Articles: analgesics.
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Klinische Pädiatrie · Jul 1989
[Use of strong opioids in the treatment of cancer pain in adults and children].
A high percentage of adults and children with advanced cancer suffer from pain. Strong opioids for pain control, e.g. morphine, slow-released morphine or buprenorphine, should be administered early according to the intensity of pain. The analgesics should be given orally whenever possible. ⋯ Correctly used strong opioids produce only a few side-effects, especially constipation and vomiting. Many studies in adult cancer patients all over the world demonstrate the effectiveness of strong opioids for pain control. Children should be treated in the same way and comparable data in children with cancer pain must be collected.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the incidence of pruritus following epidural opioid administration in the parturient.
Epidural morphine is associated with a high incidence of pruritus when used for pain control in the post-Caesarean section population. The purpose of this study was to compare the incidence of pruritus associated with epidural morphine, fentanyl, buprenorphine and butorphanol. ⋯ This study demonstrated that the incidence of pruritus was significantly higher following the use of epidural morphine and fentanyl. Even though epidural butorphanol and buprenorphine exhibited a low incidence of pruritus, their duration of analgesia was not long enough to make either attractive for single-dose administration.
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Following our earlier research, we further investigated a model that conceptualizes placebo phenomena as the result of conditioning and attempted to extend and replicate the finding that placebo responses can be conditioned in human subjects. Two groups of 10 subjects were told that they were receiving an analgesic which was in fact a placebo. During the conditioning, placebo administration was surreptitiously paired with an increase in the painful stimulus for half of the subjects and with a decrease for the other half. ⋯ A second type of experimental pain was also used to determine stimulus generalization. The results confirmed a previous finding that placebo responses can be conditioned in human subjects. The implications for clinical practice of a learning model of placebo behavior are discussed.
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Most patients receiving spinal narcotics can be monitored adequately by well-trained nurses on postoperative or postdelivery wards. Patients at high risk (e.g., those with preexisting lung disease or many elderly patients) do need monitoring in the intensive care unit. Also requiring special monitoring are patients for whom epidural narcotics alone will not cover their pain, such as young patients with multiple trauma. Patients without these restrictions, however, can be monitored successfully outside the intensive care unit, although the dose of epidural narcotic should be kept as low as possible.
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1. Flupirtine is a novel, centrally acting, non-opioid analgesic agent. The present investigation was undertaken to ascertain which neuronal systems might be responsible for its antinociceptive effect in rodents. ⋯ Flupirtine-induced antinociception also remained unchanged after pretreatment with haloperidol. 9. Flupirtine has no pharmacologically relevant affinity for alpha 1-, alpha 2-adrenoceptors, 5-HT1- and 5-HT2-receptors as shown in direct binding studies. 10. The present results indicate that the antinociceptive action induced by flupirtine depends on the descending noradrenergic pain-modulating system.