Articles: analgesics.
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This study was undertaken to examine the thermal pain thresholds over a wide area of the lower body surface following the intrathecal administration of capsaicin in rats. Thermal nociceptive thresholds measured under light halothane anesthesia were determined as skin twitch or escape response latencies to the heat stimulation (52.0 degrees C) by a thermal probe. Capsaicin (50 micrograms in 10 microliters) was injected through a chronically implanted catheter whose tip was near the lumbar enlargement of the spinal cord. ⋯ Intensities of thermal analgesia at the sole of hind paws measured by hot-plate test correlated well with those by thermal probe test. In conclusion, intrathecal capsaicin definitely produced thermal analgesia, but its intensity was considerably variable in the hind paws. These results are in keeping with our previous finding that there was much variability in the effect of capsaicin assessed by the hot-plate test, indicating a possibility that capsaicin does not spread uniformly in the CSF because of its water insolubility or difficulty in penetrating to the large nerve roots innervating the hind paws.
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A randomized, double-blind study was performed to test the analgesic effect of salmon calcitonin (sCT). The pain threshold of ten healthy subjects was measured during electrical stimulation of the dental pulp. Each subject underwent four different tests, whereby sCT at doses of 50 IU, 100 IU and 200 IU or placebo was administered subcutaneously. ⋯ The maximal threshold change was also significantly dependent on the dosage: with placebo the maximal change was 4 mA, while with sCT 50, sCT 100, and sCT 200 it was 14, 17 and 18 mA, respectively. The plasma levels of sCT and its analgesic activity were significantly correlated, as was demonstrated by means of linear regression based upon the bilogarithmic transformation of the plasma concentration. Altogether, the results prove conclusively that calcitonin given systemically possesses primary analgesic efficacy, a property that fits well into its spectrum of activity in the treatment of (painful) bone diseases.
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Neuroadenolysis of the pituitary (NALP) is an efficient measure for treatment of severe pain in patients with bony metastases. It is especially recommended for primary carcinomas of the breast or prostate. The procedure, transsphenoidal puncture of the pituitary under radiographic control and instillation of up to 2 ml 95% alcohol, is simple. ⋯ The following results are significant (P<0.05): (1) LH: poststimulation values are extremely suppressed; (2) FSH: basal values decrease; (3) ACTH: basal values decrease after the 6th day. The antalgic effect of NALP is independent of its hormonal consequences. NALP produces hormonal suppressions of various degrees, and is not a "chemical hypophysectomy".
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J Pain Symptom Manage · Sep 1989
Influence of the pain and symptom control team (PSCT) on the patterns of treatment of pain and other symptoms in a cancer center.
To assess the influence of a pain and symptom control team on the pattern of prescription of pharmacologic and nonpharmacologic treatments for cancer pain, we reviewed the charts of 100 consecutive patients admitted to the Cross Cancer Institute during 1987 and 100 patients admitted during 1984. The average daily dose of parenteral morphine per patient was 44 +/- 26 mg in 1987 versus 34 +/- 38 mg in 1984 (p less than 0.05). In 1987 and 1984, only 31 and 22% of the analgesics were ordered around the clock respectively (P:NS). ⋯ The pattern of prescription of narcotics by residents changed significantly during the last four weeks of rotation as compared to the first four weeks. We conclude that there have been some changes in the modality of treatment of pain that are probably due to changes in the pattern of prescription by the residents and continued improvement in assessment of pain by nurses. However, in several areas of treatment the impact of a pain and symptom control team remains minimal.