Articles: analgesics.
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Neuroscience letters · Jun 1989
B-vitamins potentiate the antinociceptive effect of diclofenac in carrageenin-induced hyperalgesia in the rat tail pressure test.
B-vitamins possess antinociceptive and antiinflammatory activity. The rat tail pressure test was used to examine whether a mixture of the vitamins B1, B6, and B12, clinically used as Neurobion, has antinociceptive activity itself or potentiates the effect of the non-steroidal antiinflammatory drug (NSAID) diclofenac on carrageenin-induced hyperalgesia. ⋯ Nevertheless, lower doses which alone were lacking in activity (100-250 mg/kg B1 and B6, 1-2.5 mg/kg B12 p.o.) dose-dependently potentiated the antinociceptive of diclofenac. This result supports the clinical experience of a reduced need for diclofenac when B-vitamins are administered concomitantly.
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J. Pharmacol. Exp. Ther. · Jun 1989
Multiplicative interaction between intrathecally and intracerebroventricularly administered mu opioid agonists but limited interactions between delta and kappa agonists for antinociception in mice.
Simultaneous action of morphine on supraspinal and spinal sites produces a multiplicative interaction for antinociception which may be important for the analgesia produced by systemically administered morphine. The purpose of this study was to see whether other agonists with more receptor selective opioid actions than morphine would also produce this multiplicative interaction. DAMPGO (Tyr-D-Ala2-Gly-NMePhe4-Gly-ol5), DPDPE (D-Pen2, D-Pen5, enkephalin) and U50-488H, opioid agonists highly selective for mu, delta and kappa receptors, respectively, were administered alone i.c.v. or intrathecally (i.t.) or in combination (i.c.v. plus i.t.) to determine ED50 values for the tail-flick response in mice. ⋯ The multiplicative interaction was a property characteristic of mu but not delta and kappa agonists. Based on the similarity between morphine and DAMPGO, it was postulated that both mu agonists act on redundant descending pain inhibitory pathways to produce multiplication. A second mechanism for multiplicative interaction was based on the difference between DAMPGO and morphine.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Comparison of one technique of patient-controlled postoperative analgesia with intramuscular meperidine.
We have compared analgesic requirements, perceived pain, and self-assessment of 'health locus of control' for 72 h in 88 subjects after cholecystectomy, randomized to either a standard technique of self-administration of meperidine (patient-controlled analgesia, PCA) or to intramuscular injections on demand (i.m.). Multivariate analysis revealed no statistical differences between group scores for pain (over any 24 h period) and only minor differences in total meperidine administered. ⋯ Assessment of 'health locus of control' did not show any marked changes. Analysis of patient questionnaires suggests more enthusiasm for patient-controlled analgesia, but in this study, it was difficult to clearly demonstrate any significant advantage for pain management or amount of opiate administered.
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The treatment of pain in the acute phase of a suspected acute myocardial infarction is often insufficient and has remained unchanged during recent years. The introduction of substances with a potential to limit the infarct size, such as thrombolysis and beta-blockade, have, however, decreased the requirement for narcotic analgesics (which are still the drugs of choice in many hospitals). Knowledge is still lacking regarding the duration of pain relief, the time between drug administration and pain relief, and optimal doses for various analgesics. Future research should aim at the development of drugs with a more rapid onset of action, less side effects and more complete analgesia.
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This epidemiological questionnaire-study of 362 patients suffering from chronic pain related to musculoskeletal disorders showed the following results: Most musculoskeletal pain syndromes are located in the head and back areas (57.3%). Patients who seek treatment in an orthopedic pain clinic suffer from at least moderate pain according to the verbal rating scale and from pain equal too or more than 50 on to the numeric rating scale. For most patients (51.9%) the duration of the pain has been between 1 and 10 years. ⋯ Most patients with chronic pain consult 2 to 6 doctors. For typical orthopedic pain syndromes most patients consult an orthopedist. Patients with chronic headaches consult an orthopedic specialist about as frequently as neurologist or internist specialist.