Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ANALGESICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 883 records · Page 49Linked to original sources
PubMed1997

Comparison of postoperative bupivacaine with lidocaine on pain and analgesic use following periodontal surgery.

The purpose of this study was to compare postoperative administration of bupivacaine, a long-acting local anesthetic, with lidocaine, a short-acting local anesthetic, on pain perception and analgesic use following periodontal surgery. Ten male subjects were selected on the basis of having similar bilateral mandibular quadrants with moderate to severe periodontal disease requiring osseous surgery. The study was a matched-pair, double-blind design. Carpules of 2% xylocaine with 1:100,000 epinephrine and 0.5% bupivacaine with 1:200,000 epinephrine were wrapped in opaque tape and placed in separate coded envelopes. At the time of suturing, the quadrant was injected with one Carpule from one envelope. The Carpules from the second envelope were saved for the second surgery, which took place approximately one month later. Subjects were given standardized postoperative instructions and prescriptions for Peridex and Tylenol #3. They were told not to take the analgesic unless pain or discomfort occurred. They were given a self-administered questionnaire and asked to assess pain and/or discomfort 2, 4, 6, 8, 10, and 12 hours after the procedure, the amount of analgesic taken, and time when complete sensation returned. Results showed that the quadrants which received lidocaine maintained postoperative anesthesia an average of 2.47 hours while the Marcaine quadrants had a significantly longer duration of 5.62 hours. A large intra- and intersubject variability was noted in the amount of analgesic taken. The lidocaine group reported an average of 3.70 tablets versus a significantly smaller amount for the bupivacaine group of 1.60 tablets. Throughout all time intervals, the bupivacaine group reported significantly less pain than the lidocaine group. When used at the end of a mandibular periodontal surgical procedure, bupivacaine provides a significantly greater duration of anesthesia, decreased postoperative pain, and a reduction of anesthesia, decreased postoperative pain, and a reduction in the amount of analgesics taken.

Adult↗
PubMed1983

Determination of analgesic drug efficacies by modification of the Randall and Selitto rat yeast paw test.

This report describes a modified Randall and Selitto (1957) rat yeast paw test that can evaluate differences in efficacy of different analgesics. The modifications consist of a decrease in the rate of acceleration of the noxious stimulus (mechanical pressure) on the inflamed paw from 20 to 12.5 mmHg/sec and an extension of the cut-off time from 15 to 60 sec. All the narcoticlike drugs tested (morphine, codeine, and pentazocine) increased the response latencies of the inflamed paws to the cut-off time. The nonsteroidal antiinflammatory-like drugs tested (acetylsalicylic acid, acetaminophen, indomethacin, phenylbutazone, and proquazone) showed plateaus in their analgesic effects (i.e., increasing the dose failed to produce significantly greater increases in the response latencies compared to the next lower dose). Zomepirac (80-240 mg/kg p.o.) did not show this plateau effect, but was unable to increase response latencies to greater than 30 sec because of the toxicity of higher doses (320 mg/kg p.o.). Flunixin NMG (the meglumine salt of flunixin), a nonnarcotic analgesic, did not display a plateau effect and increased response latencies to maximum values. The methodology was therefore able to discriminate analgesics active against mild to severe clinical pain (narcoticlike) from those only useful against mild to moderate pain (nonnarcotic-like).

Analgesics↗
PubMed1986

Clinical efficacy of antihistaminics as analgesics.

This paper reviews the clinical information on antihistaminic agents as analgesics and as analgesic adjuvants. The evidence indicates a direct analgesic effect of various antihistaminics. In clinical studies, diphenhydramine, hydroxyzine, orphenadrine and pyrilamine have been shown to produce analgesia as simple entities but chlorpheniramine has not and results with phenyltoloxamine have been equivocal when tested alone. Analgesic adjuvant effects of several antihistaminics have been reported. Clinically, orphenadrine and phenyltoloxamine have shown adjuvant effects with acetaminophen and aspirin. The mechanism of action remains speculative. The most recent trends in the classification of histamine receptors and how these receptors may interact with pain modulation are also considered.

Analgesics↗
PubMed1995

Use of analgesics during propofol sedation: a comparison of ketorolac, dezocine, and fentanyl.

STUDY OBJECTIVE: To evaluate the comparative efficacy and side effect profile of ketorolac 60 mg, dezocine 6 mg, and fentanyl 100 micrograms when used as analgesic supplements to a propofol infusion during monitored anesthesia care (MAC). DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Ambulatory surgery facility at a university medical center. PATIENTS: 80 outpatients undergoing breast biopsy or inguinal herniorraphy procedures under MAC. INTERVENTIONS: All patients received midazolam 2 mg intravenously (IV) followed by 1 ml of the study medication containing either dezocine 3 mg IV, ketorolac 30 mg IV, fentanyl 50 micrograms IV, or normal saline. A propofol infusion was initiated at 75 micrograms/kg/min and then varied to maintain a stable level of sedation (i.e., Observer Assessment of Alertness/Sedation scale score of 3). An additional 1 ml of the same study medication was administered IV 2 to 3 minutes prior to infiltration of the local anesthetic solution. During the operation, supplemental (rescue) medication consisted of fentanyl 25 micrograms IV, bolus injections in all four treatment groups. MEASUREMENTS AND MAIN RESULTS: Propofol infusion and supplemental fentanyl dosage requirements, oxygen saturation values, respiratory rates, recovery times, and postoperative side effects were recorded. Visual analog scales were used to assess sedation, anxiety, pain, and nausea preoperatively (baseline), upon entry into the postanesthesia care unit, and at 30-minute intervals until discharge. The fentanyl and dezocine groups required lower average infusion rates of propofol to maintain a stable level of sedation than the control (saline) group. The saline and ketorolac groups required rescue analgesic medication more frequently and/or larger supplemental dosages of fentanyl than the two opioid analgesic treatment groups. Compared with the three analgesic treatment groups, postoperative pain scores were only marginally higher in the control group. Ketorolac-treated patients had consistently (but not significantly) shorter recovery times to oral intake, ambulation, and discharge than those in the dezocine or fentanyl groups. No postoperative nausea, vomiting, or pruritus was reported in the ketorolac group. CONCLUSION: Compared with ketorolac 60 mg, fentanyl 100 micrograms and dezocine 6 mg produced a greater decrease in the propofol sedation requirement during MAC. However, the use of ketorolac in combination with propofol for MAC was associated with an improved recovery profile.

Adult↗
PubMed2005

Paediatric cancer pain management using the WHO analgesic ladder--results of a prospective analysis from 2265 treatment days during a quality improvement study.

OBJECTIVE: To collect data on pain management in paediatric oncology with respect to the WHO ladder approach. SETTING, DESIGN, PATIENTS AND METHODS: Eight German tertiary care paediatric oncology centres prospectively documented all their in-patient pain treatment courses from June 1999 to December 2000. Pain was scored using a 1-6 faces scale. RESULTS: Two hundred and twenty four patients (median age, 9 years; range 0.2-32.1) were enrolled. Three hundred and thirty three pain episodes comprising a total of 2265 treatment days were documented. Pain was mostly therapy associated. The most frequently administered non-opioid analgesics were dipyrone and paracetamol. On WHO step 2, tramadol was almost the only opioid used. During tramadol monotherapy average daily pain scores were lower than with a combination of tramadol and non-opioid analgesics. On WHO step 3, morphine was at least part of the analgesic regimen on most treatment days. Strong opioids were combined with a non-opioid analgesic on 41% of the treatment days. The mean intravenous morphine equivalence dose was 0.034 mg/kg/h. During opioid and non-opioid combination therapy, adverse effects were more frequent, and average pain scored higher than on opioid monotherapy. CONCLUSIONS: WHO-guidelines were closely followed in Germany and seem to provide effective analgesia for children with cancer pain. In our patient group there is no evidence that a combination of an opioid with a non-opioid is more effective than opioid therapy alone in in-patient paediatric oncology pain treatment.

Acetaminophen↗
PubMed2006

Antinociceptive activity of chemical congeners of improgan: optimization of side chain length leads to the discovery of a new, potent, non-opioid analgesic.

Improgan is a chemical congener of the H2 antagonist cimetidine which shows the profile of a highly effective analgesic when administered directly into the CNS. Although the improgan receptor is unknown, improgan activates analgesic pathways which are independent of opioids, but may utilize cannabinoid mechanisms. To discover selective, potent, improgan-like drugs, seven compounds chemically related to improgan were synthesized and tested for antinociceptive activity in rats after intracerebroventricular (icv) administration. Among a series of improgan congeners in which the alkyl chain length of improgan ((-CH2)3-) was varied, five compounds showed full agonist antinociceptive activity with potencies greater than that of improgan. VUF5420 (containing (-CH2)4-, EC50 = 86.1 nmol) produced maximal antinociceptive activity after doses which showed no motor impairment or other obvious toxicity, and was 2.3-fold more potent than improgan (EC50 = 199.5 nmol). As found previously with improgan, VUF5420-induced antinociception was unaffected by administration of the opioid antagonist naltrexone, but was inhibited by the CB1 antagonist SR141716A, suggesting a non-opioid, cannabinoid-related analgesic action. However, VUF5420 showed very low affinity (Kd approximately 10 microM) on CB1-receptor activation of 35S-GTPgammaS binding, indicating that this drug does not directly interact with the CB1 receptor in vivo. The present results show that VUF5420 is a high potency, improgan-like, non-opioid analgesic which may indirectly activate cannabinoid pain-relieving mechanisms.

Analgesics↗
PubMed1996

Adjuvant analgesic agents.

Adjuvant analgesics are usually considered when the patient with cancer pain fails to attain a satisfactory balance between analgesia and side effects during opioid therapy, or experiences a comorbid symptom or disorder that may be amenable to one of the adjuvant drugs. When pain is the primary indication, the use of adjuvant analgesics is one strategy that must be evaluated in comparison with other potentially analgesic approaches. The potential costs, inconvenience, and risks associated with polypharmacy must be balanced by demonstrable benefits. To offer the most informed recommendation, the clinician must have a strong working knowledge of the many drugs currently used as adjuvant analgesics and a detailed assessment of the patient and pain syndrome.

Analgesics, Non-Narcotic↗
PubMed2002

Clinical features and atopy profile in Turkish subjects with analgesic intolerance.

The factors underlying analgesic intolerance (AI), particularly the role of ethnic characteristics, are readily not clear. In this trial, we aimed to assess the predictive features of AI in Turkish subjects. One hundred and ninety patients with AI were enrolled into the study conducted in our tertiary care clinic. The types of drug causing adverse reaction(s) and types of reaction(s) were recorded. The presence of atopy was assessed by skin prick tests. According to the results, the most frequently intolerated analgesic was acetyl salicylic acid (72.1%), followed by nonsteroidal anti-inflammatory drugs (68.4%) and paracetamol (15.8%). Urticaria/angioedema (52.6%) and asthmatic response (40.5%) were the most common reactions to analgesics. Compared with the general adult population of Turkey, the rate of atopy was found be higher in patients with AI and asthma (25% vs. 45%, p = 0.004) but comparable in patients with AI but no atopic disorder (25% vs. 29.2%, p> 0.05). In conclusion, subjects exhibiting intolerance to analgesics have particular features in our population; the presence of atopy in these subjects seems to be associated with the coexistent asthma rather than the drug allergy itself.

Acetaminophen↗
PubMed1998

Magnesium sulfate reduces intra- and postoperative analgesic requirements.

UNLABELLED: In a randomized, double-blind study with two parallel groups, we assessed the analgesic effect of perioperative magnesium sulfate administration in 46 ASA physical status I or II patients undergoing arthroscopic knee surgery with total i.v. anesthesia. The patients received either magnesium sulfate 50 mg/kg preoperatively and 8 mg.kg-1.h-1 intraoperatively or the same volume of isotonic sodium chloride solution i.v. Anesthesia was performed with propofol (2 mg/kg for induction, 6-8 mg.kg-1.h-1 for maintenance), fentanyl (3 micrograms/kg for induction), and vecuronium (0.1 mg/kg for intubation). Intraoperative pain was defined as an increase of mean arterial blood pressure and heart rate of more than 20% from baseline values after the induction of anesthesia and was treated with bolus fentanyl (1-2 micrograms/kg). Postoperative analgesia was achieved with fentanyl (0.5 microgram/kg) and evaluated using the pain visual analog scale for 4 h. During the intraoperative and postoperative periods, patients in the magnesium group required significantly less fentanyl than those in the control group (control group 0.089 +/- 0.02 microgram.kg-1.min-1 versus magnesium group 0.058 +/- 0.01 microgram.kg-1.min-1; P < 0.05 and control group 0.021 +/- 0.013 microgram.kg-1.min-1 and magnesium group 0.0031 +/- 0.0018 microgram.kg-1.min-1; P < 0.01 for intraoperative and postoperative periods, respectively). We conclude that, in a clinical setting with almost identical levels of surgical stimulation, i.v. magnesium sulfate administration reduces intraoperative and postoperative analgesic requirements compared with isotonic sodium chloride solution administration. IMPLICATIONS: The perioperative administration of i.v. magnesium sulfate reduces intra- and postoperative analgesic requirements in patients with almost identical levels of surgical stimulus. Our results demonstrate that magnesium can be an adjuvant to perioperative analgesic management.

Adult↗
PubMed2000

Novel analgesic adjuncts for brachial plexus block: a systematic review.

This article reviews current evidence for the efficacy of adding novel analgesic adjuncts to brachial plexus block, the goal of which is to prolong analgesic effect without the disadvantage of systemic side effects or prolonged motor block. It may also allow for a reduction in the total dose of local anesthetic used. Novel adjuncts studied to date include opioids, clonidine, neostigmine, and tramadol. Twenty-four studies were reviewed and assessed by using specific inclusion criteria, and only those studies satisfying these criteria were included in the final assessment. Satisfactory studies were then assessed for inclusion of a systemic control group to determine peripheral effect, as opposed to possible systemic effect, of an adjunct administered peripherally. Evidence regarding the analgesic benefit of opioid adjuncts remains equivocal and more evidence is required before their routine use can be recommended. Clonidine appears to have significant analgesic benefit and to cause minimal adverse effects when used in doses up to 150 microg. Data regarding other drugs, such as tramadol and neostigmine, are not sufficient to allow for any recommendations, and further studies are required.

Adult↗
PubMed1996

Inherited, selective hyporesponsiveness to the analgesic action of nicotine in mice.

The acute dose-dependent analgesic activity of nicotine, as measured by the tail-flick assay, differed significantly between CD-1 and CF-1 outbred strains of mice. Differing responsiveness to the tail-flick stimulus did not explain this pharmacological effect. The inherent analgesic hyporesponsiveness of CF-1 mice was pharmacologically selective. Xilocaine and morphine produced an analgesic response of large magnitude in CF-1 mice. Reduced efficacy of nicotine in the CF-1 analgesia assay was not observed in its action on locomotor activity or in the induction of seizures and lethality. These findings have practical significance in identifying the importance of genotype in choice of strain for preclinical pharmacological studies of nicotine-induced analgesia and indicate that genetic analysis may provide a valuable tool for investigating the mechanism underlying the analgesic action of nicotine.

Analgesics, Non-Narcotic↗
PubMedDate not supplied

Analgesic prescription and administration to adolescents admitted to an adult versus pediatric trauma center.

OBJECTIVE: To compare the prescription and administration practices for narcotic and non-narcotic analgesics given to injured adolescents admitted to an adult versus pediatric trauma center. METHODS: A retrospective chart review of 45 medical records for documentation of prescribed and administered analgesics in the first 48 hours of hospitalization. RESULTS: Adolescents treated at the adult trauma center had significantly more narcotics ordered in the first 24 hours of admission compared to adolescents in the pediatric trauma center. However, when controlling for injury severity, there was no difference between the narcotic administration at the two trauma centers. There were no differences in the types or numbers of doses of non-narcotic analgesics prescribed or administered. CONCLUSION: There were no differences in the prescription or administration of narcotic and non-narcotic analgesics to injured adolescents in an adult versus a pediatric trauma center. Future research should focus on the prospective enrollment of injured adolescents at additional trauma centers and a larger sample size to validate or refute these findings.

Adolescent↗
PubMedDate not supplied

Acetaminophen, aspirin, or Ibuprofen in combination analgesic products.

Pain of multiple etiologies remains a substantial problem for many patients presenting in the clinical setting. Improved pain relief can be demonstrated, and adverse effects minimized, by multimodal analgesic combinations as the method to improve pain treatment. Substantial evidence supports combining analgesics for the management of pain and, in some instances, they have a heterogeneous pharmacologic sparing effect. Fixed-dose combination analgesics with demonstrated efficacy and safety are widely useful for pain management. However, work needs to continue to further explore which analgesics at which doses can be combined with a coanalgesic in a patient-specific manner to achieve additive, if not synergistic, multimodal pain relief with the fewest possible adverse consequences. Unsupervised consumption of over-the-counter drugs that contain acetaminophen, aspirin, or ibuprofen offers clinical challenges to both the patient and health care providers. Couple this often undisclosed over-the-counter medication consumption event with prescription medications, which many contain similar combination ingredients, and the potential for a therapeutic misadventure may precipitate. This article will address the safety and efficacy of acetaminophen, aspirin, and ibuprofen independently and in combination with currently available prescription dosage forms with a focus on pharmacology, pharmacotherapeutics, pharmacodynamics, and pharmacokinetics, including drug interactions at the CYP450 system. Patient-specific cautions are presented for opiate/opioid combinations, codeine, hydrocodone, oxycodone, and propoxyphene, and there is a discussion of COX I/COX II agents.

Acetaminophen↗
PubMed2004

Systematic review of the analgesic efficacy and tolerability of COX-2 inhibitors in post-operative pain control.

OBJECTIVE: To evaluate the relative analgesic efficacy and tolerability of single-dose COX-2 inhibitors in post-operative pain management. METHOD: Systematic review of randomized controlled trials (RCTs). OUTCOME MEASURES: The area under the pain relief vs. time curve was used to evaluate the proportion of patient achieving at least 50% pain relief using validated equations. The proportions of patients experiencing any adverse event or specific adverse events were also examined. RESULTS: In all, 18 RCTs were included which contained 2783 patients. The results of the effects of single-dose analgesics on the basis of 50% of patients achieving pain relief over 6 h from dental pain models suggested that oral rofecoxib 50 mg was more effective than codeine/paracetamol 60/600 mg, and the rate ratio (RR) was 2.11 (95% CI 1.6-2.75). Valdecoxib 40 mg was also more effective than oxycodone/paracetamol 10/1000 mg (RR 1.34; 95% CI 1.11-1.62). There was no significant differences between other oral COX-2 inhibitors and non-selective non-steroidal anti-inflammatory drugs (NSAIDs), except that celecoxib 200 mg was less effective than ibuprofen 400 mg (RR 0.66; 95% CI 0.48-0.90) and rofecoxib 50 mg (RR 0.65; 95% CI 0.49-0.87). The results from orthopaedic pain model showed no significant difference between rofecoxib 50 mg and naproxen sodium 550 mg (RR 1.04; 95% CI 0.73-1.49). The adverse effects of single-dose COX-2 inhibitor used in short-term post-operative pain management were generally mild and less than non-selective NSAIDs, although there was no significant difference. CONCLUSIONS: The analgesic efficacy and tolerability of single-dose COX-2 inhibitors were more effective than opioid-containing analgesics and similar to non-selective NSAIDs in post-operative pain management. Further studies are needed to examine the efficacy and tolerability of COX-2 inhibitors compared against active comparators over a longer duration to assess whether these short-term effects are mirrored by longer-term outcomes and to determine their ultimate risk-benefit profile.

Analgesics, Non-Narcotic↗
PubMed1998

Efficacy of minor analgesics in primary dysmenorrhoea: a systematic review.

OBJECTIVE: To quantify the efficacy and safety of naproxen, ibuprofen, mefenamic acid, aspirin and acetaminophen (paracetamol) in the treatment of primary dysmenorrhoea through a systemic overview of randomised controlled trials. METHODS: MEDLINE, EMBASE and the Science Citation Index were searched for randomised controlled trials. Efficacy was assessed by measurement of pain relief, requirement for rescue analgesics, restriction of daily life and absence from work or school. The rate ratios of side effects were used to assess safety. RESULTS: Fifty-six trials describing 55 comparisons of analgesics with placebo and 12 direct comparisons with other analgesics met our inclusion criteria. Women taking naproxen were over three times more likely to have at least moderate pain relief than those taking placebo. Ibuprofen, mefenamic acid and aspirin were also superior to placebo but acetaminophen was not. The requirement for rescue analgesics, restriction of daily life and absence from work or school were less frequent with naproxen and ibuprofen than placebo but not with aspirin or acetaminophen. Direct comparisons did not show any difference between naproxen and ibuprofen. Side effects occurred more frequently only with naproxen when compared with placebo. CONCLUSION: Naproxen, ibuprofen, mefenamic acid and aspirin are all effective in primary dysmenorrhoea. Ibuprofen appears to have the most favourable risk-benefit ratio. Acetaminophen appears to be less effective than nonsteroidal anti-inflammatory drugs, but there was only one trial meeting our inclusion criteria and further studies are required.

Acetaminophen↗
PubMed1995

Evidence against the participation of mu- and kappa-opioid receptors in the analgesic activity of ketorolac in rats.

The possibility that activation of opioid receptors is involved in the analgesic activity of ketorolac was explored. The analgesic effects of ketorolac, of ketocyclazocine, the prototype kappa-agonist, and of morphine, the prototype mu-agonist, were assayed in the pain-induced functional impairment model in the rat. All three drugs induced a significant analgesic effect in this model. Naloxone was able to antagonize the effects of ketocyclazocine and morphine. However, the effect of ketorolac was not blocked by naloxone, although a high dose, 3.2 mg kg-1, capable of blocking kappa-receptors was used. It is concluded that activation of mu- or kappa-opioid receptors, by either a direct or an indirect mechanism, does not play a role in the analgesic activity of ketorolac.

Analgesics↗
PubMed2005

The changing role of non-opioid analgesic techniques in the management of postoperative pain.

Given the expanding role of ambulatory surgery and the need to facilitate an earlier hospital discharge, improving postoperative pain control has become an increasingly important issue for all anesthesiologists. As a result of the shift from inpatient to outpatient surgery, the use of IV patient-controlled analgesia and continuous epidural infusions has steadily declined. To manage the pain associated with increasingly complex surgical procedures on an ambulatory or short-stay basis, anesthesiologists and surgeons should prescribe multimodal analgesic regimens that use non-opioid analgesics (e.g., local anesthetics, nonsteroidal antiinflammatory drugs, cyclooxygenase inhibitors, acetaminophen, ketamine, alpha 2-agonists) to supplement opioid analgesics. The opioid-sparing effects of these compounds may lead to reduced nausea, vomiting, constipation, urinary retention, respiratory depression and sedation. Therefore, use of non-opioid analgesic techniques can lead to an improved quality of recovery for surgical patients.

Ambulatory Surgical Procedures↗
PubMed1983

Analgesic potencies of non-narcotic, narcotic and anesthetic drugs as determined by the bradykinin-induced biting-like responses in rats.

Aversive (nociceptive) biting-like responses induced by micro-application of bradykinin solution onto rat tooth pulp were dose-dependently suppressed by non-narcotic drugs such as baclofen and lidocaine as well as carbamazepine and phenytoin, which are employed for clinical treatment of trigeminal neuralgia. The potency order of these drugs on a molar basis is baclofen (4.20) greater than carbamazepine (1.00) greater than lidocaine (0.94) greater than phenytoin (0.19). Such responses were also inhibited by morphine, pentazocine and cyclazocine (potency ratio of the three general analgesics, 1.00:0.46:8.11), indomethacin (a non-narcotic and anti-inflammatory analgesic) and alpha-chloralose (an anesthetic). The latter drug produced an analgesic effect at doses much lower than those used for anesthesia. These findings suggest that our method is feasible for evaluating the activities of general and particular analgesic drugs in the trigeminal regions.

Analgesics↗