Der Schmerz
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alpha(2)-Adrenozeptoragonisten agonists have shown antinociceptive and analgesic effects, which are not antagonized by naloxone. Therefore, the mechanism of action should be independent of opioid receptors. Most studies on this topic have been performed using clonidine. Experimentally the analgesic effect of clonidine can be suppressed by the inhibition of central adrenergic receptors. Furthermore, clonidine has analgesic effects at the spinal level. During recent years numerous studies have shown the analgesic effect of spinally or epidurally administered clonidine in humans. However, only very few studies have investigated the analgesic effect of parenterally administered clonidine in humans. ⋯ In our study the analgesic effect of 150 mug clonidine i.v. was equivalent to that of 5 mg morphine i.v. and 50 mg tramadol. Our results in humans confirm the dosage relationship of 1ratio30 found by Eisenach in sheep. Further studies on the use of parenteral clonidine for postoperative analgesia seem to be warranted.
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In 60 women undergoing vaginal hysterectomy, a total of 420 pain evaluations of postoperative pain intensity were performed by an observer and the patients. Pain intensity was rated by the observer on a visual analogue scale. The patients themselves evaluated their pain on a visual analogue scale and on a 101-point numerical rating scale. ⋯ The correlation between patients' self-assessments and observers' ratings was poor (r (2)=0.28;y=0.66x+31.3). There was also no clear correlation between pain intensity and heart rate or arterial blood pressure. A reliable assessment of pain intensity can only be performed by patients' self-assessment and not by observers' ratings.
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In the Federal Republic of Germany, strict regulations complicate the prescription of strong opioids to patients suffering from severe pain. In summer 1991 the German Association for the Study of Pain launched an initiative directed at simplification of the prescription requirements for such analgesics and submitted the suggestions to the ministries responsible. ⋯ Moreover, the prescriptions are to be simpler to make out and certain exemptions have been specified by law. Acceptance of the bill by the political committees and its realization are expected in autumn 1992.