Articles: analgesics.
-
The relationship between the age and the spread of analgesia from different epidural anesthetic doses was examined by studying analgesic dose responses in cervical epidural analgesia. Two different anesthetic doses (5 ml or 10 ml) of 2% mepivacaine were injected into the cervical epidural space at a constant pressure (80 mmHg) using an intravenous apparatus, and the spread of analgesia to pinprick was assessed. The significant correlation was found between the patient's age and the number of spinal segments blocked (5 ml : r = 0.8498, P < 0.01, 10 ml : r = 0.5988, P < 0.01). ⋯ The analgesic dose-response relation in patients over 60 years of age differed from that in patients under 39 years of age and doubling the epidural dose did not double the number of spinal segments blocked. Progressively more extensive analgesia was obtained from a given dose of local anesthetic with advancing age. It was difficult to limit the extent of analgesia by injecting a smaller dose of local anaesthetic in the elderly.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Tizanidine and ibuprofen in acute low-back pain: results of a double-blind multicentre study in general practice.
This study reports on 105 patients with acute low-back pain given tizanidine (4 mg three times daily) plus ibuprofen (400 mg three times daily) or placebo plus ibuprofen (400 mg three times daily). Patients assessed their pain using visual analogue scales in a daily diary and the doctor assessed their condition at baseline and on days 3 and 7. Both groups were treated effectively, but earlier improvement occurred in patients given tizanidine/ibuprofen, particularly regarding pain at night and at rest. ⋯ More patients given tizanidine/ibuprofen suffered drowsiness and other central nervous system effects (P = 0.025). In patients with severe acute low-back pain, however, some sedation and bed rest is advantageous. This study shows that tizanidine/ibuprofen is more effective in the treatment of moderate or severe acute low-back pain than placebo and ibuprofen alone.
-
Randomized Controlled Trial Clinical Trial
[Dose-dependence of the analgesic action of metamizol].
Whereas dipyrone is used in many countries in clinical practice at doses up to 2.5 g, the dose-response relationship of the analgesic effect has not been investigated in humans. In the present study, doses of 0.5, 1.0, 1.5, 2.0, and 2.5 g dipyrone (Novalgin) were applied orally as film-coated tablets to 18 volunteers in a randomized, placebo-controlled, double-blind design. Pain attenuation was quantified following constant and painful electrical stimulation of tooth pulp at different time intervals up to 7 h after drug administration. ⋯ Maximal analgesia was observed 1 h after administration of the tablets, independent of the dose. An increase in analgesic effect related to dose was observed at this time, the increase being less pronounced with doses exceeding 1.5 g. Generally, analgesia persisted longer with increasing dose.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Der Urologe. Ausg. A · Mar 1988
[Peridural opioid analgesia in the terminal stage of cancer. Indications--implementation--results].
The indications for the application of opioids near the spinal cord are presented and two groups of patients treated with pericutaneous and intracorporeal systems are reported. If indicated, this method offers the possibility of treating patients on an outpatient basis.
-
Special aspects of pain in children are pointed out, and the range of relevant conditions and their frequency are compared with adult pain problems. Headache and especially migraine, with incidences of up to 50% and 10%, respectively, are the most common painful conditions to be treated in the pediatric age group. Many less frequent chronic painful disorders claim the need of special, mostly neuropediatric, knowledge; optimal diagnostic precision is important for good therapeutic results. ⋯ Another problem is that of pain assessment in infants and children; some new diagnostic tools, such as color scales and the Smiley analog scale, can help to solve these specific difficulties. Furthermore, the prediatrician accepts responsibility for the patients' future as adults and is therefore involved in the early prophylaxis of analgesic abuse. The actual and future work of pediatric pain clinics, the conditions in such institutions and the philosophy behind them are presented, and the necessity for research is pointed out.