Articles: opioid-analgesics.
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Case Reports
Narcotic bowel syndrome treated with clonidine. Resolution of abdominal pain and intestinal pseudo-obstruction.
We describe the cases of five patients having a syndrome of chronic abdominal pain, vomiting, weight loss, and features of intestinal pseudo-obstruction associated with prolonged use or abuse of narcotic analgesics. In each patient, abdominal complaints were originally attributed to either mechanical bowel obstruction or an underlying gastrointestinal disorder often involving prior abdominal surgery. ⋯ Clonidine therapy was used to alleviate symptoms of narcotic analgesic withdrawal. The narcotic bowel syndrome is a clinically important and frequently unrecognized cause of chronic abdominal pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Alfentanil in minor gynaecological surgery: use with etomidate and a comparison with halothane.
Etomidate was used to induce anaesthesia in 50 healthy subjects undergoing minor gynaecological surgery who were randomly divided into two groups, one receiving alfentanil 8 micrograms/kg intravenously immediately prior to induction of anaesthesia with etomidate, and the other halothane as required to maintain adequate anaesthesia. There was a highly significant reduction in the incidence of myoclonia and involuntary movement and significant reduction of pain on injection in the alfentanil group. Tests of recovery performed in the 60 minutes following anaesthesia suggested that supplementation with alfentanil led to more rapid recovery than halothane.
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Opioid analgesics continue to be the most important drugs in modifying the response to pain. Their versatility is attested by their frequent use in both postoperative and intraoperative management of pain. Recent findings regarding the mechanism of action of opioids may signal the introduction of newer, more effective, and less addictive agents. ⋯ The adverse effects of nausea and dysphoria and the more serious effects of respiratory depression continue to be a problem, as does the possibility of abuse. Nonetheless, the clinical experience with opioids in control of pain is uncontested. Until better drugs are developed, opioids will form the basis for the control of acute pain by the dental practitioner.
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Randomized Controlled Trial Clinical Trial
The analgesic effect of a low dose of alfentanil.
The effect of a single small dose of alfentanil (6 micrograms/kg) on postoperative pain was compared with saline using a double blind study. Pain was assessed using a linear analogue scale and shown to decrease at 2, 5 and 10 minutes after injection of alfentanil (p less than 0.01). ⋯ There were no changes in pain or PE'CO2 in the control group throughout the study. Intravenous alfentanil given to patients in pain provides quick effective analgesia for a short period of time, but respiratory depression may occur.