Articles: analgesics.
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Acta Anaesthesiol Scand · Feb 1986
Randomized Controlled Trial Comparative Study Clinical TrialVentilation and ventilatory CO2 response in children during halothane anaesthesia after non-opioid (midazolam) and opioid (papaveretum) premedication.
The influence of non-opioid (NO) and opioid (O) premedication on ventilation and ventilatory CO2 response was studied in 18 spontaneously breathing children during halothane anaesthesia. Eight patients in Group NO and 10 in Group O were comparable in age, body weight and type of surgery performed. The sedative effect was evaluated and measurements by pneumotachography and in-line capnography were made immediately after induction of sleep, just before the start of surgery, during surgery and after surgery both before and after 3 min of about 2% CO2 inhalation. ⋯ ETCO2 was similar in the two groups before, during and after surgery. The ratio of VE to CO2 elimination (VCO2) and of dead space (VD) to tidal volume (VT) was higher in Group NO, but ventilatory response to CO2 inhalation immediately before the postoperative period was similar in both groups. It was concluded that opioid premedication resulted in more efficient ventilation during anaesthesia and surgery, and that CO2 response at the end of surgery was maintained in both groups.
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Anesthesia and analgesia · Feb 1986
Comparative StudyA comparison of the effects of alfentanil applied to the spinal cord and intravenous alfentanil on noxiously evoked activity of dorsal horn neurons in the cat spinal cord.
The purpose of this study was to examine the effects of alfentanil applied to the surface of the spinal cord and the effects of intravenously administered alfentanil on noxiously evoked activity of dorsal horn neurons. Extracellular single neuron recordings were obtained from wide dynamic range neurons in 26 decerebrate cats with transected spinal cords. Spinally administered alfentanil, 25 micrograms or 50 micrograms, caused 36 and 86% suppression of noxiously evoked activity, respectively. ⋯ Intravenously administered alfentanil, 12.5 micrograms/kg or 25 micrograms/kg, produced suppression of 43 and 89%, respectively, with maximum mean suppression observed at the 6- and 3-min time points, respectively. Complete recovery after intravenous administration was seen within 30 min. This study, using a sensitive neurophysiologic assay, demonstrates the important differences in onset and duration of drug effects that must be considered when comparing the responses of spinal cord neurons to intravenously administered narcotics and narcotics applied directly to the surface of the spinal cord.
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The successful management of 5 consecutive patients with intractable phantom limb pain is described. The main therapy is a combination of a narcotic and antidepressant. ⋯ There were no signs of habituation or addiction. We conclude that narcotics can be safely and successfully utilized for long-term management of phantom limb pain.
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Clinical Trial Controlled Clinical Trial
A double-blind study of the simple analgesic nefopam in rheumatoid arthritis.
The role of pure analgesics in the management of rheumatoid arthritis (RA) remains uncertain. In a double-blind cross-over study of 27 patients, nefopam was a more effective analgesic than placebo when given as a supplement to anti-inflammatory drugs. ⋯ Side-effects occurred in 9 (35%) on nefopam and none on placebo. The results suggest a valuable supplementary role for analgesics such as nefopam in the treatment of RA.