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

The effect of high-dose fentanyl on the cerebral vascular response to alterations in mean arterial blood pressure, arterial O2 tension (PaO2), and arterial CO2 tension (PaCO2) was studied in 28 mongrel dogs using the cerebral venous outflow technique. In 13 animals anesthetized with sodium pentobarbital (30 mg/kg, iv), bolus injection of fentanyl (25 micrograms/kg, iv) decreased mean arterial blood pressure (MABP) without a change in cerebral blood flow (CBF). In these animals, the response of the cerebral circulation to changes in PaO2, PaCO2, and MABP was determined before and after fentanyl administration. Fentanyl did not alter the increase in CBF caused by hypoxic hypoxia or hypercapnia. The lower and upper limit of cerebral autoregulation determined by hypovolemic hypotension and norepinephrine infusion, respectively, also were unaltered by fentanyl administration. The CBF response to alterations of MABP, PaO2, and PaCO2 were studied in another group of 15 dogs anesthetized with fentanyl (100 micrograms/kg) plus small doses (3-5 mg/kg) of pentobarbital. The CBF response to PaO2, and PaCO2 in these animals was not different from that observed in animals anesthetized with barbiturates only. The lower and upper limit of cerebral autoregulation also were not different from that observed in animals anesthetized with barbiturates only. These data suggest that fentanyl in doses sufficient to cause profound analgesia and anesthesia did not alter cerebral responsivity to changes in PaO2, and PaCO2, and MABP.
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PMID:Fentanyl and cerebral vascular responsivity in dogs. 642 Nov 99

The effects of atracurium on intraocular pressure (IOP) were compared with those of pancuronium in 20 patients less than 45 years-of-age requiring surgery for trauma of one eye. After a standard premedication and the application of topical analgesia to the upper airway, anaesthesia was induced with thiopentone i.v. and the trachea was intubated without the use of neuromuscular blockade. Following 20 min of steady state anaesthesia during which measurements of IOP, arterial pressure, heart rate, FIO2, FE'CO2 and CVP were recorded, one group of patients received atracurium 0.45 mg kg-1 and the other pancuronium 0.1 mg kg-1. The observations were repeated for a further 15 min before surgery commenced. Neither atracurium nor pancuronium produced any change in IOP. Atracurium was associated with greater cardiovascular stability than pancuronium.
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PMID:Effects of atracurium on intraocular pressure. 642 93

The effects of intrathecal (IT) administration of two doses of morphine (Group 1: 2 mg, n = 9; Group 2: 5 mg, n = 10) were studied in 19 patients after upper abdominal surgery. The ventilatory variables and occlusion pressure (P0.1) were recorded during room air breathing and during CO2 rebreathing tests prior to surgery, 24 h after surgery before IT morphine (n = 12), and 3, 5, 7, 11, and 24 h after injection. During room air breathing, minute ventilation (VE) did not change significantly in Group 1 and decreased significantly 3, 5, 7, and 11 h after injection in Group 2. During the rebreathing tests, there was a significant shift to the right of the ventilatory response to CO2 in both groups. The peak of the ventilatory depression was delayed, occurring 7 h and 11 h postinjection in Groups 1 and 2, respectively. Two patients in Group 2 developed clinically significant ventilatory depression. The shallow breathing observed after surgery was not changed after analgesia. In group 2, 5, mg IT morphine was responsible for a significant decrease in f60 (respiratory frequency for a PETCO2 of 60 mmHg). P0.1 increased markedly after surgery during both room air breathing and the rebreathing tests. After IT morphine, compared with the postoperative preanalgesic values, P0.1(60) (P0.1 at a PETCO2 of 60 mmHg) did not change in Group 1 and decreased significantly in Group 2. It is concluded that IT morphine is responsible for a ventilatory depression that is delayed and seems to be dose related and that analgesia does not abolish the shallow breathing observed after upper abdominal surgery.
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PMID:Respiratory effects of intrathecal morphine after upper abdominal surgery. 643 72

The ventilatory effects of tramadol (T) and nefopam (N) are evaluated in anesthetized patients with enflurane in a closed circuit breathing system and compared with the effects of pentazocine (P). The following parameters tidal volume (VT), minute ventilation (V), CO2 (capnometry) occlusion pressure (OP), ventilatory response to hypercarbia are recorded after 30 minutes of anaesthesia, before and after repeated injections of the analgesics, P: 15 mg, N: 40 mg, T: 100 mg are injected I.V., and analgesics administration is repeated at 30 minutes interval, so that the patients receive a total P dose of 30 mg, a total N dose of 60 mg and a total T dose of 200 mg. The administration of 15 mg of P induces a change in VT (-24%), ventilatory frequency (-40%), OP (-18) OP only returns to basal values after a second dose. The ventilatory response to hypercarbie is indeed satisfying (increase of 61% in V). After N and T, ventilatory frequency is not disturbed. V increases of 16% and 11% respectively after the first injection, and of 31% and 2% after the second injection. OP increases by 39% and 56% respectively after the first injection and gets better over time with nefopam (+ 58%), 30 mg of P. 20 mg of N and 100 mg of T are equivalent for analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Choice of a central analgesic for anesthesia with spontaneous respiration]. 652 78

The influence of caudal analgesia on pulmonary ventilation and gas exchange was studied in 26 children during halothane anaesthesia with spontaneous breathing. Two groups of children were studied with 13 patients in each group. One group received caudal analgesia. The other group had no caudal blocks. All children were subjected to lower abdominal and genital surgical procedures. Minute ventilation and respiratory rates were significantly lower in the caudal group than in the non-caudal group. Wastea minute ventilation and VD/VT ratios were increased in the non-caudal group. The end tidal carbon dioxide concentration was unchanged in both groups. The lower minute ventilation in the caudal group eliminated the same amount or even greater amounts of CO2 per minute indicating an improved gas distribution at slow respiratory rates. The improved ventilation efficiency and the excellent immediate postoperative pain relief achieved by caudal analgesia justifies its frequent use for these operative surgical procedures.
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PMID:Caudal analgesia in children. Influence on ventilatory efficiency during halothane anaesthesia. 654 87

An i.v. infusion regimen was developed to permit rapid attainment of steady-state blood pethidine concentrations (Cpss). In 10 adult volunteers (12 studies) the relationship of pethidine Cpss to the ventilatory effects of the drug were examined. Mean pethidine Cpss ranged from 170 to 320 ng ml-1, with a median Cpss of 480 ng ml-1. Increased end-tidal (PE'CO2) and mixed venous (PVCO2) and decreased slope (delta VI/delta PCO2) and position (ISO-VI) of the carbon dioxide response were all significant (P less than 0.001) for Cpss (1) less than or equal to 480 and (2) greater than 480 ng ml-1. The averaged changes in PE'CO2, PVCO2, delta VI/delta PCO2, and ISO-VI expressed as a per cent of respective control variables, were shown to be linear functions of Cpss. It is concluded that, under conditions of Cpss, significant ventilatory depression occurs at blood pethidine concentrations less than those required for analgesia. The possible significance of these findings in volunteers is discussed in terms of this application to the clinical setting of postoperative pain and its management after general anaesthesia.
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PMID:Relationship of ventilatory depression to steady-state blood pethidine concentrations. 678 54

The authors measured the minute inspired ventilation (VI) and airway occlusion pressure (P 100) responses to CO2 during rebreathing in ten patients who were given epidural morphine for analgesia following lower extremity or lower abdominal surgery. All patients were studied and blood samples for morphine analysis were obtained at four different times: preoperatively, postoperatively premorphine, and one and six hours after a single 10-mg epidural dose of preservative-free morphine in 10 ml of saline. All patients reported effective analgesia with a duration ranging from 8-25.5 h. There were no differences between the pre- and postoperative VI vs. PCO2 and P100 vs. PCO2 response slopes, indicating that the epidural local anesthetic alone had no effect on respiratory drive. Administration of 10 mg morphine epidurally caused a significant 22 per cent decrease in the average VI vs. PCO2 slope and a 33 per cent decrease in the average P100 vs. PCO2 slope one hour postmorphine when compared to the postoperative slopes. The average decrease in VI vs. PCO2 at 6 h postmorphine was not significant. The average P100 vs. PCO2 response slope was decreased significantly at 6 h postmorphine by 27 per cent. There was no significant correlation between serum morphine concentration and the ventilatory responses. The authors conclude that morphine administered by the epidural route produces decreased respiratory drive and that there is a high degree of individual variability in the magnitude and time course of this effect.
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PMID:Epidural morphine following epidural local anesthesia: effect on ventilatory and airway occlusion pressure responses to CO2. 679 85

To compare the respiratory depressant and analgesic effects of nalbuphine and morphine, six healthy male subjects were given the drugs as single 0.15-mg/kg doses, and as four successive doses of 0.15 mg/kg. Respiratory depression was monitored by ventilatory and mouth occlusion pressure responses during CO2 rebreathing, while analgesia to experimental pain was tested with the submaximal effort tourniquet ischemia test. When given as single 0.15 mg/kg doses, both drugs significantly increases the threshold and tolerance for experimental pain. The analgesic effect was similar for both drugs at this dosage, as was depression of the ventilatory and occlusion pressure responses to CO2. Morphine administered in multiple doses progressively increased pain tolerance from 30 +/- 13% above control with the first dose of 0.15 mg/kg to 107 +/- 13% above control after the fourth dose (cumulative total 0.60 mg/kg). Nalbuphine produced a 40 +/- 12% increase in pain tolerance with an initial dose of 0.15 mg/kg, but additional increments of nalbuphine did not result in significantly greater analgesia. The increasing morphine dosage was associated with progressive rightward displacements and ultimately decreases in the slope of the CO2 response curves. Nalbuphine produced an initial rightward displacement of the CO2 response curves similar to morphine, but continued administration of the drug did not result in further displacement or changes in slope. These findings demonstrate that nalbuphine, in contrast to morphine, exhibits a ceiling effect for respiratory depression which is paralleled by its limited analgesic effect on experimental pain.
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PMID:Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. 681 1

Ventilatory responses to CO2 or hypoxia were examined in rabbits during acupuncture anesthesia and compared with responses during pentobarbital anesthesia. The responses during pentobarbital anesthesia were significantly less than those during acupuncture anesthesia. The results showed that acupuncture analgesia was effective during performance of these experiments.
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PMID:Ventilatory responses to carbon dioxide and hypoxia during acupuncture anesthesia in rabbits. 682 Aug 71

The effects of epinephrine 1/200,000 as an adjuvant to epidural morphine were investigated in three healthy male volunteers, during 26-h observation sessions. Peak blood concentrations of morphine were 44 +/- 12.9 ng/ml after plain morphine and 13.7 +/- 6.7 ng/ml after epinephrine-morphine. Cutaneous hypalgesia was more intense, faster in onset, and longer in duration after epinephrine-morphine than after plain morphine, and analgesia to ice-water immersion of extremities lasted longer. Adverse side effects of pruritus, nausea, vomiting, and difficulty of micturition were also more intense after epinephrine-morphine, and respiratory sensitivity to CO2 was depressed more severely between 6 and 16 h. The results indicated that epinephrine 1/200,000 reduces vascular absorption of epidural morphine and intensifies all the manifestations of cord and brainstem uptake.
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PMID:Influence of epinephrine as an adjuvant to epidural morphine. 682 60


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