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

In a controlled randomized study, 21 patients who received a combination of ketamine and flunitrazepam with relaxation and N2O/O2-ventilation were compared with 20 patients who received neuroleptic analgesia (NLA) for intra-abdominal surgery. The two groups of patients were comparable with respect to age, sex, type of surgery, time of operation and coexistent diseases. The dosage of ketamine chosen was a total of 0.92 mg/kg per hour. For maintenance of anaesthesia, only 0.5 mg/kg per hour was used. In combination with 0.7-1.0 mg flunitrazepam and N2O/O2 ventilation, this low dose of ketamine was satisfactory. Electroencephalographic and electromyographic recordings demonstrated and adequate level of anaesthesia. The determination of serum free fatty acid levels showed a well-balanced in stress. Occasional elevations of blood pressure--which also were seen in the NLA-group--were not overcome by increasing the ketamine dosage. A brief addition of enflurane or isoflurane was more effective. The immediate postoperative onset of spontaneous respiration without complications and with normal CO2 levels was remarkable. The method was well accepted by the anaesthetist responsible and the nursing personnel.
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PMID:[Ketamine/flunitrazepam--an alternative intravenous anesthesia]. 353 37

In a retrospective study clinical experience with epidural Bupivacaine 0.75% for laparoscopy is presented; the main interest of the study is focused on the relaxation of the abdominal wall musculature as expressed by compliance: volume of CO2-insufflation/pressure. Data of 55 patients were collected (= Group A) divided into 3 subgroups according to dosage: subgroup I = 15.0 ml = 112.5 mg (n = 12), II = 17.5 ml = 131.25 mg (n = 16), III = 20.0 ml = 150.0 mg (n = 27). These 55 patients are compared with two other groups of patients: group B = epidural anaesthesia with etidocaine 1.5% (n = 14) and group C = general anaesthesia with pancuronium as muscle relaxant 0.08 mg/kg (n = 7). Within group A the 3 subgroups do not show much difference except for one significant difference (p less than 0.05): between subgroup I and III concerning the upper limits of analgesia (1.5 segments: T 7 vs T 5/6), in the lowest dose-group the patients having the lowest weight (p less than 0.05). There was interdependence only with respect to two items: spread of analgesia (upper limit) depending on total dose (p less than 0.01) and on age (p less than 0.05), as well as dose/segment depending on age (p less than 0.01); despite statistical significance the correlation was rather weak.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Epidural anesthesia with bupivacaine 0.75% for pelviscopic intervention. Clinical results of a 6-month study]. 357 12

The effect of epidural capsaicin injections on the thermal nociceptive threshold of unrestrained freely moving adult rats was examined. Capsaicin solution (1% 0.05 ml, 0.1 ml) was injected in a single dose or in two consecutive doses through an indwelling lumbar epidural catheter. Effects were compared with 1 ml 1% capsaicin injected intraperitoneally. Twelve rats served as sham-treated and vehicle controls. Nociceptive thermal stimuli were brief pulses of CO2 laser radiation directed at three body areas, hind limb, forelimb, and pinna. Capsaicin caused prolonged, segmental thermal analgesia. Maximal nociceptive threshold values in the hind limbs, attained within 24 h of epidural injection, were 2.5 (P less than or equal to 0.006) and 5.3 (P less than or equal to 0.0005) time control values for the 0.05-ml and 0.1-ml doses, respectively. Response thresholds in the forelimbs and pinna were unaffected. Two-stage epidural injection of capsaicin led to a roughly twofold elevation of threshold, as well as prolongation of the analgesia to about 14 days. Intraperitoneal injection of capsaicin resulted in elevation of nociceptive threshold which included all body areas tested. These results indicate that epidural application of capsaicin at the lumbar spinal level produced a profound and long-lasting segmental analgesia.
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PMID:Epidural capsaicin produces prolonged segmental analgesia in the rat. 358 61

The safety and effectiveness of continuous epidural fentanyl analgesia (CEFA) in the treatment of blunt chest injury was evaluated by reviewing its use in 40 patients with multiple rib fractures or flail chest. Ventilatory function tests were performed before and after the institution of CEFA and mean changes calculated. The use of CEFA was associated with significant improvement in vital capacity and maximum inspiratory pressure (p less than 0.05). Minute ventilatory volumes and tidal volumes also showed slight improvement. There was no significant change in arterial CO2 tension with the institution of CEFA, and 85% of patients had good pain relief with CEFA. None of these patients required any other narcotic administration. Documented complications associated with CEFA included pruritus, urinary retention, and transient hypotension. There were no major associated complications. The results suggest that CEFA is a safe, effective method of pain control that acts to improve ventilatory function in patients with blunt chest trauma.
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PMID:Continuous epidural fentanyl analgesia: ventilatory function improvement with routine use in treatment of blunt chest injury. 368 33

This is a comparative study of conventional surgery (knife/electric knife) and CO2 laser surgery and their effect on the outcome of stage III (including muscle) and stage IV (including bone) decubitus ulcers with an average area of 400 cm2. It is a prospective clinical study done with two groups of patients of similar age, economic and social background, as well with similar types of decubitus ulcers. Thirty patients were studied in each group. The study demonstrated a statistically significant difference in favor of the patients treated with CO2 laser with regard to operative blood loss, 0.5 cc/cm2 or 20% (P less than .01), infection rate (chi 2 test, P less than .01), and difference (60%) in recovery time (P less than .01). This translated into an average saving of 23 hospitalization days per patient. It also showed a difference, though not statistically significant, favoring the group treated with laser with respect to survival and full recovery. This probably is attributable to the lowered blood loss and infection rate as well as improved operative time and analgesia.
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PMID:CO2 laser in decubitus ulcers: a comparative study. 368 61

We determined the effects of ether, intra-arterial Na+ pentobarbital (SP) and decapitation on arterial [H+] and labile metabolites in plantaris, diaphragm and intercostal muscles of rats at rest and following exhaustive treadmill exercise. 30-60 sec post-analgesia arterial [Lactate] ([LA]a) increased with both anesthetics. SP rats retained CO2 resulting in mixed acidosis, while ether anesthetized rats hyperventilated and maintained pH. During recovery from exercise ether anesthesia had no effect but SP anesthesia caused CO2 retention. Decapitation of resting rats markedly decreased [CP] and elevated [LA] and [G6P] in all three muscles, thereby negating any subsequent exercise effects. The effects of ether differed from those of SP in that with ether anesthesia: [CP]/[Total Creatine] fell and [LA] rose significantly with exercise; resting [LA] was lower and increased with exercise; and metabolite variability was less with ether than with SP. We conclude that: anesthesia obscured the true effects of exercise on acid-base status by increasing [LA]a in the resting state; decapitation is unsuitable for the study of exercise effects on most muscle metabolites; ether anesthesia is most suitable for use in studies aimed at detecting exercise effects on muscle metabolites and for preserving arterial acid-base status closest to the unanesthetized state.
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PMID:Anesthetic effects on [H+]a and muscle metabolites at rest and following exercise. 374 42

In a randomized, double-blind study with placebo, ketamine was used as an analgesic during ventilator treatment in the period of recovery after major abdominal surgery. Forty patients were orally intubated and ventilated by means of a volume-controlled ventilator. Twenty of them received an i.v. bolus of 30 mg of ketamine followed by an 8-h infusion of 1 mg per minute. End-tidal CO2-concentration was continuously monitored and ventilation was adjusted to metabolic demands prior to assessment of pain. If pain relief was not adequate, the infusion rate was doubled, and if this was still not sufficient, 5 mg injections of ketobemidone were given i.v. If the orotracheal tube was not tolerated, the internal branch of the superior laryngeal nerve was blocked. A total of 30 injections of ketobemidone were administered to 13 control patients, but only five were given to four ketamine patients. Ten control and three ketamine patients required an internal laryngeal nerve block. Dreams and hallucinations were recalled in three patients in the control group and five in the ketamine group. Only one control and two ketamine patients experienced these as unpleasant. In this investigation, ketamine infusion in a low dose appeared to offer satisfactory analgesia and to permit tolerance of the orotracheal tube.
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PMID:Low-dose ketamine infusion for analgesia during postoperative ventilator treatment. 381 14

A case of delayed respiratory depression following an intrathecal injection of hyperbaric morphine hydrochloride is reported. This injection was made during a lumbar myelography in a 60 year old patient suffering from metastatic epiduritis unrelieved by oral or parenteral drugs. The differences in densities between the CSF, hyperbaric opiate solution and contrast medium explain the migration of the morphine hydrochloride from the lumbar thecal space to the basal cisternae, giving a fall in the responsiveness to CO2 of the brain stem respiratory centres. Parenteral naloxone did not reverse this ventilatory depression. Only the myosis and the analgesia disappeared. After 16 h of various attempts of reversal by parenteral injections, an intrathecal injection of naloxone was tried. This small dose (0.1 mg), given intrathecally, resulted in a prompt return to normal of respiratory function.
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PMID:[Respiratory depression after intrathecal injection of morphine: value of in situ naloxone]. 384 Sep 64

In six children with body weights between 11.4-18.7 kg, minute ventilation, tidal volume, respiratory rate, end-tidal CO2 concentration and CO2 elimination were measured during both CO2 free breathing and CO2 breathing due to low fresh gas flows (maximal inspired CO2 about 2%) or the addition of CO2 from Rotameters (mean inspired CO2 about 1.5%) during both halothane and enflurane anaesthesia. All patients were undergoing hypospadias repair, received caudal analgesia prior to surgery and were intubated and allowed to breathe halothane/enflurane in O2/N2O (FIO2 0.5) spontaneously through a modified T-piece system (Mapleson F). End-tidal CO2 concentrations were similar with both agents during CO2-free breathing and did not increase during CO2 breathing because of increased minute ventilation, of the same magnitude with both agents, which was achieved by larger tidal volumes. Respiratory rates were unchanged. No differences were found between halothane and enflurane at the light levels of general anaesthesia made possible by combination with caudal block.
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PMID:Ventilatory response during halothane and enflurane anaesthesia. 391 76

Lidocaine CO2, used for anaesthesia in 26 gynaecological and urological patients, was injected into the epidural space at two temperatures -20 degrees C and 36 degrees C. We found that the higher temperature resulted in a faster onset of blockade, a longer duration of action, and a greater degree of motor blockade. We found, also, with the warmed solution a higher spread of analgesia, which could enable a reduction to be made in the volume necessary for satisfactory anaesthesia.
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PMID:[Temperature-dependent effects of lidocaine-CO2 in peridural anesthesia]. 391 29


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