diluted to a 5-ml volume with sterile water, and administered at a rate of approximately 1 ml/30 s. Eight minutes after xylazine injection, either tolazoline (0.3 mg/kg) or saline solution (4 ml) was administered IV. All 8 cattle were treated, using both regimens in a random sequence; at least 1 week elapsed between treatments. Epidurally administered xylazine induced caudal analgesia (S3 to coccyx), as evaluated by no response to superficial and deep muscular pinprick, and induced sedation, cardiopulmonary depression, and inhibition of rumen motility, but all cattle remained standing. Tolazoline effectively reversed xylazine-induced rumen hypomotility, and partially antagonized xylazine-induced cardiopulmonary depression without affecting sedation and desirable local (S3 to coccyx) analgesic effects.
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PMID:Influence of tolazoline on caudal epidural administration of xylazine in cattle. 232 14

On six occasions spaced at least a week apart, two groups of rats were subjected to a variety of stressful conditions consisting of a restraint/bright light complex, either alone or in combination with a tail pinch, whole-body inversion, or partial immersion in cold water. One of these groups was injected with diazepam (2.0 mg/kg) 30 min prior to the stressors, while the other group experienced the drug in their home cages the following day. A third group also received the diazepam but was not exposed to the stressors. In three test sessions all animals were injected with either diazepam or saline and were then exposed to a novel stressor: a plus-maze used as a screening device for anxiolytic drugs. This was immediately followed by a tail-flick measure of analgesia. The longest tail-flick latencies, indicating stress-induced analgesia ("autoanalgesia"), were observed in the group that had not been exposed to stress prior to testing. The other two groups exhibited substantially shorter latencies but did not differ from one another, thus showing a "stress inoculation" effect that was uninfluenced by diazepam. In the plus-maze, diazepam tends to increase the amount of time rats will spend in the two exposed arms of the maze relative to the two enclosed arms. This effect was significantly attenuated in the group that had previously experienced the variety of stressors after a diazepam injection, suggesting a learned association between drug and stress that resulted in a diminution of the drug's anxiolytic property.
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PMID:Diazepam-stress interactions in the rat: effects on autoanalgesia and a plus-maze model of anxiety. 233 Dec 32

Recent research in this laboratory has identified a biological model in which morphine produced a hyperalgesic response to a noxious thermal stimulus. Morphine effects, however, were examined at only one injection-to-test interval (10 min). Because a single injection-to-test interval is relatively uninformative, the present research was designed to more fully characterize this morphine hyperalgesic effect. In Experiment 1, 15-day-old White Leghorn cockerels were placed on a hot plate (59 degrees C) in 10 min after injection of morphine (1.25, 2.5, 5.0, 10.0 mg/ml/kg) or the distilled water vehicle (1 ml/kg). Latency to perform a jump response or attainment of a 90-sec no-jump criterion were recorded. Experiment 2 examined morphine effects (2.5 mg/ml/kg) on hot plate jump latencies at various injection-to-test intervals (10, 30, 60, and 240 min). Morphine produced a dose-dependent hyperalgesic response. Temporal characteristics of morphine effects were evident as a U-shaped function. The dose and temporal characteristics of morphine-induced hyperalgesia in White Leghorn cockerels are similar to the dose and temporal characteristics of morphine-induced analgesia typically seen in other species.
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PMID:Dose and temporal parameters of morphine-induced hyperalgesia in domestic fowl. 233 51

The present study examined the effect of codeine, a centrally acting opiate, on the respiratory sensations elicited in normal subjects by breathing to exhaustion against externally applied inspiratory threshold loads. Subjects were tested on two separate days following the double-blind, randomized administration of either placebo or codeine (90 mg). The intensity of the sensations of effort and discomfort experienced during two loaded breathing trials (a "high" load that was 73% of the maximum inspiratory pressure (MIP) and a "low" load that was 63% of the MIP) was evaluated using category (Borg) scores on each day of study. To verify that the dosage of codeine administered was sufficient to produce analgesia, we also determined the effect of this dosage on the time that subjects could tolerate immersion of one hand in ice water. Codeine altered neither the perceived effort nor the sense of discomfort associated with breathing against external loads and had no appreciable effect on the time to exhaustion during loaded breathing trials. This dose of codeine did, however, increase the time that ice water immersion could be tolerated and reduced the rate at which the sense of discomfort increased over time during ice water trials. These results indicate that, provided the pressure-time index of respiratory muscle contraction remains constant, analgesic doses of codeine alter neither the sensations elicited by loaded breathing nor the total time that breathing against a fatiguing inspiratory load can be tolerated.
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PMID:Effect of codeine on the sensations elicited by loaded breathing. 235 94

A solution of 10% cocaine hydrochloride plus 10% water in 80% dimethyl sulfoxide (DMSO) or 5% tetracaine base in pure DMSO was topically applied to the eardrum in 112 and 52 cases respectively. Both preparations induced well-tolerated analgesia suitable for myringotomy with or without insertion of a grommet in the office environment. DMSO-tetracaine induced analgesia within ten, DMSO-cocaine within 30 minutes. This method has distinct advantages as compared to iontophoretically induced analgesia or topical agents with a destructive mode of action.
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PMID:[Topical anesthesia of the tympanic membrane using DMSO and local anesthetics]. 235 23

On the basis of two case histories, the most recent literature concerning hydrofluoric acid injuries is reviewed with particular attention to the pathogenesis and the therapeutic possibilities. It is concluded that washing with water is the primary and most important treatment. Depending upon the extent of the injury, surface treatment with 2.5% calcium gluconate solution or gel may then be employed and/or infiltration treatment with a 5-10% calcium solution. Possibly combined with local analgesia and hyaluronic acid. Intravenous or intra-arterial infusion of calcium compounds and surgical excision may be considered as specialist treatment.
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PMID:[Hydrofluoric acid injuries: pathogenesis and treatment]. 236 Feb 78


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