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At least 19 recordsLinked to original sources
PubMed1978

Stress-produced analgesia and morphine-produced analgesia: lack of cross-tolerance.

Animals exposed to cold-water swims, rotation, inescapable shocks, abrupt food deprivation and other stressors display temporary analgesia. Since repeated exposures result in adaptation of this analgesia in much the same way that repeated administration of opiates results in tolerance, the possibility of cross-tolerance between cold-water stress-induced and morphine-induced analgesia was investigated. Flinch-jump thresholds were determined in ten experimental groups of six rats each. Three groups showed dose-dependent analgesia following single injections of morphine at 5, 10 and 15 mg/kg, respectively. A fourth group, subjected to a single cold-water swim at 2 degrees C for 3.5 min, displayed analgesia comparable to that produced by 10 mg/kg of morphine. Groups subjected either to 14 daily cold-water swims or to 14 daily morphine injections at 10 mg/kg showed normal thresholds on the 14th day indicating that adaptation and tolerance had developed, respectively. The cross-over groups were exposed to either 13 days of could-water swims followed by morphine or the reverse arrangement. Both groups showed profound analgesia instead of cross-tolerance, suggesting that a non-opiate neural mechanism may mediate stress-induced analgesia.

Analgesia↗
PubMed1992

Patient-controlled epidural analgesia following post-traumatic pelvic reconstruction. A comparison with continuous epidural analgesia.

A randomised, single-blinded study was conducted to compare patient-controlled epidural analgesia with continuous infusion epidural analgesia for the treatment of pain following post-traumatic pelvic reconstruction. The patient-controlled group (n = 11) received a background infusion of 4 ml.h-1 of bupivacaine 0.125% with fentanyl 1 microgram.ml-1, and 3-6 ml bolus doses, self administered, as required (with a 15 min lockout interval). The continuous infusion group (n = 12) received a continuous infusion of the same solution through an identical apparatus, but with the demand button deactivated. This was started at 10 ml.h-1 and adjusted by the anaesthetist, as required, up to a maximum of 25 ml.h-1. Pain scores, side effects, and the volumes of drug infused were recorded over the first 3 postoperative days. One patient from each group was withdrawn because of catheter-related problems. Pain scores were similar and the incidence of nausea and pruritus was low in both groups. There was no recorded instance of respiratory depression or hypotension and there was no significant difference between the groups in the volumes of drug solution received. Patient satisfaction was equally very good in both groups. Patient-controlled epidural analgesia is an effective means of providing pain relief after post-traumatic pelvic reconstruction, but did not significantly reduce analgesic requirements in comparison with continuous infusion epidural analgesia.

Adult↗
PubMed1992

[Patient-controlled analgesia by the peridural route and classical methods of analgesia].

Patient controlled analgesia was developed to compare drug effects. Later its psychological implications were studied. Drug administration by intravenous or epidural injection has been used. The latter provides relief with much smaller doses. Simultaneous use of opioids and anti-inflammatory drugs enhances the analgesic effects. For pain relief in childbirth, opioids need to be combined with local anaesthetics for best results. Little has been achieved by patient controlled analgesia in the treatment of chronic pain.

Acute Disease↗
PubMed1976

Long-term assessment of extradural analgesia for the relief of pain in labour. II: Sense of "deprivation" after extradural analgesia in labour: relevant or not?

Ninety-nine mothers who received extradural analgesia, and 95 who received conventional methods of analgesia for the relief of pain in labour, were interviewed at 18-24 months following delivery. An increase of about 2% in the proportion of mothers experiencing a sense of "deprivation" in the long term in comparison with the findings recorded immediately after delivery was noted. This was not accompanied by the need to seek psychiatric treatment.

Adolescent↗
PubMed1992

Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery.

Epidural administration of an opioid analgesic by means of a patient-controlled analgesia (PCA) system was compared with conventional intravenous PCA for pain relief after cesarean delivery. One hundred seventeen healthy women were randomly assigned to receive hydromorphone either intravenously (IV-PCA) or epidurally (EPI-PCA) after cesarean delivery with epidural bupivacaine for operative anesthesia. The hydromorphone requirements were 3.4 and 4.2 times more in the IV-PCA group on the first (P less than 0.01) and second (P less than 0.01) postoperative days, respectively. The mean number (+/- SD) of PCA demands during the first 24 h after the operation was 105 (+/- 88) for the IV-PCA group and 33 (+/- 48) for the EPI-PCA group (P less than 0.01). This difference was also significant 24-48 h after surgery. Although the EPI-PCA group utilized significantly less opioid medication, pain and sedation scores were similar in the two treatment groups; however, a significantly larger percentage of patients in the IV-PCA group (46% vs 22%) stated that they felt drowsy during the first postoperative day. Pruritus was reported more frequently in the EPI-PCA (67%) than in the IV-PCA (33%) group. Nausea was experienced by only 10% of patients in the IV-PCA and 6% in the EPI-PCA group. There was no evidence of postoperative respiratory depression, with minimal oxygen saturation values of 93% (+/- 3%) and 94% (+/- 1%) in the IV-PCA and EPI-PCA groups, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Extradural analgesia--the preferred method of analgesia for vaginal breech delivery.

A prospective trial was designed to study the effect of extradural analgesia on the management of breech delivery. From a study of 51 patients, it was concluded that the duration of labour was not lengthened, the frequency of breech extraction was decreased and the condition of the infant was improved, as shown by foetal blood sampling and Apgar scores. Therefore we recommend strongly that extradural analgesia should be used in the management of all breech deliveries.

Anesthesia, Epidural↗
PubMed1976

[Postoperative analgesia with continous epidural analgesia and with dolantin (author's transl)].

Hemodynamic reactions to the discontinuation of epidural analgesia and to the injection of Dolantin were studied in 16 patients. One of every three patients reacted to the postoperative pain with an increase in mean arterial pressure(+30%) and in the mean pressure in the arteria pulmonalis (+40%) associated with an increase in stroke volume (+41%) and cardiac output (+49%). The administration of Dolantin did not influence either pressure measurement. In such cases the administration of antihypertensive drugs (alpha-blocking agents) or the reinstitution of epidural analgesia is neccessary.

Analgesics↗
PubMed1975

Hypno-analgesia and acupuncture analgesia: a neurophysiological reality?

The effects of hypnosis, acupuncture and analgesic drugs on the subjective experience of pain and on objective neurophysiological parameters were investigated. Pain was produced by brief electric stimuli on the wrist. Pain challengers were: hypnosis (induced by two different video tapes), acupuncture (at specific and unspecific loci, with and without electrical stimulation of the needles), morphine and ketamine. Evaluation of clinical parameters included the subjective experience of pain intensity, blood pressure, puls, temperature, psychosomatic symptoms and side effects. Neurophysiological parameters consisted of the quantitatively analyzed EEG and somatosensory evlked potential (SEP). Pain was significantly reduced by hypnosis, morphine and ketamine, but not during the control seesion. Of the four acupuncture techniques, only electro-acupuncture at specific loci significantly decreased pain. The EEG changes during hypnosis were dependent on the wording of the suggestion and were characterized by an increase of slow and a decrease of fast waves. Acupuncture induced just the opposite changes, which were most significant when needles were inserted at traditional specific sites and stimulated electrically. The evoked potential findings suggested that ketamine attenuates pain in the thalamo-cortical pathways, while hypnosis, acupuncture and morphine induce analgesia at the later CNS stage of stimulus processing. Finally some clinical-neurophysiological correlations were explored.

Acupuncture Therapy↗
PubMed1978

Cardiovascular effects of epidural analgesia. I. Thoracic epidural analgesia. An experimental study in sheep of the effects on central circulation, regional perfusion and myocardial performance during normoxia, hypoxia and isoproterenol administration.

Some circulatory effects of thoracic epidural analgesia (TEA) were investigated in splenectomized, open-chest sheep during normoxia, hypoxia and isoproterenol administration. During normoxia, TEA caused comparatively marked reductions in systemic arterial blood pressure, total peripheral resistance and cardiac output. A fall in heart rate was not compensated for by any rise in stroke volume. Myocardial contractility (LV dd/dt/IP) was not affected by TEA. The proportion of cardiac output diverted to the blocked area was markedly increased. Compensatory vasoconstriction was not observed within the unblocked area in six out of nine animals. Myocardial blood flow showed a pronounced reduction in accordance with the calculated changes of heart work, so that myocardial oxygen extraction remained unchanged. Studies under hypoxia revealed that cardiac responses to hypoxia in the sheep are mediated chiefly by neurogenic factors. TEA abolished the hypoxia-induced rise in heart rate but did not affect the increase in pulmonary vascular resistance caused by hypoxia. The administration of isoproterenol during TEA increased systemic arterial blood pressure, but due to further fall in total peripheral resistance it was not fully normalized. Cardiac output and heart rate increased markedly. Myocardial oxygen consumption and blood flow increased but did not reach control levels.

Anesthesia, Epidural↗
PubMedDate not supplied

[Pneumoencephalotomography under diaz-analgesia and narco-analgesia].

The authors reported 92 observations of anesthesia for gaseous encephalotomography interest the adult. The contrast produce is air. 49 under diazanalgesia and myoresolution. Diazepam, +Fentanyl, pancuronium bromide N2O to 60 p. 100. 25 under diazanalgesia and myoresolution. Diazepam, +Fentanyl, succinylcholine, N2O to 60 p. 100. 18 under narco-analgesia and myoresolution. +Fentyl, pancuronium bromide N2O to 60 p. 100. The conditions of the study are described in the first part. The results and their analysis permit the appreciation of: - the patient confort, the quality of the examination; -the respect of the hemodynamics for this examination, reputed to be "difficult"; -the immediatly noticeable diminution of side effects; -the absence of side effects; -the justification and interesting of the control ventilation; -the quality of waking up. In the conclusion the authors underline the interest of their different techniques and the possibility of using them in operations in sitting position in neurosurgery, and all important chirurgical intervention.

Adolescent↗
PubMed1978

Enhancement of morphine analgesia and brain levels by methamphetamine in mice.

Methamphetamine and morphine were approximately equipotent in producing analgesia in mice using the tail-flick assay. The ED50 for morphine analgesia was significantly reduced when 3.2 mg/kg of methamphetamine was given 5 or 60 min before morphine. Methamphetamine pretreatment increased the peak effect but did not alter the duration of morphine analgesia. Enhancement of morphine analgesia was apparent when methamphetamine was given up to 60 min before morphine and it did not coincide with analgesia produced by methamphetamine alone. Brain levels of morphine were found to be significantly higher in methamphetamine- compared to saline-pretreated mice, at times when enhanced analgesia was observed. Further studies showed that morphine brain levels were increased by methamphetamine pretreatment in an apparent dose-dependent manner. The analgesia observed at several morphine brain levels was compared in order to determine whether enhanced analgesia resulted from increased morphine brain levels. Methamphetamine administration 5 or 60 min before morphine shifted the log morphine brain level-response curves for morphine analgesia to the left and the morphine brain level at a given percent analgesia was significantly lower in methamphetamine- than in saline-pretreated mice. In addition, methamphetamine pretreatment enhanced methadone analgesia but had no effect on methadone brain levels.

Analgesia↗
PubMed2026

The analgesic efficacy of intrathecal morphine compared to peripheral regional analgesia in total hip arthroplasty: A systematic review and meta-analysis.

BACKGROUND: Following elective total hip arthroplasty, pain continues to be a significant problem. Intrathecal morphine or peripheral regional analgesia, that is local infiltration analgesia or peripheral nerve block, are common analgesic modalities, but it is still not known which is superior. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: The following electronic databases were searched from inception to 24 March 2026: CENTRAL; Ovid Embase; Ovid MEDLINE; Scopus; and Web of Science. ELIGIBILITY CRITERIA: Randomised controlled trials that compared intrathecal morphine to peripheral regional analgesia in patients scheduled for elective total hip arthroplasty under general or spinal anaesthesia. RESULTS: Eight trials and 471 patients were included. The peripheral regional analgesia was peripheral nerve block in six trials and local infiltration analgesia in two trials. No difference was demonstrated between intrathecal morphine and peripheral regional analgesia in regard to the first coprimary outcome, the pain score at rest at 24 h. The quality of evidence was moderate. Intrathecal morphine was found to be superior to peripheral regional analgesia with respect to the second coprimary outcome, the cumulative intravenous morphine equivalent consumption at 24 h. Mean difference (95% CI) was 11.38 mg (4.31-18.45; P  = 0.002, I2  = 81%). The quality of evidence was low. Intrathecal morphine was revealed to be superior to peripheral regional analgesia at 8-12 h for the pain score at rest, 1.24 (0.60-1.88); P  = 0.0001, I2  = 68%; pain score on movement, 1.15 (0.12-2.17), P  = 0.03, I2  = 65%; but the rate of in hospital pruritus was reduced with peripheral regional analgesia, 0.31 (0.17-0.58), P  = 0.0002, I2  = 0%. No differences in functional status were shown. CONCLUSIONS: We found no difference between intrathecal morphine and peripheral regional analgesia in regard to pain score at rest at 24 h. Intrathecal morphine may lead to a favourable effect on some but not all analgesic indices compared to peripheral regional analgesia in elective total hip arthroplasty. The quality of evidence for these positive effects was low. Intrathecal morphine reduced the systemic opioid consumption, but is not in itself an opioid free strategy. This notion is supported by the increased incidence of in hospital pruritus with intrathecal morphine. The quality of evidence for this was high. In view of the quality of evidence, high quality randomised controlled trials are required to substantiate these results.

Humans↗
PubMed1978

[Clinical basis of acupuncture analgesia (author's transl)].

Based on 249 observations acupuncture analgesia has been studied in its clinical picture and its abilities in surgery. Clinically, whatever may be the acupuncture sites, the first appearance of analgesia is noticed on the hands, the feet, the vertex, the auricles of the ears. Then, from these areas the propagation of analgesia extends towards the trunk where analgesia zones are to meet. A generalized analgesia may be obtained on the whole body with non specific, even arbitary acupuncture sites. It is incomplete, not so efficient as analgesia with novocaine. It involves only superficial layers of the skin, the buccal muquous membrane and that of the pharynx, the cornea, the teeth... Deep layers of tissues, muscles, nerves, deep viscera... are not affected by analgesia. Sixty four operations of all kinds have been performed with the view to test acupuncture analgesia. Progressive and late appearance of analgesia seems to favour the hypothesis of a humoral way in the mechanism of acupuncture analgesia.

Acupuncture Therapy↗