Articles: analgesia.
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Historical Article
Bark, blisters and the bathe: some problems of pain relief in former times.
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Comparative Study
Opiate vs non-opiate footshock-induced analgesia (FSIA): the body region shocked is a critical factor.
Previous work has demonstrated that footshock can elicit either opiate or non-opiate analgesia. The present study has demonstrated that one critical factor determining the involvement of endogenous opioids is the body region shocked. Using 90 s shock, front paw shock produced an opiate analgesia which was significantly antagonized by as little as 0.1 mg/kg systemic naloxone and morphine tolerance. ⋯ In contrast, hind paw shock produced a non-opiate analgesia which failed to be attenuated by 20 mg/kg systemic naloxone and showed no cross-tolerance to morphine. Since identical shock parameters were used for front paw and hind paw shock in the systemic naloxone experiments, stress per se clearly cannot be the crucial factor determining the involvement of endogenous opioids in footshock-induced analgesia. These results were discussed with respect to clinical treatments of pain which utilize somatosensory stimulation.
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Review
[Pharmacology of narcotics administered by the epidural or intrathecal route (author's transl)].
Owing to the presence of specific opiate receptors in the spinal cord, analgesia can be obtained with epidural or intrathecal injections of morphine derivatives. The duration of analgesia depends upon the degree of water solubility of the compound. Compounds with low coefficient of distribution in lipids (e.g. morphine) do not readily cross the blood-brain barrier and have a prolonged action, whereas the duration of analgesia induced by highly lipid-soluble compounds, such as dextromoramide and phenoperidine, is not very different from that obtained with more conventional routes of administration. ⋯ However, side-effects may be observed, and their frequency mainly depends upon the quantity of narcotic injected. These side-effects reduce the number of indications, which cannot yet be precisely determined. Epidural and intrathecal analgesia appears to be particularly useful during the post-operative period in patients liable to respiratory complications.
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Surg Gynecol Obstet · Mar 1982
Clinical Trial Controlled Clinical TrialEpidurally administered morphine for postcesarean analgesia.
A double blind study was performed to evaluate analgesia from epidurally injected morphine sulfate in 30 mothers after cesarean section following similar regional anesthetics. When compared with a saline placebo and 2 milligrams of epidurally injected morphine, a 4.5 milligram epidurally administered morphine dose resulted in a highly significant reduction in the initial 24 hour parenterally administered narcotic requirement, p less than 0.001, and a significantly greater duration of analgesia after epidural injection, p less than 0.0003. ⋯ No significant side-effects were noted. Epidurally administered morphine appears promising as a potent analgesic approach of extended duration with potential advantages for early maternal mobilization, improved fetal maternal interaction and reduced fetal narcotic exposure in the breast fed infant.