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 induction of epidural analgesia with 0.5 per cent bupivacaine on maternal haemodynamics was investigated in 21 patients with uncomplicated full-term pregnancies in early labour. Stroke volume, heart rate, and cardiac output (SV, HR, and CO) were measured by transcutaneous aortovelography (TAV). Systolic, diastolic, and mean arterial blood pressures (SBP, DNP, and MAP) were measured by indirect automatic oscillometry. Measurements were made with the patient in the left lateral decubitus position before and after an intravenous bolus of 500 ml of lactated Ringer's solution preceding induction of epidural analgesia, and again 30 and 45 minutes after induction. The 500 ml bolus of lactated Ringer's solution did not prevent fall of CO and BP measured 30 minutes after induction, when there were statistically significant decreases in CO and cardiac index (-10.2 and -10.6 per cent, p less than 0.05), and in SBP, DBP, and MAP (-9.7, -12.5, and -11.9 per cent, p less than 0.005, p less than 0.005 and p less than 0.01 respectively). At 45 minutes after induction, CO and cardiac index had returned to baseline values. Although the decreases in SDP and DBP persisted, the change in MAP was not statistically significant.
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PMID:Haemodynamic effects of induction of epidural analgesia in labour. 334 53

In the present study, the authors compared sufentanil to fentanyl in pediatric patients undergoing congenital cardiac repair. The purpose of the study was to evaluate the hemodynamic variables, time of awakening and successful extubation of the two groups. A prospective, randomized study of 60 children scheduled for elective surgery of congenital cardiac defects was made. Patients were randomly divided into two groups: Group I; sufentanil and Group II; fentanyl (mean body weight, 16.02 +/- 6.67 kg; range 4 to 35 kg; mean age, 5.22 +/- 3.55 years; range 4 months to 1 year). All were premedicated with oral chloralhydrate 50 mg/kg, one hour preoperatively. Anesthesia was induced with sufentanil 1 microg/kg (Group I) or fentanyl 2 microg/kg (Group II) and thiopenthal 2 mg/kg, followed by atracurium 0.6 mg/kg. All patients were intubated with atracurium 0.6 mg/kg. Anesthesia was maintained using isoflurane in oxygen, nitrous oxide (in non-cyanotic patients). In Group I, sufentanil 0.5 microg/kg was administered intravenously prior to skin incision, median sternotomy, cardiopulmonary bypass (CPB) and after coming off CPB. In Group II, fentanyl 1 mg/kg was administered at the same time periods. Hemodynamic parameters, heart rate (HR), systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MAP), central venous pressure (CVP) were recorded. The administration of pain therapy was determined postoperatively. There was no statistical difference in the demographic data between the patients in the two groups. Following induction of anesthesia, the systolic, diastolic and mean arterial pressures and heart rate decreased. Following tracheal intubation, all hemodynamic parameters in the sufentanil group remained below the baseline values, while the fentanyl group showed an increase above baseline values. An increase above control values of all hemodynamic variables was detected in both groups following skin incision and sternotomy, except that the mean systolic blood pressure and heart rate in the sufentanil group was less than the baseline values. No differences in hemodynamic variables were detected between the two groups following median sternotomy and skin closure. There were significant differences in mean arterial pressure at the time of intubation and skin incision between the two groups. No significant changes in CVP occurred. There were no significant differences in the average time of awakening from anesthesia. The average time before postoperative tracheal extubation was 171.38 +/- 112.74 and 113.72 +/- 67.83 minutes in the sufentanil group and fentanyl group respectively, which was statistically significant. There was no difference in the requirements for morphine (pain relief) and sedation with chlolorahydrate between the groups. Bradycardia was found in 7 and 3 patients receiving sufentanil and fentanyl respectively which was not statistically significantly different. The bradycardia recovered in a few minutes, following intravenous injection of atropine. Slow injection of the anesthetic drugs can protect patients against serious bradycardia. In conclusion, the safety and efficacy of sufentanil in patients undergoing repair of complex congenital heart defects was the same as fentanyl. There were no significant differences in times of awakening in the two groups. The patients in sufentanyl group had a longer time to extubate than the fentanyl group. The need of postoperative sedation and analgesia was the same in both groups.
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PMID:Comparison of sufentanil and fentanyl for surgical repair of congenital cardiac defects. 1245 16

The objective of this study was to compare clinical and postoperative analgesic effects of femoral or psoas compartment blocks in patients undergoing arthroscopies. Fifty patients were randomly assigned to one of the two groups. Either femoral (group F) or psoas compartment (group P) block was applied followed by sciatic nerve block. All nerve blocks were provided with a 15 ml of bupivacaine 0.5% + 10 ml of lignocaine (lidocaine) 2%. Systolic and diastolic blood pressure (SBP and DBP), heart rate, and pulse oxymetry (SpO2) were recorded. Quality of anaesthesia, time to first analgesic use, verbal pain scores (VPS), sensorial and motor blockade resolution times and side effects were also recorded. Quality of anaesthesia, complete sensory blockade of obturator and lateral cutaneous nerves were higher in the group P than in group F. However, complete motor blockade findings were similar in both groups. In the group P, VPS values measured at 10 and 15 min were lower than that of group F. These values decreased at 10 min and thereafter as to baseline values. VPS values of the group F declined at 20 min and following measurement times as to baseline values. Durations of motor and sensorial block, and time to first analgesic use were similar between two groups. Total analgesic consumption at first 24 h in group P was lower than those of group F. Regarding heart rates, SpO2, SBP and DBP values, no significant differences were found between the groups. Combined psoas-sciatic technique provided more comfortable intraoperative anaesthesia and better postoperative analgesia when compared with femoral-sciatic technique for arthroscopic procedures.
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PMID:The comparison of two lower extremity block techniques combined with sciatic block: 3-in-1 femoral block vs. psoas compartment block. 1596 2

Increased blood pressure and sweet taste are often associated with decreased pain sensitivity. Animal research suggests that endogenous opioids are involved in both these relationships. Fifty-eight healthy young adults (36 male, 22 female) participated in two sessions receiving a placebo tablet or 50mg of naltrexone on counterbalanced days. On each day, three cold-pressor tests were administered while the participant held a sweet solution, water, or nothing in their mouth when their hand was in the water. 2 Drug x 3 Solution x 2 Gender x Pre-Drug Resting Blood Pressure general linear models (GLM) were conducted separately for systolic (SBP) and diastolic (DBP) pressure. Consistent with previous research, significant main effects of SBP were observed in GLMs of pain tolerance and pain unpleasantness ratings. A main effect of solution on tolerance was seen in the GLM with DBP, which was qualified by an interaction of solution by blood pressure. Sweet taste increased pain tolerance among those with lower DBP across drug conditions. This suggests some overlap between mechanisms of sweet taste and blood pressure analgesia, without implicating opioid activity in sweet taste analgesia. However, the GLM of tolerance also produced a significant drug by DBP interaction suggesting that blood pressure-related analgesia is at least partially opioid-mediated. Also participants with higher DBP showed dampened mood reactivity to the experiment, which was partially reversible by naltrexone. These results are consistent with findings suggesting that endogenous opioid activity may contribute to generally reduced pain sensitivity, and perhaps mood reactivity, in those with higher BP.
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PMID:Effects of opioid blockade on the modulation of pain and mood by sweet taste and blood pressure in young adults. 1756 Jul 20

Objective of the study was to compare the effect of the drugs, intraoperative hemodynamic variables (heart rate, blood pressure) and associated complications (hypotension, nausea, shivering etc) between the bupivacaine and lignocaine group, when administered intrathecally in patients undergoing caesarean section. This is a randomized prospective study where the haemodynamic changes and the complications following sub arachnoid block either with 5.0% lignocaine or with 0.5% bupivacaine in 52 patients undergoing caeserian section were compared. The patients were randomly divided in two groups, group X (lignocaine group, n=26) or group B (bupivacaine group, n=26), either to receive 5.0% lignocaine 75 mg or 0.5% bupivacaine 12.5 mg. Intraoperatively heart rate, blood pressure (systolic (SBP), diastolic (DBP) and mean (MAP)), oxygen saturation were monitored. Any rescue drugs e.g. mephentermine, crystalloid 200 ml bolus, pethidine, diazepam etc given were noted with the dose and time. Urine output and total amount of fluid given was noted at the end of the surgery. Oxytocin 10 U in infusion was given after the baby was delivered in all the cases. Intraoperative blood pressures, total amount of fluid given, rescue vasopressor (mephentermine) given were compared in both the groups. Groups were also compared with respect to the patients' age, height of sensory block, motor block, duration of surgery, Apgar score and weight of the baby and duration of postoperative analgesia. It was concluded that the drugs were similar with respect to their sensory and motor effects, intraoperative hemodynamic changes like hypotension and bradycardia, and other complications like shivering and can be used interchangeably as spinal anesthetic agent for caesarean section deliveries.
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PMID:Spinal anesthesia for cesarean section: comparison of 5.0% lignocaine and 0.5% bupivacaine. 2067 6

Noxious stimuli during craniotomy may encourage hypertension and tachycardia, which may rise to morbidity in patients with intracranial hypertension. After craniotomy a moderate level of postoperative pain observed. The objective of this study was to observe the effect of intravenous paracetamol with bupivacaine scalp nerve block (SNB) on haemodynamics response as well as anaesthetic & analgesic requirements during supratentorial craniotomies. This is a single-blind, placebo-controlled, randomized clinical trial carried out in the Neurosurgery operation theatre from August 2015 to July 2017 under supervision of Department of Anaesthesia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total of 40 patients aged 18-60 years with supratentorial space occupying lesion undergoing craniotomy under general anaesthesia who were attended in the department of Neurosurgery, BSMMU were enrolled in this study and they were divided randomly into two groups, 20 patients in each. The Group A received 100ml normal saline infusion and 0.25% bupivacaine (20ml) in scalp block, while the Group B received intravenous injection paracetamol (1gm) and 0.25% bupivacaine (total 20ml) in scalp block. Statistical analyses were obtained Statistical Packages for Social Sciences (SPSS-22). The mean systolic blood pressure varied within the normal range in both groups. The mean DBP of Group B remained significantly lower than that of Group A in different follow up except at 30 minutes and 60 minutes after dura incision. However, mean MAP of Group B remained significantly lower than that of Group A in different time interval. The mean heart rate of Group B remained significantly lower than that of Group A. The mean intraoperative propofol as well as fentanyl requirements were significantly decreased in Group B in comparison to Group A. The combination of intravenous paracetamol with bupivacaine scalp nerve block provides better intra-operative haemodynamic stability and neurosurgical compliances for the patients undergoing supratentorial craniotomies under general anaesthesia.
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PMID:Effect of Intravenous Paracetamol with Bupivacaine Scalp Nerve Block on Haemodynamics Response as Well as Anaesthetic Requirements during Supratentorial Craniotomies. 3250 88