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131.
Bellamy N 《Inflammopharmacology》1997,5(2):139-152
Etodolac is a non-steroidal anti-inflammatory drug with analgesic properties. Its primary anti-inflammatory mechanism of action
is through a selective effect on cyclo-oxygenase-2 (COX-2). It is rapidly absorbed after oral administration, and maximum
plasma concentration (Cmax) is reached in 1-2 h, with an elimination half-life (t1/2 ) of 6-8 h.
Etodolac has been widely applied in the treatment of inflammatory arthritides such as rheumatoid arthritis, ankylosing spondylitis
and gout and in osteoarthritis and has been shown to be efficacious and well tolerated.
However, etodolac has other applications which rely primarily on its efficacy as an analgesic. In particular, etodolac has
been evaluated in the treatment of a variety of different pain states. Etodolac has been observed to be efficacious in the
treatment of acute pain following dental extraction, orthopaedic and urological surgery, and episiotomy, as well as in the
treatment of pain due to acute sports injuries, primary dysmenorrhoea, tendonitis, bursitis, periarthritis, radiculalgia and
low back pain.
These studies indicate that etodolac is a multipurpose analgesic with many clinical applications in addition to its use in
the treatment of inflammatory and degenerative forms of arthritis. 相似文献
132.
Jeffrey S. Mogil Pamela Flodman M. Anne Spence Wendy F. Sternberg Benjamin Kest Bogdan Sadowski John C. Liebeskind John K. Belknap 《Behavior genetics》1995,25(4):397-406
Two ongoing selective breeding projects have produced mice that display divergent analgesic responses to morphine. These two projects have selected for similar phenotypes: high and low levorphanol analgesia (HAR/LAR lines; Portland, OR) and high and low swim stress-induced analgesia (HA/LA lines; Jastrzebiec, Poland). Evidence suggests genetic commonalities between mice of the two projects. Using a Mendelian breeding protocol, we have recently found that one or two genetic loci predominantly determine the high morphine analgesia exhibited by HA mice. In the present study we demonstrate that the differential morphine analgesia (5 mg/kg. i.p.) displayed by HAR and LAR mice is similarly oligogenic, predominantly determined by two unlinked loci. A complementation analysis, in which the analgesic responses to morphine of the recessive homozygotes of each project (HAR and HA) were compared to those of their hybrid offspring (HAR x HA), revealed that different genetic loci have been fixed in each project. An intriguing bimodal distribution was observed in the HAR x HA population: Some HAR x HA hybrids displayed greater morphine analgesia than either HAR or HA mice, whereas others displayed minimal analgesia. LAR x LA hybrids displayed less analgesia than either LAR or LA mice. The analgesic responses of HAR x LA and LAR x HA mice were comparable to those of their low-line parents. These findings indicate not only that different loci were responsible for producing high morphine responders in each selection project but that these distinct loci can interact synergistically to produce superhigh and superlow responders. 相似文献
133.
134.
目的:确定硬膜外一次性镇痛法对食管癌病人术后的镇痛效果和减少并发症的意义。方法:93 例病人随机分成实验组( T 组,51 例) 和对照组( C 组,42 例) , T 组于手术结束缝合皮肤切口时经硬膜外导管于 T6 - 7 水平注射吗啡1 mg 加1 % 普鲁卡因10 ml, C 组用阿片类药物肌肉注射镇痛。结果: T 组病人术后疼痛明显减轻,各种并发症显著下降。结论:硬膜外一次性镇痛效果确切,操作方便,副作用少,对降低术后心肺并发症很有意义,尤其对年龄大、心肺功能差的病人较适合。 相似文献
135.
麻黄素并吗啡硬膜外注射的术后镇痛效果 总被引:1,自引:0,他引:1
①目的 探讨麻黄素并吗啡硬膜外注射的术后镇痛效果。②方法 对126 例泌尿外科开放手术后的病人进行间断硬膜外腔注射吗啡(2m g)、麻黄素(20m g),观察其镇痛效果,并与40 例单用吗啡( 2m g)者进行对照。③结果 吗啡、麻黄素的镇痛作用强而持久,一次用药有效时间为(28.4±3.5)h,较对照组的(18.1±2.6)h 明显延长(t= 17.1,P< 0.01)。未见出现血压波动者。④结论 吗啡加麻黄素硬膜外腔注射是安全、长效的术后镇痛方法,特别适用于术后留置导尿或尿流改道的泌尿外科开放手术。 相似文献
136.
Postoperative nausea and vomiting in children using patient-controlled analgesia: the effect of prophylactic intravenous dixyrazine 总被引:1,自引:0,他引:1
BACKGROUND: Although patient-controlled analgesia (PCA) with morphine provides a high degree of satisfactory postoperative analgesia in children, it is often associated with a high incidence of postoperative nausea and vomiting (PONV). Our aim in this study was to evaluate the prophylactic effect of dixyrazine, a phenothiazine with proven anti-emetic properties. METHODS: The incidence of nausea and vomiting was studied in 60 children using PCA after major surgery. The patients were randomised to receive either dixyrazine 0.25 mg kg-1 or placebo on the induction of anaesthesia in a double-blind, placebo-controlled design. The anaesthetic technique was standardised. The PCA pump was programmed to deliver bolus doses of morphine of 20 micrograms kg-1 with a continuous background infusion of 8-10 micrograms kg-1 h-1. Nausea, vomiting, sedation and pain scores were noted every 3 h for a period of 24 h. RESULTS: The morphine consumption of morphine was the same in both groups. During the stay in the recovery room the incidence of vomiting was 3% in the dixyrazine group compared to 30% in the placebo group (P < 0.05). On the ward, 57% versus 83% of the children vomited (P < 0.05). Rescue antiemetics were significantly lower, 30%, in the dixyrazine group compared to 60% in the placebo group (P < 0.05). Higher sedation scores were recorded for the dixyrazine group in the recovery room. No other adverse effects were found. CONCLUSION: A significant number of children using PCA with morphine after major surgery experience PONV. Although prophylactic dixyrazine reduces the incidence and severity of vomiting, the incidence still remains high. 相似文献
137.
Klasen JA Opitz SA Melzer C Thiel A Hempelmann G 《Acta anaesthesiologica Scandinavica》1999,43(10):1021-1026
BACKGROUND: After total knee arthroplasty, patients regularly suffer from severe pain. It is unclear whether epidural or systemic pain therapy is superior in terms of postoperative pain relief, patients' comfort and side effects. A new therapeutic approach, intraarticular opioids, has been suggested with the detection of opioid receptors in inflamed tissue. This method has proven suitable for clinical use in small operations (e.g. knee arthroscopy). In this study, we compared epidural analgesia and intraarticular application of morphine plus "on-demand" intravenous analgesia to "on-demand" intravenous analgesia alone. METHODS: Thirty-seven patients, scheduled for total knee arthroplasty, were randomly assigned to three treatment groups: in group 1 (EPI) patients received bolus doses of morphine via an epidural catheter; in group 2 (IA) an intraarticular bolus of 1 mg of morphine was applied at the end of the operation with subsequent use of a patient-controlled analgesia (PCA) pump; group 3 (Control), in which only PCA was provided, served as control for both analgesic procedures. Main outcome measures included visual analogue pain scales, total morphine consumption, and stress hormones. RESULTS: No statistically significant differences in visual analogue pain scales could be detected between the three groups. Application of intraarticular morphine did not reduce the amount of analgesics required for postoperative analgesia as compared to intravenous analgesia alone. Application of epidural morphine significantly suppressed beta-endorphine release, but did not significantly influence other stress hormones as compared to the control group. CONCLUSION: Epidural and intravenous analgesia after total knee arthroplasty are equivalent methods of pain relief. In major orthopaedic procedures, application of intraarticular morphine does not reduce analgesic requirements. 相似文献
138.
Summary Object. This study was undertaken to determine whether a special postoperative pain administration of tramadol and diclofenac provides
any benefits in patients who underwent microsurgical lumbar discectomy.
Methods. The study consisted of 60 patients undergoing microsurgical lumbar discectomy. Patients were randomly divided into two groups
based on the postoperative pain management: 1) Group A (n=30): no standardized pain therapy; these patients received on demand
different analgesics and at variable dosages which were selected by the neurosurgeons; 2) Group B (n=30): standardized pain
therapy with specific dosages of tramadol and diclofenac in regular time intervals during the first 48 hours after surgery.
After surgery follow-up data from a special standardized questionnaire were obtained for all 60 patients during the first
48–72 postoperative hours. The patients were asked for course and intensity of pain as well as about some specific circumstances
of clinical therapy after surgery.
The postoperative pain intensity of patients treated with the special combination of tramadol and diclofenac was significantly
diminished (24 hours after surgery: p=0.0002, 48 h: p=0.0047, 72 h: p=0.0034) in relation to the group without standardized
pain therapy. Similarly, the frequency of breakthrough pain was significantly reduced (24 h: p=0.0001, 48 h: p=0.003, 72 h:
p=0.004).
Conclusions. The results suggest that the application of tramadol and diclofenac during the first 48 hours after lumbar microdiscectomy
results in a reduction in postoperative pain without complications. We suggest that the use of this combination can be a beneficial
adjunct to lumbar disc surgery. 相似文献
139.
Sulimma F Lieb WE 《Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft》1999,96(11):724-727
Fragestellung: Orbitotomien nehmen innerhalb der Ophthalmochirurgie auf Grund der involvierten anatomischen Strukturen und des daraus resultierenden
Spektrums m?glicher perioperativer Probleme eine Sonderstellung ein. Um einen überblick über die Art und H?ufigkeit intra-
und postoperativer Probleme bei Orbitotomien zu erhalten, führten wir eine retrospektive Auswertung an unserer Klinik durchgeführter
Orbitotomien durch.
Patienten und Methode: Es wurden 48 Orbitotomien bei 46 Patienten berücksichtigt, die zwischen 08/1995 und 02/1998 operiert wurden.
Ergebnisse: Schwerwiegende intraoperative Komplikationen waren mit zwei transfusionspflichtigen Blutungen und einer Liquorfistel selten.
Sie wurden interdisziplin?r behandelt. Postoperativ traten vorübergehende funktionelle St?rungen mit guter Rückbildungstendenz
wie Visusminderungen (35 %), Motilit?tsst?rungen mit oder ohne Doppelbildwahrnehmung (20 %) und Lidfehlstellungen auf. Ihnen
liegt v. a. die postoperative ?dem- und H?matombildung zugrunde. Persistierende Funktionseinschr?nkungen waren dagegen selten
(10 %).
Schlu?folgerung: Unsere Untersuchung zeigt, da? perioperativ bei Orbitotomien v. a. vorübergehende funktionelle Einschr?nkungen auftreten,
die sich rasch zurückbilden. Schwere Komplikationen sind dagegen selten, treten v. a. intraoperativ auf und k?nnen eine interdisziplin?re
Therapie erfordern.
相似文献
140.
We programmed a formula which predicts the incidence of either myocardial infarction or cardiac death during the postoperative period. The original formula was proposed by Shah et al, based on their own data and analysis. The program is simple and is written in a language called Quick Basic. The use of this program is also simple. Such a program has improved the use of this analysis substantially. The program has been posted on to a few Computer network services as a free software.(Suwa K, Ogura S: Programming a predictive formula for angina and other risk factors in patients with cardiac diseases undergoing non-cardiac operations. J Anesth 6: 241–242, 1992) 相似文献