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PubMed2003

Peripheral antihyperalgesic and analgesic actions of ketamine and amitriptyline in a model of mild thermal injury in the rat.

UNLABELLED: In this study, we examined antihyperalgesic and analgesic actions after local peripheral administration of ketamine and amitriptyline in a rat model of mild thermal injury. Exposure of the hindpaw to 52 degrees C for 45 s under anesthesia produced a subsequent thermal hyperalgesia lasting at least 2 h. The local peripheral administration of ketamine (100-1000 nmol) 15 min before the thermal injury produced an antihyperalgesic effect when injected into the ipsilateral paw, whereas amitriptyline produced both antihyperalgesic (300 nmol) and analgesic (1000 nmol) effects. Administered after the thermal injury, ketamine had no effect, whereas amitriptyline retained its analgesic but not its antihyperalgesic effect. Amitriptyline (300 and 1000 nmol) produced an analgesic action when administered into the normal nonsensitized hindpaw. Both drugs increase paw volume, particularly at larger doses; biogenic amines are not involved in the action of amitriptyline, as was shown previously for ketamine. These results indicate that (a) ketamine produces antihyperalgesia, but not analgesia, when administered locally with a mild thermal injury model; (b) amitriptyline produces both antihyperalgesia and analgesia when administered locally; and (c) the increase in paw volume produced by these drugs occurs by different mechanisms. IMPLICATIONS: This study examines the pain-relieving properties of the local peripheral administration of ketamine and amitriptyline, two drugs in current clinical use, in a thermal injury model of hyperalgesia and demonstrates both antihyperalgesic and analgesic properties. These observations provide support for their potential use as local (e.g., topical) analgesics.

Administration, Topical↗
PubMed2006

The analgesic effect of nitroglycerin added to lidocaine on intravenous regional anesthesia.

We evaluated the analgesic effect of nitroglycerine (NTG) when added to lidocaine in IV regional anesthesia. Thirty patients undergoing hand surgery were randomly assigned to two groups. The control group (group C, n = 15) received a total dose of 40 mL with 3 mg/kg of lidocaine diluted with saline, and the NTG group (group NTG, n = 15) received an additional 200 mug NTG. Hemodynamic variables, tourniquet pain measured before and 1, 5, 10, 20, and 30 min after tourniquet inflation, and analgesic requirements were recorded during the operation. After the tourniquet deflation, at 1 and 30 min and 2 and 4 h, visual analog scale (VAS) score, time to first analgesic requirement, total analgesic consumption in the first 24 h after operation, and side effects were noted. Shortened sensory and motor block onset time (3.2 +/- 1.1 versus 4.5 +/- 1.2 min; P = 0.01 and 3.3 +/- 1.6 versus 5.2 +/- 1.8; P = 0.009 in group NTG and group C, respectively), prolonged sensory and motor block recovery times (6.8 +/- 1.6 versus 3.1 +/- 1.2 min P < 0.0001 and 7.3 +/- 1.3 versus 3.6 +/- 0.8 P < 0.0001 in group NTG and group C, respectively), shortened VAS scores of tourniquet pain (P = 0.023), and improved quality of anesthesia were found in group NTG (P < 0.05). VAS scores were lower in group NTG after tourniquet release and in the postoperative period (P = 0.001). First analgesic requirement time was longer in group NTG (225 +/- 74 min versus 39 +/- 33 min) than in group C (P < 0.0001). Postoperative analgesic requirements were significantly smaller in group NTG (P < 0.0001) but the side effects were similar in both groups. We conclude that the addition of NTG to lidocaine for IV regional anesthesia improves sensory and motor block, tourniquet pain, and postoperative analgesia without side effects.

Adult↗
PubMed1995

[Analgesic and anti-inflammatory effect of (+/-)-N,N- dimethylcarbamoylmethyl 2-[7-(2-methyl-5H-[1] benzopyrano [2,3-b] pyridyl)] propionate (Y-23023), a new non-steroidal anti-inflammatory drug].

The analgesic and anti-inflammatory activities of Y-23023, a new nonsteroidal analgesic and anti-inflammatory compound, were investigated in acute, subacute and chronic pain models in rats. In the carrageenin paw edema test, Y-23023 (0.3-3 mg/kg, p.o.) dose-dependently inhibited hyperalgesia assessed by the Randall-Selitto method and paw edema. Y-23023 (1 mg/kg, p.o.), when administered at 2 hr after carrageenin injection, significantly elevated the reduced pain threshold without affecting paw edema. Therefore, the antinociception activity induced by Y-23023 was not the result of its anti-inflammatory activity. In addition, Y-23023-induced antinociception was resistant to post-treatment with naloxone (2 mg/kg, s.c.), but was antagonized by intraplantar injection of prostaglandin E2 (1 microgram/paw). These results suggest that Y-23023 produces a peripheral analgesic effect mediated by inhibition of prostaglandin production. Y-23023 (0.3-10 mg/kg, p.o.) also had a potent inhibitory effect on the silver nitrate-induced arthritic pain. In suppressing acute and subacute pain, Y-23023 was more potent than diclofenac sodium, indomethacin and loxoprofen sodium. The analgesic and anti-inflammatory activities of Y-23023 (0.1-1 mg/kg/day, p.o.) on the adjuvant-induced hyperalgesia and the paw swelling were nearly equipotent to diclofenac sodium and indomethacin, but were more potent than loxoprofen sodium. Therefore, Y-23023 would be regarded to show predominantly strong analgesic activity in acute and subacute pain when compared with reference drugs. The above results suggest that Y-23023 is a novel analgesic compound with an anti-inflammatory activity in the clinical field.

Animals↗
PubMed1984

[The analgesic effects of non-steroidal anti-inflammatory drugs on acetylcholine-induced writhing in mice].

The experimental conditions of acetylcholine (ACh)-induced writhing were investigated, and the analgesic effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ACh-induced writhing were investigated in comparison with those on other writhings. Mice injected (i.p.) with more than 5 mg/kg of ACh showed the writhing response, and the number of writhes were almost equal in all mice. Therefore, the analgesic effects were evaluated as follows: NSAIDs were administered orally 30 min before the ACh injection (5 mg/kg, i.p.), the number of writhes were counted in each mouse during a period of 10 min following the ACh injection, and mice that did not show any writhing responses were regarded as positive for the analgesic activity. The analgesic effects of NSAIDs showing the inhibitory effect on prostaglandins (PGs) biosynthesis were more potent than those in other writhing tests. The ED50 values in the ACh-induced writhing were highly correlated with the IC50 values in the inhibitory effects on PGs biosynthesis (r = 0.81, P less than 0.01) and with the ED50 values in the anti-castor oil diarrhoea (r = 0.93, P less than 0.01). Moreover, the ED50 values of acidic NSAIDs in ACh-induced writhing were also highly correlated with the clinical doses (r = 0.90, P less than 0.001). These results suggest that the ACh-induced writhing method should be useful for the evaluation of the analgesic effects of acidic NSAIDs, and the analgesic effects on the ACh-induced writhing are related to their inhibitory effects on PGs biosynthesis.

Acetylcholine↗
PubMed1986

Effects of non-narcotic analgesics on the kidney.

Non-narcotic analgesics have acute and chronic effects on the kidney. Until quite recently chronic effects have received much more attention than acute effects. Renal papillary necrosis attributed to prolonged intake of analgesic compounds was first described from Switzerland in the 1950s, and subsequently in many countries including Scandinavia, Australia, Belgium and Canada. Renal papillary necrosis is now accepted as an effect of over-the-counter analgesic compounds and has also been recorded with many individual non-steroidal anti-inflammatory drugs (NSAIDs). Evidence suggests that uroepithelial tumours also occur as a complication of prolonged abuse of analgesic compounds. Clinical evidence associating renal papillary necrosis with compound analgesics and NSAIDs has been backed up by experimental evidence showing that these drugs cause renal papillary necrosis in animals. Acute effects of non-narcotic analgesics have been described mainly in association with aspirin and NSAIDs. In high renin states, including salt-depleted normal subjects, NSAID administration may be associated with an acute decrease in renal function, which is more obvious in patients who have underlying renal disease. Clinical syndromes which occur in association with NSAIDs include oedema, hyperkalaemia and acute renal failure and the acute nephrotic syndrome. Acute renal failure may be associated with acute interstitial nephritis and the nephrotic syndrome or may be due to acute tubular necrosis. Patients who have the nephrotic syndrome show fusion of foot processes of glomerular epithelial cells on electron microscopy as well as acute interstitial nephritis. Patients who suffer these episodes of acute renal function deterioration associated with NSAIDs recover slowly after withdrawal of the drugs, and the recovery may not be complete.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2001

A comparison of the effects of two volumes of local analgesic solution in the distal interphalangeal joint of horses with lameness caused by solar toe or solar heel pain.

The response of horses, with solar pain in the dorsal or palmar aspect of the foot, to 6 or 10 ml local analgesic solution administered into the distal interphalangeal (DIP) joint was examined. Lameness was induced in 7 horses by creating solar pain in the dorsal aspect of one forefoot and, at another time, the palmar aspect of the other forefoot with set-screws inserted into a custom-made shoe. Horses were videotaped trotting before and after application of set-screws and, in separate trials, after 6 or 10 ml local analgesic solution was administered into the DIP joint. Lameness scores were assigned by examining videotaped gaits. Scores were significantly lower (P < 0.05) for horses with set-screws applied to the angles of the sole and receiving 10 ml, but not 6 ml, local analgesic solution into the DIP joint. Scores were significantly lower (P < 0.05) for all horses with set-screws in the dorsal margin of the sole receiving either volume of local analgesic solution. Analgesia of the DIP joint was less effective in desensitising the angles of the sole than in desensitising the dorsal margin of the sole, and 10 ml local analgesic solution was more effective than 6 ml in desensitising these regions. The response of horses with solar pain to local analgesic solution in the DIP joint was influenced by the volume administered and the region of sole affected.

Analgesia↗
PubMed1980

Analgesic-associated nephropathy and transitional cell carcinoma of the urinary tract.

Epidemiologic studies from Europe suggest that patients with analgesic-associated nephropathy have an increased risk of developing transitional cell carcinoma of the urinary tract. We did a similar epidemiologic study supporting this association. Six of 115 cases of transitional cell carcinoma diagnosed over 3 years had analgesic-associated nephropathy. The patients were predominantly female, younger, and had renal pelvis tumors instead of bladder tumors (P < 0.002), an mortality rate was higher (P < 0.05). In a historical prospective study, 146 patients with interstitial nephritis diagnosed between 1974 and 1976 were divided into those with and those without analgesic-associated nephropathy. In 4 of 84 patients with analgesic-associated nephropathy transitional cell carcinoma has developed. None of the 98 patients without analgesic associated nephropathy have developed transitional cell carcinoma (P < 0.001). These data strongly incriminate analgesic abuse as a risk factor for the development of transitional cell carcinoma.

Adult↗
PubMed1999

Prolonged analgesic effect of ketamine, an N-methyl-D-aspartate receptor inhibitor, in patients with chronic pain.

We examined the role of N-methyl-D-aspartate (NMDA) receptors in chronic (pathological) pain in humans by using the NMDA receptor antagonist ketamine as a probe. Thirty patients with neuropathic pain in the trigeminal area were given an i.m. injection of ketamine 0.4 mg/kg combined with midazolam 0.05 mg/kg. Pethidine 1.0 mg/kg served as a control. Three different response patterns were observed. Ketamine caused a long-term (6-24 h) analgesic effect partly dissociated from the mental side effects in 8 of the 26 patients who completed the study; these patients also had a slight analgesic effect of pethidine. In nine patients, ketamine caused a short-lasting (<2 h) analgesic effect closely associated with the mental side effects, whereas pethidine caused little or no analgesia. The remaining nine patients did not experience any reduction of pain after either drug in spite of characteristic side effects. One week after the i.m. challenge the patients received either 4.0 mg/kg ketamine hydrochloride or placebo capsules to be taken orally as a nightly dose for three consecutive nights. Five of the eight patients who had a long-term analgesic effect of the i.m. challenge reported decreased pain on days after ketamine. None of the others reported an analgesic effect. The phenomenon of long-term depression of pain in a subgroup of patients was thus confirmed when ketamine was given p.o. These findings indicate that NMDA receptors are involved in the perception and maintenance of pathological pain in some patients. In others, pain appears to be mediated by NMDA receptor-independent mechanisms. We suggest that NMDA receptor-independent transmission in central pain pathways may contribute to the reduced efficiency of analgesic drugs often seen in chronic pain states.

Administration, Oral↗
PubMed2001

[Non-opioid analgesics in cancer pain].

Non-opioid analgesics such as NSAIDs play a central role for patients with cancer pain as well as for those with acute pain. Pain management using non-opioid analgesics need to avoid potential side effects, and the analgesic action of NSAIDs, cyclooxygenase inhibitors, would synergistically potentiate opioids' effects via the activation of the periaquaductal grey of the midbrain. The analgesic action of opioids would also be potentiated by the activation of alpha 2-adrenoceptors of the spinal cord. Thus the use of non-opioid analgesics for cancer patients taking opioid needs meticulous care. Undertreatment of pain is a persistent clinical problem for patients with cancer. Although changing medical practice is difficult and improving pain management with the rational use of combination of drugs may especially difficult, supplementation of non-opioid analgesics for opioid treatment would provide a better quality of life of cancer patients.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

[Role of transcutaneous electric stimulation in indication for implantation of an analgesic stimulator].

UNLABELLED: The author's describe: I. METHODS OF ANALGESIC CUTANEOUS STIMULATION: I) Transcutaneous analgesic stimulation: Stimulations realized by biphasic asymetrical "waves" of 0 to 80 milliamps intensity for a frequency of 10 to 100 cycles/S. -Place of the stimulation: a painful area. -Stimulation length: 15 to 20 minutes, repeated during several days. RESULTS: appreciate patients tolerance to the tingling sensation. Test the analgesic effect, sometimes sufficient to treat the patient. 2) Analgesic percutaneous stimulation: The percutaneous electrode is applicated to the dura, without penetrating it. Same types of results as for transcuteneous stimulation but more precise. II. DEFINITION of the indication of chronic implantation of an analgesic stimulator. Studying results of repeated analgesic transcutaneous stimulations allows to distinguish between several possibilities. I) Intolerance of the sensation of stimulation: Contra-Indication or increasing of the pain. 2) Complete and lasting amelioration leads to: Chronic transcutaneous neurostimulation. 3) Partial amelioration, No amelioration leads to: Acute percutaneous stimulation either successful results after stimulation, : Chronic implantation: -of peripheral nerve -on a peripheric nerve -of dorsal column -on dorsal column, either paraesthesis without Analgesia:? III - EXPERIMENTAL APPROACH TO THE MECHANISM OF ACTION OF THE "ANALGESIANT" ELECTRIC STIMULATION. A cutaneous "analgesiant" stimulation produces, in the cat, the inhibition of evocated potential in C.M. by "nociceptive" stimulation of the sciatic nerve. The inhibition only appears after a 30 minutes latence. This let suppose different mechanisms from the "Gate Control" theory. The authors specify their personal results (Tab. 2.)

Electric Stimulation↗
PubMedDate not supplied

Survey of analgesic use for nonmalignant pain in long-term care facilities in southern California.

OBJECTIVE: Many residents in long-term care facilities experience nonmalignant pain, and analgesic therapy is often inadequate in this setting. We examined the management of chronic nonmalignant pain in elderly nursing home residents. DESIGN: Retrospective chart review. SETTING: Forty skilled nursing facilities in southern California. PARTICIPANTS: Residents with a diagnosis of noncancer pain who were receiving a regular regimen of prescribed analgesics. MEASUREMENTS: The following information was recorded: demographic data, specific diagnosis for pain medication, all analgesics in current use by the resident, whether a pain rating score was available for the resident and, if so, the current score. RESULTS: Of the 3400 resident charts screened, 381 residents (11.2%) met the criteria for inclusion in the study. There were 443 diagnoses for chronic nonmalignant pain, primarily arthritis and other musculoskeletal disorders. Of 510 prescriptions for analgesics, 52% were for acetaminophen or nonsteroidal antiinflammatory medications. Centrally acting analgesics, primarily opioids, accounted for 48% of all prescriptions. Approximately three-fourths of opioid prescriptions were for fixed-dose combinations with acetaminophen, and 15% were for long-acting opioids. Pain scores were not recorded on any of the residents' charts. CONCLUSION: Nonmalignant pain in these elderly nursing home residents was often associated with musculoskeletal disorders and was not assessed systematically. Without routine pain assessments, it is not possible to determine whether the residents' pain was being treated adequately by the analgesics prescribed. We recommend a multidisciplinary approach to the institution of pain assessment and management guidelines in long-term care facilities.

Journal Article↗
PubMed1991

[Central analgesic effects of non-steroidal anti-rheumatic agents].

NSAIDs, including acetylsalicylic acid, are frequently classified as peripherally-acting analgesics. This is based on the fact that these substances, among other effects, inhibit the biosynthesis of prostaglandines. A few solid arguments, however, stand against an exclusively peripheral mode of the analgesic action of NSAIDs in the sense of an inhibition of prostaglandin synthesis. It should be noted here that the analgesically-effective doses do not suffice to block prostaglandin synthesis. Furthermore, the inhibiting effects of paracetamol and metamizol are far weaker or are not at all present, although both substances are reliably-effective analgesics. The NSAIDs indometacin, ibuprofen, and diclofenac are capable of suppressing the sensory response of the nociceptive system via a central effect. In experimental studies with rats under urethane anesthesia, the nociceptive activity of individual neurons of the thalamus (the dorsomedial part of the ventral nucleus) was measured. The activity was triggered via an electric stimulation of afferent C-fibres in the ipsilateral or contralateral sural nerve. The NSAIDs named suppressed the evoked nociceptive activity in a dose-dependent manner. At the highest doses, the suppression resulted in a difference of approx. 60% of the control activity. The ED50 values were 5 mg/kg for indometacin, 10.9 mg/kg for diclofenac, and 15.6 mg/kg for ibuprofen. These results support the theory that the central effects of NSAIDs contribute to their analgesic efficacy. The possible mechanisms of these effects will be discussed. A practical significance of the central analgesic effects of NSAIDs could be that their therapeutic applicability is not limited only to the treatment of pain, which results from an activation of nociceptors.

Animals↗
PubMed2006

Postoperative analgesic effects of lornoxicam after thyroidectomy: a placebo controlled randomized study.

The purpose of the present study was to determine the postoperative analgesic effects of lornoxicam and the reduction in tramadol consumption. Fourty patients of ASA class I-II, 18-70 years of age, undergoing thyroidectomy were assigned in a randomized manner into two groups: GroupL received 8 mg of lornoxicam i.v. at the end of the operation followed by 8 mg of lornoxicam b.i.d., i.v. for 24 hours postoperatively. GroupP received 4 ml of saline solution i.v. at the end of the operation and the same amount b.i.d., i.v. for 24 hours postoperatively. The requirements for supplemental analgesics were recorded at 0-6, 6-12 and 12-24 hour intervals. Postoperative pain scores were evaluated at 15th min. and 1, 2, 4, 6, 8, 12, 18 and 24th hours using Visual Analogue Scale (VAS). The time to first analgesic requirement was significantly longer in GroupL compared to GroupP (101.7 vs 37.9 min, p<0.001). Pain scores were significantly lower in GroupL compared to GroupP at 15th min, 1, 8 ,12 and 18th hours. Twenty four hour analgesic consumption was significantly lower in GroupL compared to GroupP (p<0.05). The amount of tramadol consumed in GroupL was 60% lower compared to GroupP (100 mg and 250 mg (mean), respectively). 100% of the patients in GroupL and 60 % of the patients in GroupP needed supplemental analgesics. The degree of satisfaction with postoperative pain management was excellent in 95 % of patients in GroupL and 25 % of patients in GroupP. Eighteen patients in GroupP and 9 patients in GroupL had nausea (p=0.002), and fifteen patients in GroupP and 8 patients in GroupL had vomiting (p=0.025). Lornoxicam decreased the opioid need, the incidence of nausea and vomiting and postoperative pain scores. Moreover, it was observed that the time needed for the first analgesic requirement was prolonged following thyroidectomies.

Adolescent↗
PubMed1985

Pharmacological effects of SCH 30497--a novel analgesic substance.

SCH 30497 (2-[3-(1,2,3,6-tetrahydro-4-2(methylphenyl)-pyridin-1-yl) -propyl]-1,2,4-triazolo[4,3-a] pyridin-3-(2H)-one) was tested for analgesic effects in the rat, mouse and squirrel monkey. SCH 30497 showed dose-related analgesic effects in the rat yeast-paw test; at peak times the ED7sec (95% confidence limits) in mg/kg via the oral, subcutaneous, intramuscular and intravenous routes of administration were as follows, respectively: 4.7 (2.1-9.8), 5.7 (3.4-9.6), 6.4 (4.1-9.8) and 1.4 (0.6-3.2). SCH 30497 was also analgesic in the acetic acid-induced writhing test in mice (ED50 = 1.9 mg/kg p.o.) and the squirrel monkey shock titration test (ED50 = 14.5 mg/kg p.o.). It was inactive in the mouse (100 mg/kg p.o.) and rat (40 mg/kg p.o.) tail-flick tests. Thus, SCH 30497 was efficacious versus chemical, mechanical and electrical nociceptive stimuli. Naloxone antagonism of the analgesic effects of SCH 30497 was species specific with significant inhibition observed only in the rat and not in the mouse or monkey. SCH 30497 did not produce Straub tail or hyperactivity in mice. Twice daily dosing at 30 mg/kg p.o. to rats for 5 days failed to produce tolerance; in separate experiments, daily injections for 10 days at 20 or 100 mg/kg p.o. failed to induce signs of dependence following naloxone challenge. SCH 30497-induced analgesia was not attenuated in rats previously made tolerant to narcotics by implantation of a morphine pellet. SCH 30497 showed a weak ability to displace 3H-Met5-enkephalin from its binding sites on rat brain membranes (IC50 = 48 microM). SCH 30497 (100 microM) did not affect prostaglandin synthesis in vitro. In vivo, the drug did not have anti-inflammatory or ulcerogenic effects up to 80 mg/kg p.o. Acute behavioral, neurological and autonomic side effects were primarily depressant in rodents and occurred at doses greater than 15 times those that were analgesically relevant. Moderate doses in the monkey (2.5 times the ED50) and high doses in mice produced convulsions. It is hypothesized that SCH 30497-like drugs represent a new class of analgesics based on this unique pharmacological spectrum of activity.

Acetates↗
PubMed1995

Comparative analysis of buprenorphine- and norbuprenorphine-induced analgesic effects based on pharmacokinetic-pharmacodynamic modeling.

The relationships between plasma or brain concentrations and analgesic effects of both buprenorphine (BN) and an active metabolite, norbuprenorphine (NBN), were investigated in rats. Maximal analgesic effects measured by a tail flick test were obtained at 10 and 30 min after intravenous (i.v.) administration of BN (8 micrograms/kg dose) and NBN (100 micrograms/kg dose), respectively. No correlation was observed between analgesic effect and the early plasma BN or NBN concentrations. However, at latency times, the concentration of BN in the plasma, cerebellum and the rest of the brain (including the brainstem, midbrain and cerebrum) was related in a counterclockwise hysteresis fashion to analgesia. There was no relationship between the estimated specific binding concentration of BN in the brain and the analgesic effects. After i.v. administration of BN or NBN, the analgesic effect of NBN was approximately one-fiftieth that of BN. The n-octanol/water partition coefficient of NBN was one-tenth that of BN. Further, the results of intraventricular administration of each drug suggested that the intrinsic analgesic activity of NBN was one-fourth that of BN. From these findings, we conclude that the remarkably weak pharmacological effect of NBN after i.v. administration may be due not only to the low permeability of NBN into the brain but also to its small intrinsic pharmacological effect.

Analgesia↗
PubMed1994

Postoperative pain management in preverbal children: the prescription and administration of analgesics with and without caudal analgesia.

A retrospective chart review was conducted to examine the prescription and administration of analgesics with and without caudal analgesia to inpatient preverbal children within the first 48 hours after surgery. The 75 subjects were between birth and 24 months of age and had undergone various operative procedures. Seventy (93%) of these subjects were prescribed analgesics, but 8 of them had only acetaminophen prescribed. Of the 70 subjects who had a medication prescribed, 64 (91%) patients received analgesics. Morphine was the most frequently administered analgesic. The prescribed and administered mean dosages were less than the minimum recommended dosage for morphine. The mean prescribed and administered dosage for other analgesics exceeded the minimum recommended dosage. Preverbal children who had caudal analgesia during surgery were more likely to receive fewer dosages of analgesics and to receive lower dosages of narcotics even after 24 hours postoperatively than children who had not had caudal analgesia.

Acetaminophen↗
PubMed2003

Postoperative pain and analgesic responses are similar in male and female Sprague-Dawley rats.

PURPOSE: Controversy exists concerning the influence of gender on pain sensitivity and response to analgesics both in animal and human studies. The present study compares postoperative pain scores in male and female rats and how they respond to analgesic interventions. METHODS: Unilateral plantar foot incisions were made in Sprague-Dawley rats of both genders, producing mechanical allodynia in an established model of postoperative pain. Postoperative pain scores were monitored for four days following incision to identify intrinsic differences between the two groups. Animals were tested with analgesics (opioids, alpha(2)-adrenergic agonists, acetylcholine esterase inhibitors, gabapentin) both systemically and intrathecally on the day after incision to assess gender differences in the anti-allodynic effect of these drugs. RESULTS: In the plantar foot incision model of postoperative pain there was no gender difference in postoperative mechanical hypersensitivity (von Frey filaments) over four days. Morphine (3 mg x kg(-1)) and gabapentin (25 mg x kg(-1)) administered intraperitoneally decreased postoperative mechanical hypersensitivity, but with no gender difference. Intrathecal morphine (1-2 nmol), gabapentin (60-120 nmol), clonidine (45 nmol), and neostigmine (6.6 nmol) also showed no gender difference in analgesic effect. CONCLUSION: The results of this study demonstrate that in Sprague-Dawley rats there are no gender differences in postoperative pain perception or the response to analgesics, indicating that this strain of rats can be used without introducing gender bias in studies of postoperative pain.

Acetates↗
PubMed1995

Lack of analgesic effect of 50 and 100 mg oral tramadol after orthopaedic surgery: a randomized, double-blind, placebo and standard active drug comparison.

Tramadol hydrochloride is a synthetic mu-opioid agonist with additional monoaminergic activity. Tramadol's analgesic effect has been equated with that of pethidine, with a more favourable side-effect profile. Tramadol has been the most-selling prescription analgesic in Germany for several years, and it is now available in many other European countries, but still there is a lack of adequately controlled clinical studies of its analgesic properties. The purpose of this study was to compare the analgesic efficacy of 50 and 100 mg oral tramadol with our standard analgesic for postoperative pain treatment, 1000 mg paracetamol + 60 mg codeine, and placebo. A single-dose, parallel group, double-blind design was used. One hundred forty-four patients were enrolled the day after total hip replacement if they had a pain intensity of 60 mm or more on a 0-100 mm visual analogue scale. Treatments were compared on the basis of pain intensity and derived variables (pain intensity difference, and summed pain intensity differences), the need of rescue medication, and a global evaluation. Serum concentrations confirmed rapid and good absorption comparable with that reported in healthy volunteers. The active drug control, paracetamol+codeine, was significantly superior to placebo for all efficacy variable (P = 0.0002-0.004), confirming good assay sensitivity. Paracetamol+codeine was also significantly superior to both 50 mg tramadol (P = 0.002-0.03) and 100 mg tramadol (P = 0.002-0.02). There was no difference between placebo and 50 and 100 mg tramadol for any of the efficacy variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaminophen↗