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)

An ideal analgesic for patients after craniotomy should neither cause respiratory depression, nor affect intracranial pressure (ICP) and cerebral perfusion pressure (CPP). The aim of the study was to evaluate the effect of Tramadol (T) on ICP and CPP, as well as to determine its analgetic efficacy in patients (pts) after craniotomy. Thirty five pts aged 16 divided by 78 years (mean 46) entered the study. Twelve had GCS (Glasgow Coma Scale) scores < or = 8 and 23 pts had scores > or = 12. Fourteen pts were mechanically ventilated and 21 pts were breathing spontaneously (BS). Tramadol was injected i.v. at a dose of 0.75 mg/kg over 3 minutes in 11 pts (Group 1), 1.0 mg/kg over 5 minutes in 13 pts (Group 2) and 1.0 mg/kg over 10 minutes in 11 pts (Group 3) PaCO2 was measured before T in all pts and at 8 minute after injection in 21 BS pts. Heart rate (HR), mean arterial blood pressure (MBP), ICP, CPP and respiratory frequency (f) were registered before and in the 1st, 3rd, 8th, and 15th minute after T. Analgetic effect was evaluated in 22 conscious pts by comparing the pain intensity before and 30 minutes after T using a five-point verbal response scale. Mean control ICP was 17 mmHg. ICP over 15 mmHg was diagnosed in 15 pts (mean ICP equal 26 mmHg). Mean CPP for all 35 pts was 85 mmHg. There were no statistically significant changes in HR, MBP, ICP, and CPP after T in any particular group, nor were there changes in ICP in subgroups with normal and elevated ICP. No significant changes in PaCO2 and f were found in BS pts. Satisfactory analgesia was obtained in 50% of pts of Group 1, and in 88% of pts of Groups 2 and 3. We conclude that tramadol in doses of 0.75 mg/kg and 1.0 mg/kg i.v. does not affect ICP and CPP in adult postcraniotomy patients and seems to be a safe and effective analgesic at a dose of 1.0 mg/kg for postcraniotomy pain control.
Neurol Neurochir Pol 2000
PMID:Tramadol for postoperative analgesia in intracranial surgery. Its effect on ICP and CPP. 1145 59

The aim of the present research was to assess in experimental and clinical study the influence of doxepin administered intraperitoneally (ip) as preemptive analgesia on the nociception in the perioperative period. The pain thresholds for mechanical stimuli were measured in rats. The objective of clinical investigation was to assess the influence of preemptive administration of doxepin on postoperative pain intensity, analgesic requirement in the early postoperative period as well as an assessment of the quality of postoperative analgesia by the patient. Doxepin injected ip (3-30 mg/kg) dose-dependently increased the pain threshold for mechanical stimuli measured in paw pressure test in rats. Doxepin injected 30 min before formalin significantly increased the nociceptive threshold in the paw pressure test. In contrast, doxepin injected 240 min before formalin or 10 min after formalin did not change the nociceptive threshold. Morphine administered subcutaneously (sc) at a dose of 1 mg/kg increased the pain threshold measured in the paw pressure test 55 min after formalin treatment. Injection of 10 mg/kg of doxepin 30 min before formalin further enhanced the response after morphine administration. The results of the clinical study demonstrated that the patients who were administered doxepin preemptively showed significantly lower pethidine requirement in order to achieve a similar level of postoperative analgesia. The results of the research under discussion confirm the theoretical assumptions that there is a possibility to modify the nociception process in the perioperative period through preemptive analgesia using a drug that modifies the activity of the descending antinociceptive system.
Pol J Pharmacol
PMID:Influence of doxepin used in preemptive analgesia on the nociception in the perioperative period. Experimental and clinical study. 1178 26

The appropriate esters 1-3 were synthesized by the alkylation of unsubstituted pyrimidin-8-on[2,1-f]theophylline I with ethyl-chloroacetate, ethyl-acrylate and ethyl-4-bromobutyrate. The acids 4-6 were obtained by hydrolysis of the esters 1-3, and transformed into Na salts 4a-6a. Amidation of the ester 1 with 25% ammonia and hydroxylamine led to amide 7 and N-hydroxyamide 8. The bromination of 1 gave 7-bromo intermediate 9 transformed to the 7-amino derivatives via nucleophilic substitution with phenylpiperazine for compound 10 and morpholine for compound 11. In the reaction of 9, 10 and 11 with sodium alcoholate, the corresponding Na salts 12a-14a were obtained. The pharmacological properties of the compounds were tested in CNS activity screening. It was found that all of the investigated compounds produced significant sedative effects in behavioral tests except weak activity of pyrimido[2,1-f]theophylline-9-sodium acetate 4a. The potent activity of pyrimido[2,1-f]theophylline-9-sodium butyrate 6a, pyrimido[2,1-f]theophylline-9-acetamide-7,7-N-phenylpiperazine-pyrimido[2,1-f]theophylline-9-sodium acetate 13a, and 7-N-morpholine-pyrimido[2,1-f]theophylline-9-sodium acetate 14a was observed. They inhibited spontaneous locomotor activity, potentiated sedation and prolonged duration of sleeping time after thiopental sodium administration. All compounds had no effects in the test of analgesia and they showed weak anti-convulsant properties. The results of this investigation may suggest hypnotic, sedative and/or tranquillizing properties of the tested compounds.
Pol J Pharmacol
PMID:Central nervous system activity of new pyrimidine-8-on[2,1-f]theophylline-9-alkylcarboxylic acids derivatives. 1239 56

Obstetric analgesia and anesthesia should provide optimal pain relief for the parturient with minimal risks. The local anesthetic agents are most commonly used for obstetric analgesia and anesthesia. We investigated the effect of local anesthetic agents: prilocaine, bupivacaine, ultracaine on myometrium in pregnant rats. In our study, we evaluated the effects of three local anesthetics at cumulative concentrations on contractions of myometrium isolated from pregnant rats. The following characteristics of the contractions were analyzed after the addition of drugs: frequency, mean duration, amplitude of each contractions and integrated area under the contraction curve. We observed that the exposure to prilocaine, bupivacaine and ultracaine decreased amplitude, duration and integrated area under the contraction curve. In conclusion, the study drugs at higher concentrations decreased contractions of myometrium, but all drugs at higher concentrations elevated the frequency.
Pol J Pharmacol
PMID:Effects of local anesthetics on pregnant uterine muscles. 1285 26

The aim of this study was to assess the influence of iv tramadol on opioid requirement in the early postoperative period. The subjects were 90 patients scheduled for colon surgery (hemicolectomy) who received general anesthesia using the (N2O/O2) isoflurane technique. Thirty patients (group I) were administered 100 mg of tramadol iv before induction of general anesthesia (preemptive analgesia). Group II (30 patients) was administered 100 mg of tramadol iv immediately after peritoneal closure (preventive analgesia) and control group (30 patients) received 100 mg of tramadol iv immediately after operation. Following the operation, all patients were administered tramadol in the PCA-iv mode in order to treat postoperative pain. In the postoperative period, the following parameters were measured: pain intensity (using VAS), total consumption of tramadol, time until the first PCA activation, and frequency of side effects (drowsiness, nausea, vomiting). In patients of groups I and II who had received preemptive or preventive analgesia, a significantly lower total consumption of tramadol, as compared with control group, was observed in the early postoperative period. However, the time until the first PCA activation was significantly shorter in group I as compared to the other two groups. No significant differences between the groups were found regarding pain intensity and frequency of side effects.
Pol J Pharmacol
PMID:Influence of pre- or intraoperational use of tramadol (preemptive or preventive analgesia) on tramadol requirement in the early postoperative period. 1286 26

Prednisolone is an analgesic and anti-inflammatory drug. It possesses poor aqueous solubility and has irritant effects on stomach mucosa. In order to modulate its gastric side effect and increase aqueous solubility, physical mixture and solid dispersion of prednisolone were prepared with skimmed milk. In this study, anti-inflammatory and analgesic effects of these formulations were investigated in comparison to the plain drug itself employing hind paw edema test and Randall's analgesia test. Based on the data, it was determined that the drug maintained its pharmacological activity even after formulating in the form of physical mixture and solid dispersion.
Pol J Pharmacol
PMID:Investigations of anti-inflammatory and analgesic activities of prednisolone solid dispersion prepared with skimmed milk. 1292 57

The examination was carried out in 60 men at the age of 56 to 78 (mean age 65.3 years) treated by suturing of vascular prosthesis due to aneurysm of abdominal part of aorta, in which postoperative analgesia was done with the use of bupivacaine with opioids administered extradurally. Patients were divided into two groups consisting of 30 individuals each. In group I, patients were given 0.25% bupivacaine with phentanyl, while in group II--bupivacaine appropriate for the need of the patient. Postoperative analgesia, in particular stages was complete in 75% of patients of group II and 63% of group I at twenty-four hour long maintenance of the initial dose of analgesics. Twenty-four hour long dose of bupivacaine to 210+/-20.5 mg in group I and 145+/-11.5 mg, while morphine 5.1+/-1.2 mg. Fluctuation of the chosen haemodynamic and gasometric parameters were of no clinical importance. 7 patients suffered from nausea and vomiting, these patients included 2 patients from group I and in 5 patients from group II. On this basis of results, one may confirm that both methods of analgesia are equally effective, although it was possible to reduce the twenty-four hour long dose of bupivacaine, thus limiting the risk of depressive effect on heart muscle.
Pol Merkur Lekarski 2004 Jun
PMID:[Effectiveness of extrameningeally administered opioids in patients with aortic prosthesis]. 1551 Aug 86

There is no doubt, that local anesthesia for knee arthroscopic surgery is rather simple, reliable, well tolerated, cost-effective and safe procedure acceptable also for one-day-surgery and outpatients. Patient's acceptance and satisfaction are behind those measurable data and could be predicted only after the question if the patients would prefer intraarticular analgesia when they should need to have another arthroscopy performed. The aim of the investigation was to compare this prediction with real patients feeling. Comparison was made between the types of anesthesia (regional, intraarticular) used for knee surgery, twice the same knee and patient. The retrospective data (mean 9 months after the last surgery) showed higher patients satisfaction (93.5%) with local anesthesia if compare with regional (2.6%) and femoral nerve block (3.9%).
Chir Narzadow Ruchu Ortop Pol 2004
PMID:[Local or regional anesthesia in knee arthroscopic surgery--patients satisfaction]. 1552 5

Type and frequency of early postoperative complications were analyzed in a group of 226 patients (190 men and 36 women) at the age of 45 to 83 (mean age 65.3 +/- 8.2) who were operated as planned due to aneurysm of abdominal part of aorta. Patients were divided into two groups (I and II) depending on method of analgesia. Group I which constituted 173 patients operated at associated general and extrameningeal analgesia and group II constituted 53 patients operated at general analgesia. The division into groups was unintentional and was due to the fact that general analgesia was carried out in patients with contraindication of extrameningeal catheter use or technical troubles with its appliance. Patients of both groups were divided into groups (A and B) depending on type of complication or cause of death (A--cardiogenic, B--extracardiac). The followed up group is characterized by increased incidence in men than in women (5:1), the age of both sexes is not significantly different respectively men and women 65.5 and 65.2 years. In most cases, patients suffered from arterial hypertension (20.4%), ischaemic heart disease and myocardial infarction (21.2%) and chronic obstructive lung disease (12%). Early postoperative complications without lethal outcome occurred in 76 patients (33.6%), in 7.5% they included cardiogenic complications, while in 26% extracardiac complications, among which acute ischaemia of lower extremities (8.8%) and postoperative pulmonary complications (5.7%) were the most dominating. The observed group is characterized by relatively high postoperative mortality (9.3%). 4% of patients died due to cardiogenic reasons, while 5.3% of patients died due to extracardiac reasons. The most common cause of death in the last group was infection and embolism of mesentery (3.6%). Strong relation between preoperative loading, operation time, time of aorta occlusion, type of grafted prosthesis and frequency as well as type of postoperative complications was confirmed. The relationship was not confirmed with respect to the type of analgesia.
Pol Merkur Lekarski 2004 Jul
PMID:[Early postoperative complications in patients with aneurysm of the abdominal aorta treated with vascular prosthesis]. 1555 3

The aim of this study was to examine the effect of ketoprofen used in preemptive analgesia on the intensity of pain and requirement for analgesics in the perioperative period. Sixty patients scheduled for elective lumbar disc prolapse surgery were randomly divided into two groups. In the PRE group (n = 30) ketoprofen was administered one hour before incision. In the POST group ( n = 30) ketoprofen was used immediately after the surgery. The operation was performed under general anesthesia. Postoperative analgesia was realized by NCA (Nurse Controlled Analgesia) and the "required" dose of ketoprofen was 100 mg. After the operation, pain intensity was measured using visual-analog scale (VAS), ketoprofen requirements, the time to the first dose of ketoprofen, and levels of prostaglandin E(2) (PEG(2)) in blood serum were compared. There were no differences between the groups in the VAS pain scores, and levels of PGE(2) in blood serum. However, in patients of PRE group who had received preemptive analgesia, a significantly lower total consumption of ketoprofen, as compared with POST group, was observed between 12th and 36th postoperative hours. It was also found that the time which elapsed between the end of the operation and the first NCA activation was significantly shorter in the PRE group, as compared with the POST group. The results of our study confirm the possibility of modifying the nociception process in the perioperative period through preemptive analgesia by ketoprofen.
Pol J Pharmacol
PMID:Influence of pre-operative ketoprofen administration (preemptive analgesia) on analgesic requirement and the level of prostaglandins in the early postoperative period. 1559 42


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