NATURAL AND PARTIALLY SYNTETIC ANALGESICS

Directory of Open Access Journals (Sweden)

Stevan Glogovac

2005-12-01

Full Text Available Humans have a long hystory of stimulating and mind-altering substances use. Depressive drugs, including morphine and other narcotics, barbiturates and ethanol, are strongly addictive for susceptible individuals. The phenomenon is most striking in the case of opiates. Morphine is an alkaloid of opium. Named after the Roman god of dreams, Morpheus, the compound has potent analgesic properties toward all types of pain. By supstitution of two hydroxylic groups of morphine many natural and semysyntetic derivatives with different pharmacological activity and analgesic action are obtained. Determinations and quantifications of narcotic analgesics in drug addicts are important in forensic medicine and clinical toxicology. With development of highly sensitive chromatography technique (HPLC-GC, GH-MS, more and more substances are determined, including opioid drugs: morphine, codeine, dyhydrocodeine, and heroin and 6-monoacetyl morphine. Hair analysys by HPLC/MS spectroscopy is an effective forensic tool for determining the use of abused drugs. The “fingerprint” for heroin in the mixture with the other substances(1-10 components is determined by 1D-TOCSY NMR.

Anti-inflammatory and Analgesic Activities of Amorphophallus bulbifer

African Journals Online (AJOL)

HP

time of the animals treated with either standard or extract. Pentazocin ... standard. Results: The extract showed significant anti-inflammatory and analgesic activities at the two test dose ..... effectiveness of analgesic agents in the tail- flick pain ...

Can quantitative sensory testing predict responses to analgesic treatment?

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Grosen, K; Fischer, I W D; Olesen, A E; Drewes, A M

2013-10-01

The role of quantitative sensory testing (QST) in prediction of analgesic effect in humans is scarcely investigated. This updated review assesses the effectiveness in predicting analgesic effects in healthy volunteers, surgical patients and patients with chronic pain. A systematic review of English written, peer-reviewed articles was conducted using PubMed and Embase (1980-2013). Additional studies were identified by chain searching. Search terms included 'quantitative sensory testing', 'sensory testing' and 'analgesics'. Studies on the relationship between QST and response to analgesic treatment in human adults were included. Appraisal of the methodological quality of the included studies was based on evaluative criteria for prognostic studies. Fourteen studies (including 720 individuals) met the inclusion criteria. Significant correlations were observed between responses to analgesics and several QST parameters including (1) heat pain threshold in experimental human pain, (2) electrical and heat pain thresholds, pressure pain tolerance and suprathreshold heat pain in surgical patients, and (3) electrical and heat pain threshold and conditioned pain modulation in patients with chronic pain. Heterogeneity among studies was observed especially with regard to application of QST and type and use of analgesics. Although promising, the current evidence is not sufficiently robust to recommend the use of any specific QST parameter in predicting analgesic response. Future studies should focus on a range of different experimental pain modalities rather than a single static pain stimulation paradigm. © 2013 European Federation of International Association for the Study of Pain Chapters.

Analgesic effects of dexamethasone in burn injury

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Werner, Mads U; Lassen, Birgit Vibeke; Kehlet, Henrik

2002-01-01

and secondary hyperalgesia. RESULTS: The burn injury induced significant increases in erythema (P burn did not differ between dexamethasone and placebo treatments (P >.6). There were no significant......BACKGROUND AND OBJECTIVES: Glucocorticoids are well-known adjuvant analgesics in certain chronic pain states. There is, however, a paucity of data on their analgesic efficacy in acute pain. Therefore, the aim of the study was to examine the analgesic effects of dexamethasone in a validated burn...... model of acute inflammatory pain in humans. METHODS: Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Intravenous dexamethasone 8 mg or placebo was administered on 2 separate study days. Two hours after drug administration, a first-degree burn...

The effectiveness of analgesic electrotherapy in the control of pain ...

African Journals Online (AJOL)

The change in pain perceived was assessed after a course of analgesic electrotherapy using a visual analogue scale as well as changes in use of analgesics and walking ability. Results: The level of pain reported and use of analgesics dropped significantly after the electrotherapy course, compared to the control group.

Do caffeine-containing analgesics promote dependence? A review and evaluation.

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Feinstein, A R; Heinemann, L A; Dalessio, D; Fox, J M; Goldstein, J; Haag, G; Ladewig, D; O'Brien, C P

2000-11-01

Debates about the suspected association between kidney disease and use of analgesics have led to concern about whether caffeine could stimulate an undesirable overuse of phenacetin-free combined analgesics. A committee was asked to critically review the pertinent literature and to suggest guides for clinical practice and for consideration of international regulatory authorities. A group of international scientists, jointly selected by the regulatory authorities of Germany, Switzerland, and Austria and the pharmaceutical industry. All invited experts evaluated relevant literature and reports and added further information and comments. Caffeine has a synergistic effectiveness with analgesics. Although caffeine has a dependence potential, the potential is low. Experimental data regarding dependence potential for caffeine alone may not correspond to the conditions in patients with pain. Withdrawal is not likely to cause stimulation or sustainment of analgesic intake. For drug-induced headache, no single or combined analgesic was consistently identified as causative, and no evidence exists for a special role of caffeine. Strong dependence behavior was observed only in patients using phenacetin-containing preparations, coformulated with antipyretics/analgesics and caffeine. This finding may have led to the impression that caffeine stimulates overuse of analgesics. Although more experimental and long-term data would be desirable to show possible mechanisms of dependence and to offer unequivocal proof of safety, the committee concluded that the available evidence does not support the claim that analgesics coformulated with caffeine, in the absence of phenacetin, stimulate or sustain overuse.

Repeated Time-to-event Analysis of Consecutive Analgesic Events in Postoperative Pain

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Juul, Rasmus Vestergaard; Rasmussen, Sten; Kreilgaard, Mads

2015-01-01

BACKGROUND: Reduction in consumption of opioid rescue medication is often used as an endpoint when investigating analgesic efficacy of drugs by adjunct treatment, but appropriate methods are needed to analyze analgesic consumption in time. Repeated time-to-event (RTTE) modeling is proposed as a way...... to describe analgesic consumption by analyzing the timing of consecutive analgesic events. METHODS: Retrospective data were obtained from 63 patients receiving standard analgesic treatment including morphine on request after surgery following hip fracture. Times of analgesic events up to 96 h after surgery...... were extracted from hospital medical records. Parametric RTTE analysis was performed with exponential, Weibull, or Gompertz distribution of analgesic events using NONMEM®, version 7.2 (ICON Development Solutions, USA). The potential influences of night versus day, sex, and age were investigated...

[Management of opioid maintenance treatments when analgesic treatments are required].

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Laprevote, Vincent; Geoffroy, Pierre A; Rolland, Benjamin; Leheup, Benoît F; Di Patrizio, Paolo; Cottencin, Olivier; Schwan, Raymund

2013-01-01

Opioid maintenance treatments (OMT) reduce illicit opiate use and its associated risks. They are often prescribed on a long-term basis. Physiological changes induced by long-term OMT may cause hyperalgesia and cross-tolerance to opioid agonists, which suggests that the dosage of analgesic treatment should be modified in cases of acute pain, especially when an opioid-based analgesia is required. When treatment with analgesics is necessary, OMT must be maintained, except in exceptional cases. If a split-dosing schedule is temporarily employed during OMT, the daily dosage should not be increased for analgesic purposes. Analgesic treatment must be managed differently in case of treatment with buprenorphine or methadone. With buprenorphine, non-opioid analgesics should be introduced first, if possible. If this strategy is inefficient or contraindicated, a temporary or definitive switch to methadone should be considered. In the case of methadone-based OMT, opioid analgesics should be added directly and the dosage should be adapted according to the level of pain reported by the patient. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Analgesic properties of Capraria biflora leaves aqueous extract.

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Acosta, S L; Muro, L V; Sacerio, A L; Peña, A R; Okwei, S N

2003-12-01

The analgesic properties of dried leaves of Capraria biflora were investigated. The aqueous extract (50-200 mg kg(-1)) produced moderate inhibition of acetic acid-induced writhing in mice. At the same doses, a better analgesic effect was observed on the hot plate test.

The analgesic effect of different antidepressants combined with ...

African Journals Online (AJOL)

Background: Combination analgesics provide more effective pain relief for a broader spectrum of pain. This research examines the possible potentiation of the analgesic effect of different classes of antidepressants when combined with aspirin in thermal model of pain using Albino mice. Methods: Different groups of six ...

Retrospective Evaluation of Analgesics Prescribing Pattern in a ...

African Journals Online (AJOL)

The study was designed to retrospectively evaluate the analgesics prescribing pattern in the Accident and Emergency (A and E) Unit of University of Benin Teaching Hospital, Benin City. The data was retrieved from the pharmacy archives type of analgesics and its routes of administration whether oral or parenteral in all ...

Outlook Analgesic Infusion Pumps Market Size - Trends and Opportunity Forecast to 2023

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nishthavohra

2018-01-01

Analgesic infusion pumps are instruments used to carry analgesic drugs directly into patient’s body directly for pain management. Analgesic drugs provide relief from chronic disorders, including complex regional pain syndrome (CRPS), failed back syndrome pain, myocardial infarction, pneumonia, myocardial ischemia, post-operative pain, and hypertension. Lidocaine, phenol and morphine are some of the common medicines used in analgesic infusion pumps. Explore Report At: https://www.psmarket...

Analgesic and Anti-Inflammatory Activity of Pinus roxburghii Sarg.

Directory of Open Access Journals (Sweden)

Dhirender Kaushik

2012-01-01

Full Text Available The Chir Pine, Pinus roxburghii, named after William Roxburgh, is a pine native to the Himalaya. Pinus roxburghii Sarg. (Pinaceae is traditionally used for several medicinal purposes in India. As the oil of the plant is extensively used in number of herbal preparation for curing inflammatory disorders, the present study was undertaken to assess analgesic and anti-inflammatory activities of its bark extract. Dried and crushed leaves of Pinus roxburghii Sarg. were defatted with petroleum ether and then extracted with alcohol. The alcoholic extract at the doses of 100 mg/kg, 300 mg/kg, and 500 mg/kg body weight was subjected to evaluation of analgesic and anti-inflammatory activities in experimental animal models. Analgesic activity was evaluated by acetic acid-induced writhing and tail immersion tests in Swiss albino mice; acute and chronic anti-inflammatory activity was evaluated by carrageenan-induced paw oedema and cotton pellet granuloma in Wistar albino rats. Diclofenac sodium and indomethacin were employed as reference drugs for analgesic and anti-inflammatory studies, respectively. In the present study, the alcoholic bark extract of Pinus roxburghii Sarg. demonstrated significant analgesic and anti-inflammatory activities in the tested models.

Use of analgesic drugs and risk of ovarian cancer

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Ammundsen, Henriette B; Faber, Mette T; Jensen, Allan

2012-01-01

The role of analgesic drug use in development of ovarian cancer is not fully understood. We examined the association between analgesic use and risk of ovarian cancer. In addition, we examined whether the association differed according to histological types....

Dental therapeutic practice patterns in the U.S. II. Analgesics, corticosteroids, and antibiotics.

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Moore, Paul A; Nahouraii, Helen S; Zovko, Jayme G; Wisniewski, Stephen R

2006-01-01

This article examines the prescribing practices for peripherally acting and centrally acting analgesics, corticosteroids, and antibiotics following third molar extraction. A nationwide survey involving the prescribing patterns of a random national sample of 850 practicing oral surgeons was performed in 2004. Ibuprofen was the peripherally acting analgesic respondents used most frequently in the previous month, selected by 73.5% of the respondents. The ibuprofen dose prescribed most frequently was 800 mg, followed by doses of 600 mg and 400 mg. The centrally acting analgesic prescribed most frequently was the combination formulation of hydrocodone with acetaminophen, selected by 64.0% of the respondents. Recommendations for oral analgesics to manage postoperative pain relied on the peripherally acting analgesic ibuprofen or the centrally acting analgesic combination formulation hydrocodone with acetaminophen. Routine instructions to use centrally acting analgesics "as needed for pain" suggest that centrally acting analgesics are offered to manage pain that postoperative peripherally acting analgesics and intraoperative long-acting local anesthetics do not control adequately. The frequency with which oral and maxillofacial surgeons administered antibiotics and corticosteroids varied widely based on perceived patient need and dentist expectations.

Evaluation of anti-pyretic and analgesic activity of Emblica officinalis Gaertn.

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Perianayagam, James B; Sharma, S K; Joseph, Aney; Christina, A J M

2004-11-01

The present study was designed to investigate the anti-pyretic and analgesic activity of ethanol (EEO) and aqueous (AEO) extracts of Emblica officinalis fruits in several experimental models. A single oral dose of EEO and AEO (500 mg/kg, i.p.) showed significant reduction in brewer's yeast induced hyperthermia in rats. EEO and AEO also elicited pronounced inhibitory effect on acetic acid-induced writhing response in mice in the analgesic test. Both, EEO and AEO did not show any significant analgesic activity in the tail-immersion test. These findings suggest that extracts of Emblica officinalis fruits possessed potent anti-pyretic and analgesic activity. Preliminary phytochemical screening of the extracts showed the presence of alkaloids, tannins, phenolic compounds, carbohydrates and amino acids, which may be responsible for anti-pyretic and analgesic activities.

Case Report - Analgesic nephropathy as a cause of end‑stage renal ...

African Journals Online (AJOL)

Analgesic nephropathy is a subtle but significant cause of chronic renal failure. There is paucity of data on analgesic nephropathy in Nigeria. This case presentation is to highlight the need to have high index of suspicion in patients at risk of developing analgesic nephropathy. In March 2009 a 55‑year‑old businessman was ...

The analgesic effects of exogenous melatonin in humans.

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Andersen, Lars Peter Holst

2016-10-01

The hormone, melatonin is produced with circadian rhythm by the pineal gland in humans. The melatonin rhythm provides an endogenous synchronizer, modulating e.g. blood pressure, body temperature, cortisol rhythm, sleep-awake-cycle, immune function and anti-oxidative defence. Interestingly, a number of experimental animal studies demonstrate significant dose-dependent anti-nociceptive effects of exogenous melatonin. Similarly, recent experimental- and clinical studies in humans indicate significant analgesic effects. In study I, we systematically reviewed all randomized studies investigating clinical effects of perioperative melatonin. Meta-analyses demonstrated significant analgesic and anxiolytic effects of melatonin in surgical patients, equating reductions of 20 mm and 19 mm, respectively on a VAS, compared with placebo. Profound heterogeneity between the included studies was, however, present. In study II, we aimed to investigate the analgesic, anti-hyperalgesic and anti-inflammatory effects of exogenous melatonin in a validated human inflammatory pain model, the human burn model. The study was performed as a randomized, double blind placebo-controlled crossover study. Primary outcomes were pain during the burn injury and areas of secondary hyperalgesia. No significant effects of exogenous melatonin were observed with respect to primary or secondary outcomes, compared to placebo. Study III and IV estimated the pharmacokinetic variables of exogenous melatonin. Oral melatonin demonstrated a t max value of 41 minutes. Bioavailability of oral melatonin was only 3%. Elimination t 1/2 were approximately 45 minutes following both oral and intravenous administration, respectively. High-dose intravenous melatonin was not associated with increased sedation, in terms of simple reaction times, compared to placebo. Similarly, no other adverse effects were reported. In Study V, we aimed to re-analyse data obtained from a randomized analgesic drug trial by a selection of

Factors influencing use of analgesics among construction workers in ...

African Journals Online (AJOL)

2Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Legon. Corresponding ... Many respondents (68.0%) used Brand 1 a locally manufactured analgesic with paracetamol ... advertisements for analgesics in the media. Funding: .... based on awareness of its use, required dosage,.

[Analgesic abuse and psychiatric comorbidity in headache patients].

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Radat, F; Irachabal, S; Swendsen, J; Henry, P

2002-01-01

Headache patients frequently overuse analgesic medications: 20% of the patients from headache centers is concerned by this problem, which has been estimated to occur in four percent of the community migrainers. Frequent use of various types of headache medication may paradoxically cause an increase in headache attack frequency as well as their chronicisation due to potentially complex mechanisms of sensitization. Patients will enter into a self- perpetuating cycle of daily headaches and use of symptomatic medications which can lead to addiction and to social and occupational impairement. Indeed, many patients will experience pharmacological tolerance and dependence but also by some kind of craving. International Headache Society qualify these patients as abusers referring mostly to the amount of substance ingested. Hence patients are labelled analgesic abusers . However, as many of these analgesic medications contained psychotropic substances (i.e. caffeine, codeine.), these patients may fulfill DSM IV criteria of dependance. Nevertheless, the dependance criteria should be adapted to chronic pain patients. Indeed, if pharmacological dependence and tolerance criteria are easy to apply in such patients, it is not the case for the criteria a great deal of time spent to obtain substances, to use substances or to recover from substances effects . As analgesic medications are legally obtained from medical practitioners, drug seeking behaviours are mostly: obtaining medications from multiple providers, repeating episodes of prescription loss and multiplying requests for early refills. Moreover the detrimental effects of analgesic abuse on psychosocial functioning is likely to be related to pain rather than to medication overuse. Finally the best indicator of addictive behaviors in such patients, is the loss of control over the use of analgesic medication despite the adverse consequences over pain. Comorbidity with addiction to other substances has never been specifically

Phytochemical Screening and Evaluation of Analgesic Activity of Oroxylum indicum.

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Das, B K; Al-Amin, M M; Russel, S M; Kabir, S; Bhattacherjee, R; Hannan, J M A

2014-01-01

We aimed to study phytochemical screening and analgesic activity of ethanol extract of Oroxylum indicum. The dried powder of the barks of the plant was extracted with 95% ethanol and was subjected to various phytochemical tests to ascertain the principle constituents contained in the extract. The result revealed the presence of alkaloids, flavonoids, tannins, glycosides in the ethanol extract of Oroxylum indicum. The extract was screened for analgesic activity by using hot plate, acetic acid-induced writhing and formalin test. The ethanol extract of the plant at two different doses (250 and 500 mg/kg) showed significant (Panalgesic effect in all test methods (hot plate, acetic acid-induced writhing and formalin). The analgesic activity was compared with a standard drug (ketorolac at 10 mg/kg). Based on the present findings and previous literature review it can be concluded that flavonoids and tannins might be responsible for the analgesic activity. We suggest that ethanol extract of Oroxylum indicum might have potential chemical constituents that could be used in the future for the development of novel analgesic agent.

The usage and efficacy of a combination analgesic preparation ...

African Journals Online (AJOL)

Combination analgesics are frequently prescribed for the treatment of a multitude of conditions. Many of these preparations contain agents with no proven analgesic efficacy. We examined 3059 patients using a new combination agent containing only paracetamol, codeine, and ibuprofen. It appears that despite a wide ...

Anti-inflammatory and analgesic activity of water extract from ...

African Journals Online (AJOL)

This study was done to evaluate the antiinflammatory and analgesic activities of the water extract of the plant in experimental animal models (anti-inflammatory action by carrageenan-induced rat paw edema, the analgesic activity by acetic acid-induced writhing response method. The water extract of I. asarifolia in doses of ...

Role of serotonin in pathogenesis of analgesic induced headache

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Srikiatkhachorn, A.

1999-12-16

Analgesic abuse has recently been recognized as a cause of deterioration in primary headache patients. Although the pathogenesis of this headache transformation is still obscure, and alteration of central pain control system is one possible mechanism. A number of recent studies indicated that simple analgesics exert their effect by modulating the endogenous pain control system rather than the effect at the peripheral tissue, as previously suggested. Serotonin (5-hydroxytryptamine ; 5-HT) has long been known to play a pivotal role in the pain modulatory system in the brainstem. In the present study, we investigated the changes in 5-HT system in platelets and brain tissue. A significant decrease in platelet 5-HT concentration (221.8{+-}30.7, 445.3{+-}37.4 and 467.2{+-}38.5 ng/10{sup 9} platelets, for patients with analgesic-induced headache and migraine patients, respectively, p<0.02) were evident in patients with analgesic induced headache. Chronic paracetamol administration induced a decrease in 5-HT{sub 2} serotonin receptor in cortical and brain stem tissue in experimental animals (B{sub max}=0.93{+-}0.04 and 1.79{+-}0.61 pmol/mg protein for paracetamol treated rat and controls, respectively, p<0.05). Our preliminary results suggested that chronic administration of analgesics interferes with central and peripheral 5-HT system and therefore possibly alters the 5-HT dependent antinociceptive system. (author)

Safety of lornoxicam in the treatment of postoperative pain: a post-marketing study of analgesic regimens containing lornoxicam compared with standard analgesic treatment in 3752 day-case surgery patients.

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Rawal, Narinder; Krøner, Karsten; Simin-Geertsen, Marija; Hejl, Charlotte; Likar, Rudolf

2010-01-01

Post-marketing surveillance studies can provide supplemental data on the safety of medications in the general population. This study aimed to evaluate the safety of analgesic regimens including the NSAID lornoxicam in the short-term treatment of postoperative pain in a clinically relevant population. Randomized, open-label, multicentre, multinational, observational cohort study of 4 days' duration. In-hospital postoperative setting, with discharge to home treatment within 24 hours of surgery. Adults aged > or =18 years expected to be in need of analgesic treatment after day-case surgery. Analgesic regimens containing lornoxicam were compared with a standard analgesic treatment, which was defined as the treatment that the patient would normally receive at the centre. Following day-case surgery, patients were provided with appropriate analgesic medication, and adverse events (AEs; defined as all recorded events with symptoms) were recorded by the investigator during the in-hospital stay and by the patient for the next 3 days using entries recorded morning and evening in a patient diary. Statistical analyses tested for between-treatment differences in AEs, adverse drug reactions (ADRs; defined as events probably, possibly or unlikely to be related to treatment) and gastrointestinal AEs (GI-AEs). A total of 4152 patients were randomized to treatment. Since 400 patients did not take any analgesic, the safety population consisted of 1838 patients for lornoxicam and 1914 patients for standard analgesic treatment. Demographic and disease characteristics were similar between the two treatment groups, as were the type of surgery and the anaesthesia used in surgery. In the safety population, 16.9% of patients received no analgesic in hospital, and when analgesics were provided they were often administered in combination. Similarly, approximately 17% of patients did not take any analgesics at home. AEs were reported in 27.1% and 29.4% of patients in the lornoxicam and standard

Analgesic activity of Nelsonia canescens (Lam.) Spreng.root in albino rats

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Mohaddesi, Behzad; Dwivedi, Ravindra; Ashok, B. K.; Aghera, Hetal; Acharya, Rabinarayan; Shukla, V. J.

2013-01-01

Present study was undertaken to evaluate analgesic activity of root of Nelsonia canescens (Lam.) Spreng, a folklore medicinal plant used as the one of the source plant of Rasna. Study was carried out at two dose levels (270 mg/kg and 540 mg/kg) in albino rats. Analgesic activity was evaluated in formalin induced paw licking, and tail flick methods whereas indomethacin and pentazocine were used as standard analgesic drugs, respectively. At both the dose levels, test drug non-significantly decreased paw licking response at both time intervals. In tail flick model, the administration of the test drug increased pain threshold response in a dose dependent manner. In therapeutically equivalent dose level, analgesic activity was observed only after 180 min while in TED ×2 treated group analgesia was observed at 30 min and lasted even up to 240 min. The results suggested that N.canescens root possess moderate analgesic activity. PMID:24250136

Analgesics use in competitive triathletes: its relationship to doping and on predicting its usage.

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Dietz, Pavel; Dalaker, Robert; Letzel, Stephan; Ulrich, Rolf; Simon, Perikles

2016-10-01

The two major objectives of this study were (i) to assess variables that predict the use of analgesics in competitive athletes and (ii) to test whether the use of analgesics is associated with the use of doping. A questionnaire primarily addressing the use of analgesics and doping was distributed among 2,997 triathletes. Binary logistic regression analysis was performed to predict the use of analgesics. Moreover, the randomised response technique (RRT) was used to estimate the prevalence of doping in order to assess whether users of analgesics have a higher potential risk for doping than non-users. Statistical power analyses were performed to determine sample size. The bootstrap method was used to assess the statistical significance of the prevalence difference for doping between users and non-users of analgesics. Four variables from a pool of 16 variables were identified that predict the use of analgesics. These were: "version of questionnaire (English)", "gender (female)", "behaviour in case of pain (continue training)", and "hours of training per week (>12 h/week)". The 12-month prevalence estimate for the use of doping substances (overall estimate 13.0%) was significantly higher in athletes that used analgesics (20.4%) than in those athletes who did not use analgesics (12.4%). The results of this study revealed that athletes who use analgesics prior to competition may be especially prone to using doping substances. The predictors of analgesic use found in the study may be of importance to prepare education material and prevention models against the misuse of drugs in athletes.

Analgesic Treatment in Laparoscopic Gastric Bypass Surgery

DEFF Research Database (Denmark)

Andersen, Lars P H; Werner, Mads U; Rosenberg, Jacob

2014-01-01

This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines. The litera......This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines...

Imaging drugs with and without clinical analgesic efficacy.

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Upadhyay, Jaymin; Anderson, Julie; Schwarz, Adam J; Coimbra, Alexandre; Baumgartner, Richard; Pendse, G; George, Edward; Nutile, Lauren; Wallin, Diana; Bishop, James; Neni, Saujanya; Maier, Gary; Iyengar, Smriti; Evelhoch, Jeffery L; Bleakman, David; Hargreaves, Richard; Becerra, Lino; Borsook, David

2011-12-01

The behavioral response to pain is driven by sensory and affective components, each of which is mediated by the CNS. Subjective pain ratings are used as readouts when appraising potential analgesics; however, pain ratings alone cannot enable a characterization of CNS pain circuitry during pain processing or how this circuitry is modulated pharmacologically. Having a more objective readout of potential analgesic effects may allow improved understanding and detection of pharmacological efficacy for pain. The pharmacological/functional magnetic resonance imaging (phMRI/fMRI) methodology can be used to objectively evaluate drug action on the CNS. In this context, we aimed to evaluate two drugs that had been developed as analgesics: one that is efficacious for pain (buprenorphine (BUP)) and one that failed as an analgesic in clinical trials aprepitant (APREP). Using phMRI, we observed that activation induced solely by BUP was present in regions with μ-opioid receptors, whereas APREP-induced activation was seen in regions expressing NK(1) receptors. However, significant pharmacological modulation of functional connectivity in pain-processing pathways was only observed following BUP administration. By implementing an evoked pain fMRI paradigm, these drugs could also be differentiated by comparing the respective fMRI signals in CNS circuits mediating sensory and affective components of pain. We report a correlation of functional connectivity and evoked pain fMRI measures with pain ratings as well as peak drug concentration. This investigation demonstrates how CNS-acting drugs can be compared, and how the phMRI/fMRI methodology may be used with conventional measures to better evaluate candidate analgesics in small subject cohorts.

Post natal use of analgesics: comparisons between conventional postnatal wards and a maternity hotel.

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Nordeng, Hedvig; Eskild, Anne; Nesheim, Britt-Ingjerd

2010-04-01

To investigate factors related to analgesic use after delivery, and especially whether rates of analgesic use were different in a midwife-managed maternity hotel as compared to conventional postnatal wards. One maternity hotel and two conventional postnatal wards at Ullevål University Hospital in Oslo, Norway. Data were obtained from hospital records for 804 women with vaginal deliveries. Postnatal analgesic use. Overall, approximately half the women used analgesics after vaginal delivery in both conventional postnatal wards and maternity hotel. The factors that were significantly associated with use of analgesics postnatally in multivariate analysis were multiparity, having a non-Western ethnicity, smoking in pregnancy, younger age, instrumental delivery, analgesic use during labour, maternal complications post partum, and duration of postnatal stay 4 days or more. The use of analgesics is determined by socio-demographic and obstetric factors rather than the organisation of the ward.

National consumption of opioid and nonopioid analgesics in Croatia: 2007–2013

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Krnic, Darko; Anic-Matic, Andrea; Dosenovic, Svjetlana; Draganic, Pero; Zezelic, Sasa; Puljak, Livia

2015-01-01

Background The increased consumption of analgesics has been documented worldwide during the last 2 decades. The aim of the study was to examine the trends in opioid and nonopioid analgesic consumption in Croatia between 2007 and 2013. Methods Data on opioid consumption were extracted from the database of the national authority. All opioid and nonopioid analgesics were included in the analysis. Data were presented as defined daily doses per 1,000 inhabitants per day. Adequacy of opioid consumption was calculated using adequacy of consumption measure. Results During the examined 7-year period, the total consumption and total cost of all analgesics in Croatia showed continuous increase. In the M01A group (anti-inflammatory and antirheumatic products, nonsteroids), ibuprofen had an exponential increasing trend, and in 2011, it overtook diclofenac consumption. Ibuprofen and diclofenac had the highest consumption also in the M02A group of topical products for joint and muscular pain. Tramadol was by far the most consumed type of opioids (N02A group) and paracetamol in the group of other analgesics and antipyretics (N02B). The adequacy of consumption measure value was 0.19, indicating that Croatia is a country with a low opioid consumption. Conclusion Between 2007 and 2013, both consumption of analgesics and their cost in Croatia had an increasing trend. Comparisons with data from other countries, based on the published literature, indicate that analgesic consumption in Croatia is still relatively low. Calculation of the adequacy of opioid consumption indicated that Croatia is a country with low opioid consumption. Further studies are necessary for establishing whether current analgesic consumption in Croatia corresponds to patient needs. PMID:26357478

Analgesic and Anti-inflammatory Profile of n-Hexane Fraction of ...

African Journals Online (AJOL)

Purpose: To evaluate the analgesic and anti-inflammatory activities of n-hexane extract of the whole plant of Viola betonicifolia Sm, family: Violaceace. Methods: The n-hexane fraction of Viola betonicifolia (VBHF) was tested for its analgesic and antiinflammatory activities (carrageenan-induced and histamine-induced ...

Analgesic activity of Nelsonia canescens (Lam.) Spreng.root in albino rats

OpenAIRE

Mohaddesi, Behzad; Dwivedi, Ravindra; Ashok, B. K.; Aghera, Hetal; Acharya, Rabinarayan; Shukla, V. J.

2013-01-01

Present study was undertaken to evaluate analgesic activity of root of Nelsonia canescens (Lam.) Spreng, a folklore medicinal plant used as the one of the source plant of Rasna. Study was carried out at two dose levels (270 mg/kg and 540 mg/kg) in albino rats. Analgesic activity was evaluated in formalin induced paw licking, and tail flick methods whereas indomethacin and pentazocine were used as standard analgesic drugs, respectively. At both the dose levels, test drug non-significantly decr...

The evidence of neuraxial administration of analgesics for cancer-related pain

DEFF Research Database (Denmark)

Kurita, G P; Benthien, K S; Nordly, M

2015-01-01

related to cancer, pain, neuraxial route, analgesic and side effects. The search was performed in PubMed, EMBASE, and Cochrane for the period until February 2014. Studies were analysed according to methods, results, quality of evidence, and strength of recommendation. RESULTS: The number of abstracts...... retrieved was 2147, and 84 articles were selected for full reading. The final selection comprised nine articles regarding randomised controlled trials (RCTs) divided in four groups: neuraxial combinations of opioid and adjuvant analgesic compared with neuraxial administration of opioid alone (n = 4); single...... neuraxial drug in bolus compared with continuous administration (n = 2); single neuraxial drug compared with neuraxial placebo (n = 1); and neuraxial opioid combined with or without adjuvant analgesic compared with other comprehensive medical management than neuraxial analgesics (n = 2). The RCTs presented...

National consumption of opioid and nonopioid analgesics in Croatia: 2007–2013

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Krnic D

2015-08-01

Full Text Available Darko Krnic,1 Andrea Anic-Matic,2 Svjetlana Dosenovic,2 Pero Draganic,1 Sasa Zezelic,1 Livia Puljak2 1Agency for Medicinal Products and Medical Devices, Zagreb, 2Laboratory for Pain Research, School of Medicine, University of Split, Split, Croatia Background: The increased consumption of analgesics has been documented worldwide during the last 2 decades. The aim of the study was to examine the trends in opioid and nonopioid analgesic consumption in Croatia between 2007 and 2013. Methods: Data on opioid consumption were extracted from the database of the national authority. All opioid and nonopioid analgesics were included in the analysis. Data were presented as defined daily doses per 1,000 inhabitants per day. Adequacy of opioid consumption was calculated using adequacy of consumption measure. Results: During the examined 7-year period, the total consumption and total cost of all analgesics in Croatia showed continuous increase. In the M01A group (anti-inflammatory and antirheumatic products, nonsteroids, ibuprofen had an exponential increasing trend, and in 2011, it overtook diclofenac consumption. Ibuprofen and diclofenac had the highest consumption also in the M02A group of topical products for joint and muscular pain. Tramadol was by far the most consumed type of opioids (N02A group and paracetamol in the group of other analgesics and antipyretics (N02B. The adequacy of consumption measure value was 0.19, indicating that Croatia is a country with a low opioid consumption. Conclusion: Between 2007 and 2013, both consumption of analgesics and their cost in Croatia had an increasing trend. Comparisons with data from other countries, based on the published literature, indicate that analgesic consumption in Croatia is still relatively low. Calculation of the adequacy of opioid consumption indicated that Croatia is a country with low opioid consumption. Further studies are necessary for establishing whether current analgesic consumption in

Analgesic effect of the aqueous seed extract of Persea Americana ...

African Journals Online (AJOL)

Persea americana, Mill (Lauraceae) is one of the medicinal plants used in Nigeria for pain relief. Based on its ethnomedicinal use in pain management, the seed of the plant was extracted with distilled water and screened for analgesic activity. The analgesic screening was done in mice using four models: acetic ...

Evaluation of Analgesic and Anti-inflammatory Activities of the Root ...

African Journals Online (AJOL)

Evaluation of Analgesic and Anti-inflammatory Activities of the Root Extracts of Indigofera spicata F. in Mice. ... The results clearly demonstrate the analgesic and anti-inflammatory effects of the aqueous and 80% methanolic root extracts of the plant, providing evidence in part for the folkloric use of the plant. Keywords: ...

Analgesic effects of branding in treatment of headaches.

Science.gov (United States)

Branthwaite, A; Cooper, P

1981-01-01

The effect of branding--that is, the labelling and marketing--of a well-known proprietary analgesic used to treat headaches was studied in a sample of women given a branded or unbranded form with either an inert or an active formulation. The sample was also divided according to whether the subjects were regular users of the brand or users of other brands. The findings showed that branded tablets were overall significantly more effective than unbranded tablets in relieving headaches. Differential effects were observed: the effects of branding were more noticeable one hour after the tablets were taken compared with 30 minutes; in the women given the placebo; and in the users of the brand compared with the users of other brands. It is hypothesised that these effects are due to increased confidence in obtaining relief with a well-known brand, and that branding has an analgesic effect that interacts with the analgesic effects of placebos and active ingredients. PMID:6786566

Analgesics use and ESRD in younger age: a case-control study

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Moehner Sabine

2007-12-01

Full Text Available Abstract Background An ad hoc peer-review committee was jointly appointed by Drug Authorities and Industry in Germany, Austria and Switzerland in 1999/2000 to review the evidence for a causal relation between phenacetin-free analgesics and nephropathy. The committee found the evidence as inconclusive and requested a new case-control study of adequate design. Methods We performed a population-based case-control study with incident cases of end-stage renal disease (ESRD under the age of 50 years and four age and sex-matched neighborhood controls in 170 dialysis centers (153 in Germany, and 17 in Austria from January 1, 2001 to December 31, 2004. Data on lifetime medical history, risk factors, treatment, job exposure and intake of analgesics were obtained in a standardized face-to-face interview using memory aids to enhance accuracy. Study design, study performance, analysis plan, and study report were approved by an independent international advisory committee and by the Drug Authorities involved. Unconditional logistic regression analyses were performed. Results The analysis included 907 cases and 3,622 controls who had never used phenacetin-containing analgesics in their lifetime. The use of high cumulative lifetime dose (3rd tertile of analgesics in the period up to five years before dialysis was not associated with later ESRD. Adjusted odds ratios with 95% confidence intervals were 0.8 (0.7 – 1.0 and 1.0 (0.8 – 1.3 for ever- compared with no or low use and high use compared with low use, respectively. The same results were found for all analgesics and for mono-, and combination preparations with and without caffeine. No increased risk was shown in analyses stratifying for dose and duration. Dose-response analyses showed that analgesic use was not associated with an increased risk for ESRD up to 3.5 kg cumulative lifetime dose (98 % of the cases with ESRD. While the large subgroup of users with a lifetime dose up to 0.5 kg (278 cases and

Assessment of ropivacaine postoperative analgesic effect after periapical maxillary incisors surgery

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Tijanić Miloš

2012-01-01

Full Text Available Background/Aim. Ropivacaine is a relatively new longacting local anesthetic. The aim of this study was to compare the postoperative analgesic effect of topical anesthetics ropivacaine 0.75% and lidocaine 2% with adrenaline in the postoperative treatment of periapical lesions in the maxilla. Methods. The study was conducted on 60 subjects, divided into two groups. The study-group received 0.75% ropivacaine without a vasoconstrictor, while the control group was treated with 2% lidocaine with adrenaline (1 : 80.000. Block anesthesia for n. infraorbitalis was used and local anesthetics were applied also on the palatine side for the end branches of n. nasopalatinus. The following parameters were observed: time elapsed from the application of an anesthetic until the first occurrence of pain after the surgery and first intake of an analgesic, the intensity of initial pain, pain intensity 6 h after the application of anesthetics and the total number of analgesics taken within 24 h after the completion of surgery. Results. The pain appeared statistically significantly earlier in the patients who had been given lidocaine with adrenaline (p < 0.001, while statistically significantly higher mean values of initial postoperative pain (p < 0.05 and pain intensity 6 h after the intervention (p < 0.01 were also registered in the same group of patients. In the period of 24 h upon the intervention, the study-group patients were taking less analgesics as compared to the control-group subjects (46.6% vs 73.3%, who were given analgesics earlier, although no statistically significant differences were observed related to the number of analgesic doses taken. Conclusion. The results of our study indicate a better postoperative analgesic effect of ropivacaine as compared to lidocaine with adrenaline.

Emerging analgesic drugs for Parkinson's disease.

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Perez-Lloret, Santiago; Rey, María Verónica; Dellapina, Estelle; Pellaprat, Jean; Brefel-Courbon, Christine; Rascol, Olivier

2012-06-01

Pain affects between 40 and 85% of Parkinson's disease (PD) patients. It is a frequently disabling and overlooked feature, which can significantly reduce health-related quality of life. Unfortunately, there are no universally recommended treatments for this condition. Evidence about the efficacy and safety of available analgesic treatments is summarized in this review. Potential targets for upcoming therapies are then discussed in light of what is currently known about the physiopathology of pain in PD. Protocols for efficacy and safety assessment of novel analgesic therapies are discussed. Finally, critical aspects of study protocol design such as patient selection or outcomes to be evaluated are discussed. Preliminary results indicate that duloxetine, cranial electrotherapy stimulation, rotigotine, subthalamic or pallidum nuclei stimulation or lesion or levodopa could be effective for treating pain in PD. Similarly, some case reports indicate that repetitive transcranial magnetic stimulation (rTMS) or apomorphine could be effective for relieving painful off-period dystonia. Clinical trials with rTMS or oxycodone/naloxone prolonged-release tablets for neuropathic pain or botulinum toxin for off-period dystonia are underway. Success of clinical trials about analgesic strategies in PD will depend on the selection of the right PD population to be treated, according to the type of pain, and the proper selection of study outcomes and follow-up of international recommendations.

The labour ward analgesic service at King Edward VIII Hospital ...

African Journals Online (AJOL)

The labour ward analgesic service at King Edward VIII. Hospital, Durban. D. A. ROCKE, C. C. ROUT, H. D. RUSSELL, S. SINGH. Abstract The provision of analgesic services to the labour ward at King Edward VIII Hospital was studied during a I-week period. Of249 patients, 113 (45%) received no analgesia whatsoever.

Analgesic, anti-inflammatory and antioxidant properties of Buddleja globosa, Buddlejaceae.

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Backhouse, N; Rosales, L; Apablaza, C; Goïty, L; Erazo, S; Negrete, R; Theodoluz, C; Rodríguez, J; Delporte, C

2008-03-05

Buddleja globosa, known as "matico", is employed in Chile for wound healing. To validate the traditional use of the crude drug through in vivo and in vitro evaluation of the anti-inflammatory, analgesic and antioxidant properties of its extracts. Sequential hexane, dichloromethane, methanol and total methanol extracts were studied using bioguided fractionation. The following activities were investigated: analgesic (writhing test), oral and topic anti-inflammatory (paw- and ear-induced edema), free radical scavenging and antioxidant activities (1,1-diphenyl-2-picrylhydrazyl, DPPH, superoxide anion, lipid peroxidation and xanthine oxidase inhibition). Sodium naproxen, nimesulide, indomethacin were used as reference drugs for in vivo, quercetin and allopurinol for in vitro assays. A mixture of alpha- and beta-amyrins was isolated from the hexane extract that showed 41.2% of analgesic effect at 600 mg/kg, inhibited by 47.7 and 79.0% the arachidonic acid (AA) and 12-deoxyphorbol-13-decanoate (TPA)-induced inflammation at 3mg/20 microL/ear, respectively. A mixture of beta-sitosterol, stigmasterol, stigmastenol, stigmastanol and campesterol was isolated from the fraction CD4-N and beta-sitosterol-glycoside from the fraction CD5-N, reducing TPA-induced inflammation by 78.2 and 83.7% at 1mg/20 microL/ear, respectively. The fraction CD4-N at 300 mg/kg also showed analgesic activity (38.7%). The methanol extract at 600mg/kg per os showed anti-inflammatory effect (61.4%), topic anti-inflammatory (56.7% on TPA) and analgesic activity (38.5%). Verbascoside and luteolin-7-O-glucoside were the major components of the methanol extract; apigenin 7-O-glucoside was also detected. Inhibition of superoxide anion, lipoperoxidation, and DPPH bleaching effect was found in the methanol serial and global extracts. The present report demonstrate the analgesic and anti-inflammatory properties of Buddleja globosa and validate its use in Chilean traditional medicine.

Analgesic effect of the aqueous and ethanolic extracts of clove

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Mina Kamkar Asl

2013-04-01

Full Text Available Objective: The beneficial effects of clove on toothache have been well documented. We have also previously shown the analgesic effects of clove essential oil. The present work was done to investigate the analgesic effects of the aqueous extract of clove using hot plate test. The possible role of opioid receptors in the analgesic effects of clove was also investigated using naloxone. Materials and Methods: Ninety male mice were divided into nine groups: (1 Saline, (2-4 Aaqueous (Aq 50, Aq 100, and Aq 200 groups which were treated with 50, 100, and 200 mg/kg of aqueous extract of clove, respectively, (5-7 Ethanolic (Eth 50, Eth 100, and Eth 200 groups which were treated with 50, 100, and 200 mg/kg of ethanolic extract of clove, respectively, and (8-9 Aq 100- Naloxone and Aq 200- Naloxone which were pretreated with 4 mg/kg of naloxone before injection of 100 or 200 mg/kg of the aqueous extract. The hot plate test was performed as a base record 10 min before injection of drugs and consequently repeated every 10 minutes after the injection. Results: The maximal percent effect (MPE in the animal groups treated with 50, 100, and 200 mg/kg of aqueous extract was significantly higher than the control group. Pretreatment with naloxone reduced the analgesic effects of both 100 and 200 mg/kg of the aqueous extract. Administration of all three doses of the ethanloic extract also non-significantly increased the MPE. Conclusion: The results of the present study showed that aqueous extract of clove has analgesic effect in mice demonstrated by hot plate test which is reversible by naloxone. The role of opioid system in the analgesic effect of clove might be suggested. However, more investigations are needed to elucidate the exact mechanism(s.

Comparative analgesic activity of the root bark, stem bark, leaves ...

African Journals Online (AJOL)

The analgesic activity of the water extracts (50,100 and150 mg/Kg body weight) of the root bark, stem bark, leaves, fruits and seeds of Carissa edulis were evaluated in mice using the mechanical method (tail-chip method) and chemical method (acetic acid induced writhing). The plant was found to have analgesic activity, ...

Synthesis and biological screening of 4-(1-pyrrolidinyl) piperidine derivatives as effective analgesics

International Nuclear Information System (INIS)

Saify, Z.S.; Malick, T.Z.; Mallick, T.Z.

2014-01-01

A variety of 4(1-pyrrolidinyl) piperidine analogs 2-6 with variable substituents on phenyl ring of phenacyl moiety were synthesized and evaluated for their analgesic inhibitory potential by tail flick method revealed significant analgesic activity. The synthetic compounds exhibit analgesic inhibitory potential was ranging from significant to highly significant activity. Compounds were evaluated by thermal stimuli (tail immersion method) at the dose of 50 mg/kg of body weight. The compounds 2-5 showed significant and highly significant analgesic activity. Pethidine was used as reference drug. Same compounds tested at the dose of 75mg/kg of body weight showed toxicity. The size of the substituent, electron donating or withdrawing affect of substituents as well as the position of substituent on phenyl ring affected the activity. These compounds could be considered to develop a new class of analgesics. (author)

Screening of Bauhinia purpurea Linn. for analgesic and anti-inflammatory activities

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Shreedhara, C.S.; Vaidya, V.P.; Vagdevi, H.M.; Latha, K.P.; Muralikrishna, K.S.; Krupanidhi, A.M.

2009-01-01

Objectives: Ethanol extract of the stem of Bauhinia purpurea Linn. was subjected to analgesic and anti-inflammatory activities in animal models. Materials and Methods: Albino Wistar rats and mice were the experimental animals respectively. Different CNS depressant paradigms like analgesic activity (determined by Eddy's hot plate method and acetic acid writhing method) and anti-inflammatory activity determined by carrageenan induced paw edema using plethysmometer in albino rats) were carried out, following the intra-peritoneal administration of ethanol extract of Bauhinia purpurea Linn. (BP) at the dose level of 50 mg/kg and 100 mg/kg. Results: The analgesic and anti-inflammatory activities of ethanol extracts of BP were significant (P Bauhinia purpurea has shown significant analgesic and anti-inflammatory activities at the dose of 100 mg/kg and was comparable with corresponding standard drugs. The activity was attributed to the presence of phytoconstituents in the tested extract. PMID:20336222

Analgesic Effects of Various Extracts of Root of Abutilon indicum linn.

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Sumitra Singh

2009-12-01

Full Text Available

Analgesic activity of piracetam: effect on cytokine production and oxidative stress.

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Navarro, Suelen A; Serafim, Karla G G; Mizokami, Sandra S; Hohmann, Miriam S N; Casagrande, Rubia; Verri, Waldiceu A

2013-04-01

Piracetam is a prototype of nootropic drugs used to improve cognitive impairment. However, recent studies suggest that piracetam can have analgesic and anti-inflammatory effects. Inflammatory pain is the result of a process that depends on neutrophil migration, cytokines and prostanoids release and oxidative stress. We analyze whether piracetam has anti-nociceptive effects and its mechanisms. Per oral pretreatment with piracetam reduced in a dose-dependent manner the overt pain-like behavior induced by acetic acid, phenyl-p-benzoquinone, formalin and complete Freund's adjuvant. Piracetam also diminished carrageenin-induced mechanical and thermal hyperalgesia, myeloperoxidase activity, and TNF-α-induced mechanical hyperalgesia. Piracetam presented analgesic effects as post-treatment and local paw treatment. The analgesic mechanisms of piracetam were related to inhibition of carrageenin- and TNF-α-induced production of IL-1β as well as prevention of carrageenin-induced decrease of reduced glutathione, ferric reducing ability and free radical scavenging ability in the paw. These results demonstrate that piracetam presents analgesic activity upon a variety of inflammatory stimuli by a mechanism dependent on inhibition of cytokine production and oxidative stress. Considering its safety and clinical use for cognitive function, it is possible that piracetam represents a novel perspective of analgesic. Copyright © 2013 Elsevier Inc. All rights reserved.

Reimbursement of analgesics for chronic pain.

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Pedersen, Line; Hansen, Anneli Borge; Svendsen, Kristian; Skurtveit, Svetlana; Borchgrevink, Petter C; Fredheim, Olav Magnus S

2012-11-27

The prevalence of chronic non-malignant pain in Norway is between 24% and 30%. The proportion of the population using opioids for non-malignant pain on a long-term basis is around 1%. The purpose of our study was to investigate how many were prescribed analgesics on reimbursable prescription under reimbursement code -71 (chronic non-malignant pain) in 2009 and 2010, which analgesics were prescribed and whether prescribing practices were in accordance with national guidelines. We retrieved pseudonymised data from the National Prescription Database on all those who received drugs with reimbursement code -71 in 2009 and 2010. The data contain information on drug, dosage, formulation, reimbursement code and date of issue. 90,731 patients received reimbursement for drugs indicated for chronic non-malignant pain in 2010. Of these, 6,875 were given opioids, 33,242 received paracetamol, 25,865 non-steroid inflammatory drugs (NSAIDs), 20,654 amitryptiline and 16,507 gabapentin. Oxycodone was the most frequently prescribed opioid, followed by buprenorphine, tramadol and codeine/paracetamol. Of those who were prescribed opioids, 4,047 (59%) received mainly slow-release opioids, 2,631 (38%) also received benzodiazepines and 2,418 (35%) received benzodiazepine-like sleep medications. The number of patients who received analgesics and opioids on reimbursable prescriptions was low compared to the proportion of the population with chronic pain and the proportion using opioids long-term. 38% of those reimbursed for opioids also used benzodiazepines, which is contrary to official Norwegian guidelines.

Evaluation of analgesic activity of various extracts of Sida tiagii Bhandari.

Science.gov (United States)

Kumawat, Ram Kumar; Kumar, Suresh; Sharma, Sunil

2012-01-01

Sida tiagii Bhandari mostly found in India and Pakistan which belongs to family Malvaceae, is traditionally used as analgesic, anti-inflammatory, sedative, anxiolytic, anti-seizure and anti-platelet. The present study was done to explore the analgesic activity of various extracts of fruits of the plant Sida tiagii Bhandari. The grinded fruits were extracted with 90% ethanol and partitioned with n-hexane (n-hexane extract; HS) and ethyl acetate (ethyl acetate extract; EAS), successively. The residual ethanol fraction (residual ethanol extract; RES) was also prepared by drying on water bath separately. All three extracts were administered orally at a dose of 200 mg/kg and 500 mg/kg of body weight. The analgesic activity of above extracts was evaluated by using acetic acid induced writhing, tail immersion and tail flick tests in Swiss albino mice. The EAS extract was found to reduce pain and RES extract of Sida tiagii B. was found to have good analgesic activity in comparison to other extracts.

Anti-inflammatory, analgesic, and antipyretic activities of virgin coconut oil.

Science.gov (United States)

Intahphuak, S; Khonsung, P; Panthong, A

2010-02-01

This study investigated some pharmacological properties of virgin coconut oil (VCO), the natural pure oil from coconut [Cocos nucifera Linn (Palmae)] milk, which was prepared without using chemical or high-heat treatment. The anti-inflammatory, analgesic, and antipyretic effects of VCO were assessed. In acute inflammatory models, VCO showed moderate anti-inflammatory effects on ethyl phenylpropiolate-induced ear edema in rats, and carrageenin- and arachidonic acid-induced paw edema. VCO exhibited an inhibitory effect on chronic inflammation by reducing the transudative weight, granuloma formation, and serum alkaline phosphatase activity. VCO also showed a moderate analgesic effect on the acetic acid-induced writhing response as well as an antipyretic effect in yeast-induced hyperthermia. The results obtained suggest anti-inflammatory, analgesic, and antipyretic properties of VCO.

Association between prenatal exposure to analgesics and risk of schizophrenia

DEFF Research Database (Denmark)

Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

2004-01-01

infections, concomitant drug treatment during pregnancy, an index of pregnancy complications, parental social status and parental age. RESULTS: In a risk set of 7999 individuals, 116 cases of schizophrenia were found (1.5%). Prenatal exposure to analgesics in the second trimester was associated......BACKGROUND: Disturbances in the central nervous system originating during foetal life may increase the risk of schizophrenia. AIMS: To illuminate the hypothesis that prenatal exposure to analgesics may affect foetal neurodevelopment, leading to increased risk of schizophrenia in adulthood. METHOD......: Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Central Register, we studied the relationship between prenatal exposure to analgesics and the risk of schizophrenia. The effect of prenatal exposure was adjusted for parental history of schizophrenia, second-trimester viral...

Analgesic use - prevalence, biomonitoring and endocrine and reproductive effects

DEFF Research Database (Denmark)

Kristensen, David Møbjerg; Mazaud-Guittot, Sverine; Gaudriault, Pierre

2016-01-01

policies, habits, accessibility, disease patterns and the age distribution of each population. Biomonitoring indicates ubiquitous and high human exposure to paracetamol and to salicylic acid, which is the main metabolite of acetylsalicylic acid. Furthermore, evidence suggests that analgesics can have......Paracetamol and NSAIDs, in particular acetylsalicylic acid (aspirin) and ibuprofen, are among the most used and environmentally released pharmaceutical drugs. The differences in international trends in the sale and consumption of mild analgesics reflect differences in marketing, governmental...

A short history of anti-rheumatic therapy - V. Analgesics

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P. Marson

2011-06-01

Full Text Available The pharmacological treatment of pain has very ancient origins, when plant-derived products were used, including mandrake extracts and opium, a dried latex obtained from Papaver somniferum. In the XVI and XVII centuries opium came into the preparation of two compounds widely used for pain relief: laudanum and Dover’s powder. The analgesic properties of extracts of willow bark were then recognized and later, in the second half of the XIX century, experimental studies on chemically synthesized analgesics were planned, thus promoting the marketing of some derivatives of para-amino-phenol and pyrazole, the predecessors of paracetamol and metamizol. In the XX century, nonsteroidal anti-inflammatory drugs were synthesized, such as phenylbutazone, which was initially considered primarily a pain medication. The introduction on the market of centrally acting analgesics, such as tramadol, sometimes used in the treatment of rheumatic pain. is quite recent.

Canadian veterinarians’ use of analgesics in cattle, pigs, and horses in 2004 and 2005

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Hewson, Caroline J.; Dohoo, Ian R.; Lemke, Kip A.; Barkema, Herman W.

2007-01-01

Anecdotal evidence suggests that many veterinarians may not use analgesics in livestock for routine surgical procedures or painful disease states. To investigate this, we conducted a national mail survey of a random sample of 1431 Canadian veterinarians (response rate, 50.1%). Questions primarily concerned veterinarians’ analgesic usage for common surgeries and medical conditions in beef and dairy cattle, pigs, and horses, and attitudes toward pain management. More than 90% of veterinarians used analgesic drugs for equine surgeries, for cesarean section in sows and cows, and for bovine claw amputation and omentopexy. However, in these and other categories, the analgesics used were often inadequate, and many veterinarians did not give analgesics to young animals. When castrated, 6 mo of age, and 95.8% of horses. Respondents largely agreed that there are no long-acting, cost-effective analgesics available for use in livestock (median rating 8/10; interquartile range 4–9), and that the long or unknown withdrawal periods of some drugs outweighed the benefits of using them (median rating 7/10; interquartile range 4–9). The results indicate an urgent need for veterinarians to manage pain in livestock better. Continuing education would help, as would an increase in the number of approved, cost-effective analgesic drugs with known withdrawal periods. PMID:17334029

The In Vivo Analgesic Activity of Aqueous and Ethanolic Extracts of ...

African Journals Online (AJOL)

The standard drug, Piroxicam also produced a significant (P < 0.05) reduction in writhings, producing pain inhibition of 70.3 %. Conclusions: The analgesic effects produced by crude extracts of both experimental plants confirm that they are endowed with analgesic properties. Further work is suggested to isolate active ...

Perceived efficacy of analgesic drug regimens used for koalas (Phascolarctos cinereus) in Australia.

Science.gov (United States)

de Kauwe, Tyron; Kimble, Benjamin; Govendir, Merran

2014-06-01

Recent publications report that some therapeutic drugs used in koalas (Phascolarctos cinereus) have poor oral absorption and are rapidly eliminated. Therefore, information on both the analgesic drug dosage regimens used to treat koalas in Australia and koala caretakers' perceptions of the efficacy of these drugs to control pain was collected for the purpose of identifying the most popular analgesics to prioritize future analgesic pharmacokinetic studies for this species. A one-page, double-sided questionnaire was distributed both electronically and by mail to Australian koala care facilities such as zoos and wildlife hospitals. Information was received from 13 respondents. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most frequently used analgesics, followed by full micro- and partial opioid receptor agonists and acetaminophen with or without codeine. The full micro-opioid receptor agonists and acetaminophen with or without codeine were most consistently considered efficacious, with wider variation in perceived efficacy of the NSAIDs. Analgesic drug combinations were generally thought efficacious.

Pattern of self-medication with analgesics among Iranian University students in central Iran

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Shadi Sarahroodi

2012-01-01

Full Text Available Background: Self-medication is defined as the use of drugs for the treatment of self-diagnosed disorders. It is influenced by factors such as education, family, society, law, availability of drugs and exposure to advertisements. This study was performed to evaluate self-medication with analgesics and its pattern among different groups of Iranian University Students. Materials and Methods: A randomized, cross-sectional, multicenter study was conducted from December 2009 to February 2010. The target population of this study was 564 students out of 10,000 students attending four medical and non-medical science universities in Qom state. Data was analyzed using SPSS version 16, and analysis was conducted with descriptive analysis procedures. Results: 76.6% of the students had used analgesics in self-medication in the previous 3 months. The frequency of analgesic use in the study period was once in 19.2% of the participants, twice in 22.2%, three times in 16.3% and more than three times in 35.5% of the participants, although 6.8% of them were not sure when they were used. Of all the respondents, 49.8% reported headache as the problem. This was the most common problem, after which came Dysmenorrhea,headache and stomach ache. Bone and joint pains were other problems that led to the use of analgesics. The most commonly used source of information for self-medication with analgesics was advice from friends and family (54.7%, previously prescribed medications (30.1%, their medical knowledge (13.3% and recommendation of a pharmacist (1.9%. Conclusion: Self-medication with analgesics is very high among Iranian students in Qom city. This could be an index for other parts of the Iranian community. Because the source of information about analgesics is inappropriate, we would recommend education courses about analgesics and self-medication on the radio and television for the entire population.

The Analgesic Effect of Pineapple Fruit Juice on Mice

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Ainul Atiqah binti Hilmi

2014-08-01

Full Text Available Background: Pain is a feeling stimulated by the nervous system which can be suppressed by giving an analgesic agent. Some studies revealed that pineapples have an analgesic effect. This study aim was to determine analgesic effect of pineapple on mice. Methods: In this experimental study, the effect was examined by using a writhing method on the 28 male mice. Subjects were divided into 4 groups with 7 mice each. The control group received aquades and other groups received pineapple fruit juice with 20%, 40% and 80% concentration with the dosage of 10 mL/kg/body weight. After 30 minutes, 3% acetic acid was injected intraperitoneally to induce pain. Writhing responseswere observed every 5 minutes for 30 minutes. Results: The result for mean of total writhing reaction was 2.39±0.40, 1.92±0.40, 1.50±2.13, 1.66±0.11 respectively for group 1 to 4. These data indicated a significant decrease of total writhing response in mice with 20%, 40% and 80% concentration compared to control group (p=0.023;p=0.000 and p=0.000 respectively. Most optimal concentration was40% with the protective percentage equal to 71.8%. Conclusion: Pineapple fruit juice concentrations (20%, 40%, and 80%has an analgesic effect with the most optimal concentration of 40%.

Analgesic activity of crude aqueous extract of the root bark of ...

African Journals Online (AJOL)

Objective: The analgesic activity of crude aqueous extract of the root bark of Zanthoxylum xanthozyloides was studied in mice and rats with the view to verifying the claim in folklore medicine that the extract has analgesic activity. Method: The extract was obtained by Soxhlet extraction and rotatory evaporation, followed by ...

Factors influencing use of analgesics among construction workers in the Ga-Eastmunicipality of the Greater Accra region, Ghana.

Science.gov (United States)

Badzi, Caroline D; Ackumey, Mercy M

2017-12-01

Analgesics also known as painkillers are widely used for pain relief. There are severe health implications associated with excessive use of analgesics. This paper examines factors influencing the use of analgesics among construction workers in the Ga-East Municipality (GEM) of the Greater Accra region of Ghana. This is a cross-sectional study involving 206 construction workers randomly sampled from 7 construction sites in the GEM. A structured questionnaire was used to elicit responses on knowledge of analgesics, types of analgesics used and factors influencing the use of analgesics. Chi-square test analysis was used to examine factors influencing analgesic use. The majority of workers were aged between 15 to 44 years (89.8%) and 51.9 percent of respondents had completed Junior high school. Many respondents (68.0%) used Brand 1 a locally manufactured analgesic with paracetamol, aspirin and caffeine as the active ingredients and 31.6 percent of respondents had no knowledge of possible side effects of continuous use of analgesics. Chi square analysis showed that age was significantly associated with use of analgesics (peffects did not influence use (p>0.05). Television and radio advertisements influenced use of analgesics (peffects was inadequate. Pharmacists and chemists involvement in education of clients of the side effects of analgesics is highly recommended to minimise misuse. The Food and Drugs Authority should regulate the proliferation of advertisements for analgesics in the media. None declared.

Bottlenecks in the development of topical analgesics: molecule, formulation, dose-finding, and phase III design

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Keppel Hesselink JM

2017-03-01

Full Text Available Jan M Keppel Hesselink,1 David J Kopsky,2 Stephen M Stahl3 1Institute Neuropathic Pain, Bosch en Duin, the Netherlands; 2Institute Neuropathic Pain, Amsterdam, the Netherlands; 3University of California San Diego, La Jolla, CA, USA Abstract: Topical analgesics can be defined as topical formulations containing analgesics or co-analgesics. Since 2000, interest in such formulations has been on the rise. There are, however, four critical issues in the research and development phases of topical analgesics: 1 The selection of the active pharmaceutical ingredient. Analgesics and co-analgesics differ greatly in their mechanism of action, and it is required to find the most optimal fit between such mechanisms of action and the pathogenesis of the targeted (neuropathic pain. 2 Issues concerning the optimized formulation. For relevant clinical efficacy, specific characteristics for the selected vehicle (eg, cream base or gel base are required, depending on the physicochemical characteristics of the active pharmaceutical ingredient(s to be delivered. 3 Well-designed phase II dose-finding studies are required, and, unfortunately, such trials are missing. In fact, we will demonstrate that underdosing is one of the major hurdles to detect meaningful and statistically relevant clinical effects of topical analgesics. 4 Selection of clinical end points and innovatively designed phase III trials. End point selection can make or break a trial. For instance, to include numbness together with tingling as a composite end point for neuropathic pain seems stretching the therapeutic impact of an analgesic too far. Given the fast onset of action of topical analgesics (usually within 30 minutes, enrichment designs might enhance the chances for success, as the placebo response might decrease. Topical analgesics may become promising inroads for the treatment of neuropathic pain, once sufficient attention is given to these four key aspects. Keywords: topical, analgesics

Nonprescription analgesics and their use in solid-organ transplantation: a review.

Science.gov (United States)

Gabardi, Steven; Luu, Linh

2004-09-01

To review the pharmacology, adverse events, drug interactions, and use of the nonprescription analgesics in solid-organ transplant recipients. Studies evaluating nonprescription analgesics in solid-organ transplantation were considered for evaluation. English-language studies were selected for inclusion. Nonprescription analgesics (aspirin, choline salicylate, magnesium salicylate, sodium salicylate, ibuprofen, ketoprofen, naproxen sodium, and acetaminophen) are the most commonly purchased over-the-counter agents in the United States. These agents, although generally considered safe, have been associated with a number of toxicities. The salicylates and nonsteroidal anti-inflammatory drugs have been associated with gastrointestinal damage, hematologic changes, liver and kidney dysfunction, and breathing difficulties. Acetaminophen has been shown to induce hematologic changes and liver and renal dysfunction. A closer look at the nonprescription analgesics reveals their potential for harm when used by solid-organ transplant recipients. In this patient population, the salicylates and nonsteroidal anti-inflammatory drugs should generally be avoided if possible, because of their potential toxicities, especially renal dysfunction. Low-dose aspirin, for the prevention of cardiovascular and cardiocerebral events, appears to be safe, but patients must still be followed closely. Acetaminophen is generally considered the nonprescription analgesic and antipyretic of choice in transplant recipients because of its favorable toxicity profile. However, it is imperative that patients and transplant practitioners are aware that this agent is not without toxicities and proper monitoring is advised.

Analgesic nephropathy as a cause of end-stage renal disease in a ...

African Journals Online (AJOL)

2011-03-09

Mar 9, 2011 ... He was not a diabetic and did not use mercury-containing soap or cream or herbal ... Grade 2 hypertensive retinopathy. A diagnosis of analgesic .... Early detection of AN and discontinuation of analgesic use stabilizes or ...

Anti-inflammatory and analgesic activity of r.a.p . ( Radix Angelicae ...

African Journals Online (AJOL)

The objective of this paper was to study the anti-inflammatory and analgesic effects of Radix Angelicae Pubescentis (R.A.P) ethanol extracts. Three classic anti-inflammatory models and two analgesic models were used in this research. In anti-inflammatory tests, all the extracts have a certain inhibition on the acute ...

Study of analgesic activity of ethanol extract of Phlogacanthus thyrsiflorus on experimental animal models

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Apurba Mukherjee

2009-06-01

Full Text Available The aim of the study was to evaluate the central and peripheral analgesic action of Phlogacanthus thyrsiflorus in experimental animal models. The extract was prepared by percolation method and acute oral toxicity testing was performed as per OECD guidelines. Analgesic activity was assessed by tail flick method (for central action and glacial acetic acid-induced writhing test (for peripheral action. Leaves extract (500 mg/kg, p.o. and aspirin (100 mg/kg showed significant peripheral analgesic activity (p<0.05. Leaves extract (500 mg/kg, p.o. and pethidine (50 mg/kg, i.p. also showed significant central analgesic activity (p<0.05. Naloxone (1 mg/kg, s.c. was used to find the mechanism of central analgesic action. Some partial agonistic activity for the opioid receptors seems to be probable mechanism of action.

Analgesic efficacy with rapidly absorbed ibuprofen sodium dihydrate in postsurgical dental pain

DEFF Research Database (Denmark)

Nørholt, Sven Erik; Hallmer, F; Hartlev, Jens

2011-01-01

To evaluate the onset of analgesic effect for a new formulation of ibuprofen sodium dihydrate versus conventional ibuprofen (ibuprofen acid).......To evaluate the onset of analgesic effect for a new formulation of ibuprofen sodium dihydrate versus conventional ibuprofen (ibuprofen acid)....

[Analgesic efficacy of magnetoledotherapy in patients with low back pain syndromes].

Science.gov (United States)

Krukowska, Jolanta; Woldańska-Okońska, Marta; Jankowska, Katarzyna; Kwiecień-Czerwieniec, Ilona; Czernicki, Jan

2010-01-01

Low back pain syndromes most often occur due to overloading of the musculoskeletal system. The cause is a frequent, improper lifting of heavy objects, most commonly by those working physically, with repetitive movements of bending and straightening of the trunk (turning and bending with load). This problem affects not only adults but also children and adolescents. There is a growing interest in new forms of analgesic therapy nowadays, especially in those that exhibit synergistic therapeutic effects. The aim of this work is to evaluate the analgesic efficacy of magnetoledotherapy in patients with lumbar--sacrum spinal pain syndromes caused by joints degenerative changes. The examination was carried out in 66 patients of both sexes aged 30 to 76 (average 54.7 +/- 13.8) with low back pain syndrome caused by spinal degenerative changes. The patients were divided into three groups according to the applied analgesic therapy (magnetoledotherapy, magnetostimulation, TENS currents). Level of pain has been evaluated four times in all patients--before the start of therapy and after 5, 10 and 15 applications with the use of the modified Laitinen Questionnaire and Visual-Analoque Scale (VAS). Post therapy levels of pain in the studied patients decreased significantly. According to Laitinen questionnaire, the greatest improvement was observed in the group treated with magnetoledotherapy and TENS currents and the smallest improvement was observed in the group treated with magnetostimulation. 1. Magnetoledotherapy shows significant analgesic efficacy in patients with low back pain syndrome and shows no side effects. 2. Concurrent application of both the infrared radiation generated by LED's and magnetostimulation synergistically reinforces analgesic effect in patients with low back pain syndrome, especially in level of pain and frequency of its occurrence, which results in the increase of movement activity and decrease in administration of analgesics.

[Toxicity of analgesics in the family doctor practice].

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Kuźniar-Placek, Justyna; Szponar, Jarosław; Panasiuk, Lech

2012-01-01

Analgesic usage without any consultation with a physician is very common in Poland. It increases the risk of occurrence of the harmful effect or harmful interaction with other medicaments taken by the patient. The abuse of painkillers applies not only to opioid but also to nonopioid analgesics. The largest group of commonly available medicaments are NSAIDs. The most frequent undesirable effect of NSAIDs' is dyspepsia. Among the most dangerous, and very often the ones without any symptoms, are gastric and duodenum ulceration for which the bleeding and perforation may be the first manifestation. Each non steroidal anti-inflammatory drug taken in large doses can be a cause of analgesic nephropathy. Its deceitful course can delay the diagnosis leading to chronic kidney failure. A complex supplements, that include central acting substances, increase the risk of kidney damage, as well as physical and psychological addiction. NSAIDs can cause: the heart failure to be more severe, treatment resistant arterial hypertension, increase an effectiveness of anticoagulants or antidiabetic drugs. The problem is also that some medicaments are available without a prescription (acetylsalicylic acid, ibuprofen, acetaminophen), especially that they are ingredients of many complex supplements considered safe. Taking doses larger than therapeutic or simultaneously taking many supplements of the same active substance had many times led to poisoning and even death. Equally dangerous can be an abuse of tramadol, codeine and COX-2 inhibitors. Therefore, prudential prescription of NSAIDs, knowledge of risks related to therapy and informing the patients about their side effects, may decrease the number of patients abusing the analgesics which can lead to lowering the number of deaths caused by serious complications.

Joint pain epidemiology and analgesic usage in Madagascar.

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Samison, Luc Hervé; Randriatsarafara, Fidiniaina Mamy; Ralandison, Stéphane

2017-01-01

To describe the epidemiology of joint pains and document analgesics usage in an African context. Patients suffering from joint pain were recruited from nine sites located in Antananarivo, Madagascar, including 6 hospital services and 3 clinics. Doctors collected information on the etiology and characteristics of the patients' pain. Analgesics prescribed by these doctors were also documented. In total, 400 patients were enrolled in the study (52.5% women, mean age of 42.34 years ± 17.7 [4-86]). Pain of mechanical type was found in 260 participants, 65%; 95% CI [60.1% to 69.6%] and inflammatory type pains in 128 cases 32%; 95% CI [27.5% to 36.9%]. Mixed pains were found in 12 patients (3%). The median duration of pain prior to the consultation was 6.5 days. The average pain intensity was 57.9 ± 19.9 mm of a total of 100 mm maximum on a visual analogue scale, VAS. The etiologies of mechanical type pains were dominated by fracture, common low back pain and tendonitis. Arthrosis was the dominant cause of inflammatory type pain, followed by rheumatoid arthritis and gout. NSAIDs (74.5%) were the most frequently prescribed analgesics followed by paracetamol (49.5%), weak opioids (23%) and corticosteroids (12.25%). Two-thirds of medical prescriptions (65.3%) were of combined analgesics. These findings demonstrated that mechanical type pains were the main reason for consultations for joint pain in these situations in Antananarivo, Madagascar. The most frequently prescribed pain-relieving medications were NSAIDs, paracetamol, weak opioids and corticosteroids. This descriptive study may be a useful starting point for further epidemiological studies of pain in the African context.

Analgesic efficacy of preoperative dexketoprofen trometamol: A systematic review and meta-analysis.

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Esparza-Villalpando, Vicente; Pozos-Guillén, Amaury; Masuoka-Ito, David; Gaitán-Fonseca, César; Chavarría-Bolaños, Daniel

2018-03-01

Post-Market Research Clinical evidence supports the use of dexketoprofen trometamol (DEX) to manage acute postoperative pain. However, controversies surround the impact of the use of this drug in preoperative analgesic protocols. The aim of the present meta-analysis was to evaluate the effectiveness of the preoperative administration of DEX under postoperative pain conditions. Electronic and manual searches were conducted through diverse electronic databases. A systematic review and meta-analysis to evaluate the analgesic efficacy of the preoperative administration of DEX was performed including Randomized Clinical Trials (RCTs) published between 2002 and 2017. Suitable individual studies were evaluated through a quality system, and the data were extracted and analyzed. Fourteen RTCs were included (12 parallel trials and 2 cross-over trials), published in the English and Turkish languages. Follow-up periods ranged from 4, 6, 8, 24, and 48 hr. All trials measured the outcome result as Acute Pain Level (APL) (VAS, NRS, VRS), time to requiring a second dose of DEX or analgesic emergency and consumption of opioids via patient-controlled analgesia. When the comparators were other drugs - paracetamol, Lornoxicam or placebo during the preoperative time, preoperative administration of DEX was superior. When the comparison comprised preoperative and postoperative DEX, both alternatives exhibited comparable analgesic effects. The analgesic efficacy of the preoperative administration of DEX when compared to placebo, lornoxicam, and paracetamol on postoperative pain was evident. Preoperative administration of DEX compared to its immediate postoperative administration showed a similar analgesic effect. © 2017 Wiley Periodicals, Inc.

Analgesic effects of various extracts of the root of Abutilon indicum linn

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Naveen Goyal

2009-01-01

Full Text Available Purpose : Abutilon indicum (Linn. sweet (Malvaceae commonly called ′Country Mallow′ is a perennial plant up to 3 m in height. It is abundantly found as a weed in the sub-Himalayan tract and in the hotter parts of India. The plant is traditionally used for treatment of several diseases like bronchitis, body ache, toothache, jaundice, diabetes, fever, piles, leprosy, ulcers, cystitis, gonorrhea, diarrhea, and so on. Abutilon indicum Linn. is reported to have hepatoprotective, hypoglycemic, antimicrobial, male contraceptive, and antidiarrheal activities. The present study was done to evaluate the analgesic potential of various extracts of the root of Abutilon indicum Linn. Materials and Methods : The powdered root (900 g was subjected to successive solvent extraction, with solvents in increasing order of polarity, namely, petroleum ether (60 - 80΀C, methanol, and ethanol, using the soxhlet apparatus for 72 hours. The marc was extracted by cold maceration for 72 hours, to obtain a water-soluble extract. The peripheral analgesic activity was studied using acetic acid-induced writhing method in Swiss albino mice (20 - 30 g, while the central analgesic activity was evaluated by the tail flick method and the tail immersion method. Results : Results indicated that all the tested extracts, except the methanol extract, exhibited significant analgesic activity in both animals′ models. Petroleum ether extract showed higher analgesic activity. The activity may be related to the central mechanism or may be due to the peripheral analgesic mechanisms. Conclusion : The present study authenticates the traditional use.

Effects of Analgesic Advertisements on Community in Hegarmanah Village, Jatinangor

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Nurhayati binti Shaharuddin

2014-08-01

Full Text Available Background: Currently, there are numerous analgesic advertisements which have been published in various media and have also attracted attention of the society. The aim of this study is to find out effects of analgesic advertisements on awareness and attention towards these advertisements on the community in Hegarmanah Village, Jatinangor. Methods: The study used the descriptive method with participants consisting of community members in Hegarmanah Village who have seen, watched or heard about the analgesic advertisements and who were aged 18 years and above. The sample for this study consisted of 100 respondents. This study was conducted in September 2012–December 2012. Results: The results showed that 82% of the respondents have seen the ads in at least the last 3 months and mostly watched them on television. About 52% of respondents agreed that many of the ads did not provide sufficient information. In addition, 50% only read a little bit of the ads rather than the whole advertisement. Fifty three percents of the respondents had the intention to try the medication after seeing the ads. More than 80% were aware about how to use the medication, medication’s side effects, warnings and contraindications and 65% agreed that, they could make a better decision on their health condition after seeing the ads. Conclusions: The analgesic advertisements indeed affected the community by making them aware about the ads and attracted them to buy as well as try the product itself. Further studies on factors which influence intake of over-the-counter analgesic drugs and also about the self-medication are required. [AMJ.2014;1(2:1–6

The availability of prescription-only analgesics purchased from the internet in the UK.

Science.gov (United States)

Raine, Connie; Webb, David J; Maxwell, Simon R J

2009-02-01

Increasing numbers of people are accessing medicines from the internet. This online market is poorly regulated and represents a potential threat to the health of patients and members of the public. Prescription-only analgesics, including controlled opioids, are readily available to the UK public through internet pharmacies that are easily identified by popular search engines. The majority of websites do not require the customer to possess a valid prescription for the drug. Less than half provide an online health screen to assess suitability for supply. The majority have no registered geographical location. Analgesic medicines are usually purchased at prices significantly above British National Formulary prices and are often supplied in large quantities. These findings are of particular relevance to pain-management specialists who are trying to improve the rational use of analgesic drugs. To explore the availability to the UK population of prescription-only analgesics from the internet. Websites were identified by using several keywords in the most popular internet search engines. From 2000 websites, details of 96 were entered into a database. Forty-six (48%) websites sold prescription analgesics, including seven opioids, two non-opioids and 18 nonsteroidal anti-inflammatory drugs. Thirty-five (76%) of these did not require the customer to possess a valid prescription. Prescription-only analgesics, including controlled opioids, are readily available from internet websites, often without a valid prescription.

[Pain patients in street traffic. Do analgesics impair driving safety?].

Science.gov (United States)

Sohn, W

2003-06-05

Analgesics--in particular when self-prescribed or taken over the long term--may have a negative effect on safety on the road. This applies not only to vehicle drivers, but also to cyclists and pedestrians. Psychotropic effects of analgesics of all three WHO categories play a major causal role. Impairments may take the form of sleepiness, impaired vision, giddiness, loss of muscular tone or cardiovascular reactions. On the other hand, untreated severe pain has a high risk potential, since it may reduce both cognitive and psychomotoric performance. During the stabilization phase or dose adjustment of opioids, the patient must cautioned not to drive, and particular care must be taken in patients on concomitant or long-term medication or drinking excessive alcohol. In the last resort, the prescription of an analgesic is an individual decision involving both physician and patient.

A Bacterial Toxin with Analgesic Properties: Hyperpolarization of DRG Neurons by Mycolactone.

Science.gov (United States)

Song, Ok-Ryul; Kim, Han-Byul; Jouny, Samuel; Ricard, Isabelle; Vandeputte, Alexandre; Deboosere, Nathalie; Marion, Estelle; Queval, Christophe J; Lesport, Pierre; Bourinet, Emmanuel; Henrion, Daniel; Oh, Seog Bae; Lebon, Guillaume; Sandoz, Guillaume; Yeramian, Edouard; Marsollier, Laurent; Brodin, Priscille

2017-07-18

Mycolactone, a polyketide molecule produced by Mycobacterium ulcerans , is the etiological agent of Buruli ulcer. This lipid toxin is endowed with pleiotropic effects, presents cytotoxic effects at high doses, and notably plays a pivotal role in host response upon colonization by the bacillus. Most remarkably, mycolactone displays intriguing analgesic capabilities: the toxin suppresses or alleviates the pain of the skin lesions it inflicts. We demonstrated that the analgesic capability of mycolactone was not attributable to nerve damage, but instead resulted from the triggering of a cellular pathway targeting AT₂ receptors (angiotensin II type 2 receptors; AT₂R), and leading to potassium-dependent hyperpolarization. This demonstration paves the way to new nature-inspired analgesic protocols. In this direction, we assess here the hyperpolarizing properties of mycolactone on nociceptive neurons. We developed a dedicated medium-throughput assay based on membrane potential changes, and visualized by confocal microscopy of bis-oxonol-loaded Dorsal Root Ganglion (DRG) neurons. We demonstrate that mycolactone at non-cytotoxic doses triggers the hyperpolarization of DRG neurons through AT₂R, with this action being not affected by known ligands of AT₂R. This result points towards novel AT₂R-dependent signaling pathways in DRG neurons underlying the analgesic effect of mycolactone, with the perspective for the development of new types of nature-inspired analgesics.

Analgesic Activity of Some 1,2,4-Triazole Heterocycles Clubbed with Pyrazole, Tetrazole, Isoxazole and Pyrimidine

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Ramdas Bhanudas Pandhare

2013-02-01

Full Text Available Purpose: In the present study in vivo analgesic activity of some previously synthesized 1,2,4-triazole derivatives containing pyrazole, tetrazole, isoxazole and pyrimidine ring have been evaluated. Methods: Acetic acid induced writhing method and Hot plate method has been described to study analgesic activity of some 1,2,4-triazole derivatives containing pyrazole, tetrazole, isoxazole and pyrimidine as a pharmacological active lead. Results: Thirty six different derivatives containing 1,2,4-triazole ring were subjected to study their in vivo analgesic activity. Chloro, nitro and methoxy, hydroxy and bromo substituted derivatives showed excellent analgesic activity and dimethylamino, furan and phenyl substituted derivatives showed moderate analgesic activity in both of the methods. Compounds IIIa, IIId, IIIf, IIIi, IIIj, IVa, IVb, IVd, IVf, IVh, IVj IV3a and IIj were found to be superior analgesic agents after screening by Acetic acid induced writhing method. Compounds IIIb, IIId, IIIf, IIIh, IIIj, IVa, IVb, IVd, IVf, IVh, IVi, IV3c, IV3e and IIj were showed analgesic potential after screening of Hot plate method. Conclusion: All tested compounds containing 1,2,4-triazole were found to be promising analgesic agents, for this activity pyrazole, tetrazole, isoxazole and pyrimidine leads might be supported.

Analgesic exposure in pregnant rats affects fetal germ cell development with inter-generational reproductive consequences

DEFF Research Database (Denmark)

Dean, Afshan; van den Driesche, Sander; Wang, Yili

2016-01-01

Analgesics which affect prostaglandin (PG) pathways are used by most pregnant women. As germ cells (GC) undergo developmental and epigenetic changes in fetal life and are PG targets, we investigated if exposure of pregnant rats to analgesics (indomethacin or acetaminophen) affected GC development...... smaller ovaries and reduced follicle numbers during puberty/adulthood; as similar changes were found for F2 offspring of analgesic-exposed F1 fathers or mothers, we interpret this as potentially indicating an analgesic-induced change to GC in F1. Assuming our results are translatable to humans, they raise...

Analgesic use in patients with knee and/or hip osteoarthritis referred to an outpatient center

DEFF Research Database (Denmark)

Knoop, Jesper; van Tunen, Joyce; van der Esch, Martin

2017-01-01

Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine...... factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted. Self-reported use...

Phytochemical Screening and Evaluation of Analgesic Activity of Oroxylum indicum

OpenAIRE

Das, B. K.; Al-Amin, M. M.; Russel, S. M.; Kabir, S.; Bhattacherjee, R.; Hannan, J. M. A.

2014-01-01

We aimed to study phytochemical screening and analgesic activity of ethanol extract of Oroxylum indicum. The dried powder of the barks of the plant was extracted with 95% ethanol and was subjected to various phytochemical tests to ascertain the principle constituents contained in the extract. The result revealed the presence of alkaloids, flavonoids, tannins, glycosides in the ethanol extract of Oroxylum indicum. The extract was screened for analgesic activity by using hot plate, acetic acid-...

Prescription of opioid and nonopioid analgesics for dental care in emergency departments: Findings from the National Hospital Ambulatory Medical Care Survey.

Science.gov (United States)

Okunseri, Christopher; Okunseri, Elaye; Xiang, Qun; Thorpe, Joshua M; Szabo, Aniko

2014-01-01

The aim of this study was to examine trends and associated factors in the prescription of opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics by emergency physicians for nontraumatic dental condition (NTDC)-related visits. Our secondary aim was to investigate whether race/ethnicity is a possible predictor of receiving a prescription for either type of medication for NTDC visits in emergency departments (EDs) after adjustment for potential covariates. We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997-2000 and 2003-2007, and used multinomial multivariate logistic regression to estimate the probability of receiving a prescription for opioid analgesics, nonopioid analgesics, or a combination of both, compared with receiving no analgesics for NTDC-related visits. During 1997-2000 and 2003-2007, prescription of opioid analgesics and combinations of opioid and nonopioid analgesics increased, and that of no analgesics decreased over time. The prescription rates for opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics for NTDC-related visits in EDs were 43 percent, 20 percent, 12 percent, and 25 percent, respectively. Majority of patients categorized as having severe pain received prescriptions for opioids for NTDC-related visits in EDs. After adjusting for covariates, patients with self-reported dental reasons for visit and severe pain had a significantly higher probability of receiving prescriptions for opioid analgesics and opioid and nonopioid analgesic combinations. Prescription of opioid analgesics increased over time. ED physicians were more likely to prescribe opioid analgesics and opioid and nonopioid analgesic combinations for NTDC-related visits with reported severe pain. © 2014 American Association of Public Health Dentistry.

Post-marketing withdrawal of analgesic medications because of adverse drug reactions: a systematic review.

Science.gov (United States)

Onakpoya, Igho J; Heneghan, Carl J; Aronson, Jeffrey K

2018-01-01

Many analgesics have been withdrawn from the market because of adverse drug reactions. Controversy still surrounds the use of some approved analgesics for pain management. However, the trends and reasons for withdrawal of analgesics when harms are attributed to their use have not been systematically assessed. Areas covered: We conducted searches in PubMed; Embase; Google Scholar; clinicaltrials.gov; WHO databases of withdrawn products; websites of the European Medicines Agency, the US Food and Drug Administration, the UK Medicines and Healthcare products Regulatory Agency; Meyler's Side Effects of Drugs; Stephens' Detection of New Adverse Drug Reactions; the Pharmaceutical Manufacturing Encyclopedia; and the Merck Index. We included licensed analgesics that were withdrawn after marketing because of adverse reactions between 1950 and March 2017. We excluded herbal products, non-human medicines, and non-prescription medicines. We used the Oxford Centre for Evidence Based Medicine criteria to document the levels of evidence, and chi-squared tests to compare withdrawal patterns across geographical regions. Expert opinion: Pharmacovigilance systems in low-resource settings should be strengthened. Greater co-ordination across regulatory authorities in assessing and interpreting the benefit-harm balance of new analgesics should be encouraged. Future reporting of harms in clinical trials of analgesics should follow standardized guidelines.

Analgesic Prescription Patterns and Pain Outcomes in Southeast Asia: Findings From the Analgesic Treatment of Cancer Pain in Southeast Asia Study

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Dang Huy Quoc Thinh

2018-04-01

Full Text Available Purpose: To identify patterns of analgesic prescription and to explore patient-reported pain intensity, sleep disturbance, and quality of life among cancer patients with pain in Southeast Asia (SEA. Methods: This cross-sectional observational study included 465 adult outpatients prescribed analgesics for cancer pain for 1 month or longer at 22 sites in Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam. Data on analgesic prescription and cancer characteristics were extracted from medical records. Pain intensity, sleep disturbance, and quality of life measures were recorded via questionnaires. Results: Most patients (84.4% had stage III or IV cancer. A total of 419 patients (90.7% were prescribed opioids; of these, 42.2% received only weak opioids, whereas 57.8% received at least one strong opioid. The mean worst pain intensity during the past 24 hours was 4.76 (standard deviation [SD], 2.47 on a scale of 0 (no pain to 10 (worst possible pain; the mean current pain intensity was 4.10 (SD, 2.61. More than half of patients (54.8% reported sleep disturbance caused by pain in the past 7 days. The majority of patients reported problems with pain/discomfort (82.3%, usual activities (65.8%, mobility (58.2%, and anxiety/depression (56.3%. The median daily dose prescribed in oral morphine equivalents was 30 mg for both morphine and tramadol. Conclusion: Despite unrelieved pain, sleep disturbance, and issues with quality of life, a notable proportion of patients were prescribed only weak opioids, and opioid doses prescribed were generally low. Efforts focused on encouragement of prescriptions with analgesic strength and/or doses proportional to the pain management needs of patients are vital to improve the status of cancer pain management in the region.

Antipyretic, analgesic and anti-inflammatory activity of Viola betonicifolia whole plant.

Science.gov (United States)

Muhammad, Naveed; Saeed, Muhammad; Khan, Haroon

2012-05-02

Pyrexia, algesia and inflammation are associated with several pathological conditions. Synthetic drugs available for the treatment of these conditions cause multiple unwanted effects. Several studies are ongoing worldwide to find natural healing agents with better safety profile. The current study was thus aimed at evaluating antipyretic, analgesic and anti-inflammatory activities of the methanolic extract of whole plant of V. betonicifolia (VBME). VBME was employed to assess antipyretic activity in yeast induced hyperthermia. Analgesic profile was ascertained in acetic acid induced writhing, hot plat and tail immersion test. Nevertheless, the anti-inflammatory activity was tested in carrageenan induced paw edema and histamine induced inflammatory tests. BALB/c mice were used at test doses of 100, 200 and 300 mg/kg body weight intra peritoneally (i.p). In yeast induced pyrexia, VBME demonstrated dose dependently (78.23%) protection at 300 mg/kg, similar to standard drug, paracetamol (90%) at 150 mg/kg i.p. VBME showed a dose dependent analgesia in various pain models i.e. acetic acid, hot plat and tail immersion having 78.90%, 69.96% and 68.58% protection respectively at 300 mg/kg. However, the analgesic action of VBME was completely antagonized by the injection of naloxone like opiate antagonists. Similarly carrageenan and histamine induces inflammation was significantly antagonized by VBME, 66.30% and 60.80% respectively at 300 mg/kg. It is concluded that VBME has marked antipyretic, analgesic and anti-inflammatory activities in various animal models and this strongly supports the ethnopharmacological uses of Viola betonicifolia as antipyretic, analgesic and anti-inflammatory plant.

Analgesic effects of manual therapy in patients with musculoskeletal pain: a systematic review

NARCIS (Netherlands)

J. Nijs; Dr. L.P. Voogt; F. Struyf; M. Meeys; D. Meuffels; J. de Vries

2015-01-01

BACKGROUND: Current evidence shows that manual therapy elicits analgesic effect in different populations (healthy, pain inflicted and patients with musculoskeletal pain) when carried out at the spinal column, although the clinical significance of these effects remains unclear. Also the analgesic

Analgesic principle from Curcuma amada.

Science.gov (United States)

Faiz Hossain, Chowdhury; Al-Amin, Mohammad; Rahman, Kazi Md Mahabubur; Sarker, Aurin; Alam, Md Mahamudul; Chowdhury, Mahmudul Hasan; Khan, Shamsun Nahar; Sultana, Gazi Nurun Nahar

2015-04-02

The rhizome of Curcuma amada has been used as a folk medicine for the treatment of rheumatic disorders in the northern part of Bangladesh and has also used for the treatment of inflammation and fever in the Ayurvedic and Unani systems of medicine. Aim of the study was to investigate the analgesic principle of the MeOH extract of the rhizome of Curcuma amada by an in vivo bioassay guided chromatographic separation and purification, and the structure elucidation of the purified compound by spectroscopic methods. Dried powder of Curcuma amada rhizomes was extracted with MeOH. The analgesic activity of the crude extract and its chromatographic fractions as well as the purified compound itself was evaluated by the acetic acid induced writhing method and the formalin induced licking test in Swiss albino mice. The MeOH extract was separated by chromatographic methods and the pure active compound was purified by crystallization in hexanes. The structure of the pure compound was then elucidated by spectroscopic methods. The MeOH extract of Curcuma amada exhibited 41.63% and 45.53% inhibitions in the acetic acid induced writhing method at doses of 200mg/kg and 400mg/kg, respectively. It also exerted 20.43% and 28.50% inhibitions in early phase at doses of 200mg/kg and 400mg/kg, respectively, and 30.41% and 42.95% inhibitions in late phase at doses of 200mg/kg and 400mg/kg, respectively in the formalin induced licking test. Vacuum Liquid Chromatography (VLC) of crude extract yielded five fractions and Fr. 1 was found to have the most potent analgesic activity with inhibitions of 36.96% in the acetic acid induced writhing method and 47.51% (early phase), 39.50% (late phase) in the formalin induced licking test at a dose of 200mg/kg. Column chromatography of Fr. 1 on silica gel generated seven fractions (SF. 1-SF. 7). SF. 2 showed the most potent activity with inhibition of 49.81% in the acetic acid induced writhing method at a dose of 100mg/kg. Crystallization of SF. 2 yielded

Synthesis and Analgesic Activity Evaluation of Some Agmatine Derivatives

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Song Li

2006-06-01

Full Text Available A series of N,N’-disubstituted-2-nitroethene-1,1-diamine and N,N’-disubstituted- N’’-cyanoguanidine derivatives were prepared and evaluated for in vivo analgesic activity. The blood brain barrier (BBB VolSurf model was used to predict the BBB permeation profiles of our synthesized compounds. Some compounds show both remarkable analgesic activity and good BBB permeation profiles, and these compounds might be developed for treatment of opioid tolerance and dependence.

Experimental substantiation of effectively administration of vinboron for analgesic activity increase of ibuprofen

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F. V. Hladkykh

2016-12-01

Full Text Available Background. The increase of NSAIDs safety is current direction of modern pharmacology, because of so-called "class-specific" adverse reactions, which are common to this class, and the leading place among them is occupied by gastro-intestinal toxicity. In previous studies we have proved the ability of vinboron to neutralize ulcerogenic effect of ibuprofen (Hladkykh F.V. and al., 2014. The presence of the proven analgesic activity in the domestic antispasmodics (Stepaniuk H.I. and al., 2007 serves as the basis for research of vinboron action on analgesic aspect of ibuprofen pharmacotherapeutic effec. Aim is to conduct research in silico of the relation «molecular structure – anelgetic activity» of vinboron and to prove experimentally in vivo the practicability of vinboron using with the aim to increase the analgesic activity of ibuprofen on the model of adjuvant arthritis in rats. Materials and methods. The study of the relation «molecular structure – activity anelgetic» of vinboron was conducted in silico by PASS- analysis of biological activity spectrum. The analysis was set online with direct insertion of structural formula of vinboron in browser using Marvin JS web-resource «PASS Online» (http://www.way2drug.com/passonline. Analgesic activity in vivo was studied on the model of acute thermal pain, which was simulated in the conventional behavioral test of nociception «Hot plate». The lag of pain reaction was determined at the beginning («0» day, on 7, 14, 21 and 28 days of experiment. Results and discussion. According to the PASS-forecast the mechanisms of vinboron analgesic activity is caused by agonism towards the vanilloid (TRPV1 receptors (Pa=0,490; Pi=0,008, agonism to the μ (mu – receptor (Pa=0,323; Pi=0,036, inhibition of GABA (Pa=0,329; Pi=0,089 and others. Experimental studies have shown that the combined administration of ibuprofen and vinboron analgesic activity was higher than the results by ibuprofen monotherapy

antipyretic and analgesic activities of sphenoceutrum jollyanum

African Journals Online (AJOL)

The petroleum ether and methanol extracts of Sphenoceutrum jollyanum leaves possess significant in vitro analgesstic and antipyretic activities. Key Words: Sphenocentrum jollyanum, Menispermaceae, analgesic activity, antipyretic activity. Nig. J. Nat. Prod. And Med. Vol.2 1998: 52-53 ...

Analgesic effects of ultrasound-guided transverse abdominis plane block using different volumes and concentrations of local analgesics after laparoscopic cholecystectomy.

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Şahin, Ayça Sultan; Ay, Necmiye; Şahbaz, Nuri Alper; Akay, Mehlika Kocabaş; Demiraran, Yavuz; Derbent, Abdurrahim

2017-02-01

Objective To evaluate the effects of an ultrasound-guided transverse abdominis plane (US-TAP) block used for postoperative pain relief by comparing the efficacy of two different volumes/concentrations of the local anaesthetic bupivacaine in patients undergoing laparoscopic cholecystectomies. Methods This randomized study enrolled patients undergoing laparoscopic cholecystectomies. They were randomized to two groups: group A received a 20 ml US-TAP block (50 mg bupivacaine +10 ml saline solution) and group B received a 30 ml US-TAP block (50 mg bupivacaine + 20 ml saline solution). The intraoperative consumption of remifentanil, the requirement for postoperative rescue analgesics, patient satisfaction scores, postoperative complications, and postoperative pain as measured by a visual analogue scale at 20 min, 12 h, and 24 h were recorded. Results A total of 60 patients enrolled in the study. There were no differences between the two groups with respect to demographic characteristics, duration of anaesthesia and patient satisfaction scores. The intraoperative consumption of remifentanil, postoperative VAS scores (20 min, 12 h and 24 h) and the requirement for postoperative analgesics were all significantly lower in group B who received a larger volume but a lower concentration of local anaesthetic solution compared with group A. Conclusion A US-TAP block can form part of a balanced postoperative analgesic regimen following laparoscopic cholecystectomy.

Analgesic Usage in Elderly at Public Health Center: A study in West Java, Indonesias

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Gembong Soeyono Putro

2017-03-01

Full Text Available Background: Various analgesics prescriptions for elderly are not appropriate according to the guideline and can cause the increase of side effects such as gastric problems. Puskesmas as a public health center in Indonesia has an important role in anticipating this problem. The objectives of this study was to identify the analgesic usage in elderly patients at the public health center. Methods: This retrospective descriptive study was conducted for 3 months at Tanjungsari public health center, Sumedang, West Java, Indonesia, using total sampling. The data was taken from 417 medical records from 2013. The data taken from medical records were: sex, analgesic drug, diagnosis, and drug for gastric problem. Results: From the collected data, the most analgesics prescribed for the elderly patients was paracetamol, followed by Piroxicam, Mefenamic acid, and Ibuprofen. Not all of the elderly patients who received NSAIDs, were given gastric drug. Conclusions: The most prescribed analgesic drug given to elderly patients at the public health center is paracetamol. [AMJ.2017;4(1:16–9

Possible analgesic and anti-inflammatory interactions of aspartame with opioids and NSAIDs.

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Sharma, Sameer; Jain, N K; Kulkarni, S K

2005-06-01

The purpose of the present study was to investigate analgesic and anti-inflammatory properties of aspartame, an artificial sweetner and its combination with various opioids and NSAIDs for a possible synergistic response. The oral administration of aspartame (2-16mg/kg, po) significantly increased the pain threshold against acetic acid-induced writhes in mice. Co-administration of aspartame (2mg/kg, po) with nimesulide (2 mg/kg, po) and naproxen (5 mg/kg, po) significantly reduced acetic acid-induced writhes as compared to effects per se of individual drugs. Similarly when morphine (1 mg/kg, po) or pentazocine (1 mg/kg, po) was co-administered with aspartame it reduced the number of writhes as compared to their effects per se. Aspartame (4,8,16 mg/kg, po) significantly decreased carrageenan-induced increase in paw volume and also reversed the hyperalgesic effects in rats in combination with nimesulide (2 mg/kg, po). The study indicated that aspartame exerted analgesic and anti-inflammatory effects on its own and have a synergistic analgesic response with conventional analgesics of opioid and non-opioid type, respectively.

Analgesic Potential of Opuntia dillenii and Its Compounds Opuntiol and Opuntioside Against Pain Models in Mice

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Faheema Siddiqui

2016-05-01

Full Text Available Opuntia dillenii (Nagphana traditionally used against inflammation and also possess analgesic effect. Thus in the present study analgesic properties of O. dillenii cladode methanol extract, its fractions obtained via vacuum liquid chromatography along with isolated α-pyrones, opuntiol and its glucoside, opuntioside were analyzed. The acetic acid-induced writhes were reduced by O. dillenii test agents with opuntioside being most effective (IC 50 26 ± 0.9 mg/kg and equipotent to diclofenac and β-sitosterol. Consistently, it also elicited most potent effect (IC 50: 28 ± 1.1 and 24 ± 1.2 mg/kg during early and late phases of formalin-induced paw licking, producing effect similar to diclofenac and indomethacin. It was also most effective in hot plate test. Naloxone (opioid antagonist reversed the analgesic effects of extract and fractions but failed to antagonize the opuntiol and opuntioside analgesic effects. In conclusion, edible O. dillenii extract, its fractions, opuntiol and opuntioside reduced peripheral and centrally mediated pain via opioid dependent and independent systems. Among them opuntioside emerged as most effective analgesic possibly due to the presence of glucose moiety at position 7 of its α-pyrone ring. This is the first report of opuntiol and opuntioside analgesic effect which may serve as lead compounds in designing of new analgesics.

Differential Effectiveness of Clinically-Relevant Analgesics in a Rat Model of Chemotherapy-Induced Mucositis.

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Alexandra L Whittaker

Full Text Available Chemotherapy-induced intestinal mucositis is characterized by pain and a pro-inflammatory tissue response. Rat models are frequently used in mucositis disease investigations yet little is known about the presence of pain in these animals, the ability of analgesics to ameliorate the condition, or the effect that analgesic administration may have on study outcomes. This study investigated different classes of analgesics with the aim of determining their analgesic effects and impact on research outcomes of interest in a rat model of mucositis. Female DA rats were allocated to 8 groups to include saline and chemotherapy controls (n = 8. Analgesics included opioid derivatives (buprenorphine; 0.05mg/kg and tramadol 12.5mg/kg and NSAID (carprofen; 15mg/kg in combination with either saline or 5-Fluorouracil (5-FU; 150mg/kg. Research outcome measures included daily clinical parameters, pain score and gut histology. Myeloperoxidase assay was performed to determine gut inflammation. At the dosages employed, all agents had an analgesic effect based on behavioural pain scores. Jejunal myeloperoxidase activity was significantly reduced by buprenorphine and tramadol in comparison to 5-FU control animals (53%, p = 0.0004 and 58%, p = 0.0001. Carprofen had no ameliorating effect on myeloperoxidase levels. None of the agents reduced the histological damage caused by 5-FU administration although tramadol tended to increase villus length even when administered to healthy animals. These data provide evidence that carprofen offers potential as an analgesic in this animal model due to its pain-relieving efficacy and minimal effect on measured parameters. This study also supports further investigation into the mechanism and utility of opioid agents in the treatment of chemotherapy-induced mucositis.

Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies

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Choueiri, Toni K.; Je, Youjin; Cho, Eunyoung

2013-01-01

Analgesics are the most commonly used over-the-counter drugs worldwide with certain analgesics having cancer prevention effect. The evidence for an increased risk of developing kidney cancer with analgesic use is mixed. Using a meta-analysis design of available observational epidemiologic studies, we investigated the association between analgesic use and kidney cancer risk. We searched the MEDLINE and EMBASE databases to identify eligible case-control or cohort studies published in English until June 2012 for 3 categories of analgesics: acetaminophen, aspirin or other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Study-specific effect estimates were pooled to compute an overall relative risk (RR) and its 95% confidence interval (CI) using a random effects model for each category of the analgesics. We identified 20 studies (14 with acetaminophen, 13 with aspirin, and 5 with other NSAIDs) that were performed in 6 countries, including 8,420 cases of kidney cancer. Use of acetaminophen and non-aspirin NSAIDs were associated with an increased risk of kidney cancer (pooled RR, 1.28; 95% CI, 1.15 to 1.44 and 1.25; 95% CI, 1.06 to 1.46, respectively). For aspirin use, we found no overall increased risk (pooled RR, 1.10; 95% CI, 0.95 to 1.28), except for non-US studies (5 studies, pooled RR=1.17, 95% CI, 1.04 to 1.33). Similar increases in risks were seen with higher analgesic intake. In this largest meta-analysis to date, we found that acetaminophen and non-aspirin NSAIDs are associated with a significant risk of developing kidney cancer. Further work is needed to elucidate biologic mechanisms behind these findings. PMID:23400756

The effect of whole body irradiation on the action of strong analgesics of mice

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Cvetkovicj, M.; Milovanovicj, A.; Tanasijevicj, D.

1987-01-01

The effect of whole body irradiation of male mice with single doses of 3 and 7 Gy ( 60 Co source) on analgesic action of three morphine-like drugs was studied. Over the first 6 days after irradiation, the analgesic effect of alfentanil and fentanyl was significantly less pronounced in irradiated animals than in control ones. During the subsequent period of 24 days till the end of experiment, the analgesic effect in irradiated animals gradually increased reaching and exceeding the control values. On the contrary, the analgesic effect of butorphanole was less pronounced in irradiated animals than in control ones, although the difference was not significantly. The difference between butorphanole and other two drugs are probably due to chemical structure and the metabolic fate in the body. (author) 8 refs.; 2 figs

Antipyretic, analgesic and anti-inflammatory activity of Viola betonicifolia whole plant

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Muhammad Naveed

2012-05-01

Full Text Available Abstract Background Pyrexia, algesia and inflammation are associated with several pathological conditions. Synthetic drugs available for the treatment of these conditions cause multiple unwanted effects. Several studies are ongoing worldwide to find natural healing agents with better safety profile. The current study was thus aimed at evaluating antipyretic, analgesic and anti-inflammatory activities of the methanolic extract of whole plant of V. betonicifolia (VBME. Methods VBME was employed to assess antipyretic activity in yeast induced hyperthermia. Analgesic profile was ascertained in acetic acid induced writhing, hot plat and tail immersion test. Nevertheless, the anti-inflammatory activity was tested in carrageenan induced paw edema and histamine induced inflammatory tests. BALB/c mice were used at test doses of 100, 200 and 300mg/kg body weight intra peritoneally (i.p. Results In yeast induced pyrexia, VBME demonstrated dose dependently (78.23% protection at 300mg/kg, similar to standard drug, paracetamol (90% at 150mg/kg i.p. VBME showed a dose dependent analgesia in various pain models i.e. acetic acid, hot plat and tail immersion having 78.90%, 69.96% and 68.58% protection respectively at 300mg/kg. However, the analgesic action of VBME was completely antagonized by the injection of naloxone like opiate antagonists. Similarly carrageenan and histamine induces inflammation was significantly antagonized by VBME, 66.30% and 60.80% respectively at 300mg/kg. Conclusions It is concluded that VBME has marked antipyretic, analgesic and anti-inflammatory activities in various animal models and this strongly supports the ethnopharmacological uses of Viola betonicifolia as antipyretic, analgesic and anti-inflammatory plant.

Synthesis, Analgesic, Anti-inflammatory and Antimicrobial Activities ...

African Journals Online (AJOL)

Purpose: Microbial infections often produce pain and inflammation. Chemotherapeutic, analgesic and anti-inflammatory drugs are prescribed simultaneously in normal practice. The compound possessing all three activities is not common.The purpose of the present study was to examine whether molecular modification ...

ANALGESIC EFFICACY OF TRAMADOL IN PEDIATRIC TONSILLECTOMY WITH ADENOIDECTOMY

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Janez Benedik

2015-05-01

Full Text Available Background: Tonsillectomy is one of the most commonly performed surgical prcedures in childhood. Acute pain after tonsillectomy and adenoidectomy can be treated with non-opioid and opioid analgesics. Our hypothesis stated that tramadol iv after induction of anaesthesia has superior analgesic effect compared to acetaminophen.Methods:  In a prospective, randomised study we compared analgesic efficacy of tramadol (group T: 2 mg/kgBW iv and acetaminophen (group A: elixir 15 mg/kgBW before op. procedure in a group of 108 children (age 3-7 years. Exclusion critheria: allergy, liver or kidney failure, epilepsy, febrile convulsions. A standard anaesthetic technique was used: propofol, alfentanil, vecuronium, positive pressure ventilation with 60% nitrous oxide in oxygen. After the procedure each child received acetaminophen suppositories (10 mg/kgBW/4-6h and combined suppositories. Monitoring: vital signs during and after op. procedure, pain intensity on the ward (facial pain score.    Results: There were no significant differences between the two groups in age distribution (mean age 5,2 years, ASA physical status, body weight, operative procedure, pain scores (VAS 6h after operative procedure; group T: 4,21±1,45; group A: 4,06±1,33, oxygen saturation, pulse frequency and the consumption of acetaminophen suppositories. Significant difference was in the consumption of combined suppositories (group T: 1,85±0,79; group A: 1,43±0,69, p=0,003.   Conclusion: Our study has shown, that tramadol is not a superior analgesic for the relief of posttonsillectomy pain in children compared to acetaminophen. 

Analgesic and anti-inflammatory properties of the fruits of Vernonia anthelmintica (L Willd.

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Alok Pandey

2014-09-01

Full Text Available Objective: To evaluation of analgesic and anti-inflammatory properties of the fruits of Vernonia anthelmintica (L Willd. (V. anthelmintica. Method: Hot plate method in mice, acetic acid induced writhing response in mice, tail immersion test and carrageenan-induced paw edema in rats and cotton pellet induced granuloma in rats method were used for screening analgesic and anti-inflammatory properties of the fruit of V. anthelmintica (family: Asteraceae. Results: The result of the study showed that the ethanolic extract of V. anthelmintica (100 and 200 mg/kg body weight, p.o. fruits possed peripheral and central analgesic activity in animal model. The V. anthelmintica fruits extract showed in vivo anti-inflammatory activity on acute and chronic anti-inflammatory activity models in rats. Conclusions: On the basis of result it can be concluded that saponins, steroids, tannins and flavonoids are the major constituents that are present in the fruits of V. anthelmintica which may be responsible for its analgesic and anti-inflammatory activity.

anti-inflammatory and analgesic activities: chemical constituents of ...

African Journals Online (AJOL)

a

*Corresponding author. E-mail: bedisag@yahoo.fr. ANTI-INFLAMMATORY AND ANALGESIC ACTIVITIES: CHEMICAL CONSTITUENTS OF ESSENTIAL OILS OF OCIMUM GRATISSIMUM,. EUCALYPTUS CITRIODORA AND CYMBOPOGON GIGANTEUS INHIBITED. LIPOXYGENASE L-1 AND CYCLOOXYGENASE OF ...

Pharmacokinetics of Sustained-Release Analgesics in Mice

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Kendall, Lon V; Hansen, Ryan J; Dorsey, Kathryn; Kang, Sooah; Lunghofer, Paul J; Gustafson, Daniel L

2014-01-01

Buprenorphine and carprofen, 2 of the most commonly used analgesics in mice, must be administered every 8 to 12 h to provide sustained analgesia. Sustained-release (SR) formulations of analgesics maintain plasma levels that should be sufficient to provide sustained analgesia yet require less frequent dosing and thus less handling of and stress to the animals. The pharmacokinetics of SR formulations of buprenorphine (Bup-SR), butorphanol (Butp-SR), fentanyl (Fent-SR), carprofen (Carp-SR), and meloxicam (Melox-SR) were evaluated in mice over 72 h and compared with those of traditional, nonSR formulations. Bup-SR provided plasma drug levels greater than the therapeutic level for the first 24 to 48 h after administration, but plasma levels of Bup-HCl fell below the therapeutic level by 4 h. Fent-SR maintained plasma levels greater than reported therapeutic levels for 12 h. Therapeutic levels of the remaining drugs are unknown, but Carp-SR provided plasma drug levels similar to those of Carp for the first 24 h after administration, whereas Melox-SR had greater plasma levels than did Melox for the first 8 h. Butp-SR provided detectable plasma drug levels for the first 24 h, with a dramatic decrease over the first 4 h. These results indicate that Bup-SR provides a stable plasma drug level adequate for analgesia for 24 to 48 h after administration, whereas Carp-SR, Melox-SR, Fent-SR, and Butp-SR would require additional doses to provide analgesic plasma levels beyond 24 h in mice. PMID:25255070

Anti-Inflamatory and Analgesic Activities of Securidaca ...

African Journals Online (AJOL)

Securidaca longepedunculata Fers (Polygalaceae) is commonly used in many parts of Africa for the treatment of rheumatic conditions, fever, headache and various other inflammatory based diseases. The present study was carried out to evaluate the anti-inflammatory and analgesic activity of Securidaca longepedunculata ...

An in vitro analysis of the cariogenic and erosive potential of pediatric liquid analgesics

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Shaam Saeed

2015-01-01

Full Text Available Background: Analgesics such as Ibuprofen and Paracetamol, which are clinically used for the treatment of fever and/or pain, are among the most frequently used pediatric medicines. However, the properties of these preparations determine their cariogenic and erosive potential. Aims: The main objective of this study was to analyze the pH, viscosity and total sugar content in a variety of Syrian pediatric liquid analgesics (PLA. Setting and Design: A total of 16 available liquid analgesics that belong to the Paracetamol and Ibuprofen group were analysed. Materials and Methods: The endogenous pH was measured using a digital pH meter, the viscosity was measured using a digital rotational viscometer and the total sugar content was performed according to Fehling method. Statistical Analysis: Data were presented by means of descriptive statistics (mean, standard deviation, minimum and maximum values. Results: The mean endogenous pH of PLA was 4.63 ± 0.57 ranging between 3.93 and 5.68, and almost all of analgesics (93.8% had pH values ≤5.5. The mean viscosity of PLA was 243.56 ± 186.6 cP and varied between 20.5 cP and 640.5 cP. Sugars were detected in 11 (68.75% analgesics, and varied considerably among sugar-containing analgesics from 5.38 to 69.4 (g/100 mL with a mean concentration of 24.97 ± 23.24 g/100 mL. Conclusion: PLA are potentially cariogenic and erosive because of low pH, high viscosity and high total sugar content. This may increase our concerns about the dental health of children who take liquid analgesics frequently or when long-term treatment is indicated.

The analgesic efficacy of continuous transversus abdominis plane block in renal transplant recipients

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Beena Kandarp Parikh

2015-01-01

Full Text Available Background and Aims: Transversus abdominis plane (TAP block is suitable for operations where parietal pain is a major cause of pain. Renal transplant recipients are ideally suited to gain maximum benefit from TAP block as the incision classically involves the lower abdomen. This study was conducted to evaluate the analgesic efficacy of continuous TAP block in transplant recipients. Material and Methods: In a prospective double-blind study, 40 chronic renal failure patients undergoing open renal transplant were randomly divided into two groups. At the end of surgery during closure, a multiorifice epidural catheter was placed in TAP plane. Study group (Group S received Inj bupivacaine bolus 1 mg/kg (0.25% followed by infusion 0.25 mg/kg (0.125% through the catheter, whereas control group (Group C received normal saline through the catheter. Inj pentazocine (0.3 mg/kg was given as rescue analgesic at visual analogue score (VAS > 3 in any group at rest or on movement. The analgesic efficacy was judged by VAS, time of first rescue analgesic, and total analgesic consumption in 24 h. Results: Patients in Group S had significant lower VAS scores, longer time to first rescue analgesic (270 ± 347.96 vs. 42.85 ± 32.27 min and lower pentazocine consumption (9.75 ± 13.95 vs. 56.42 ± 12.46 mg in 24 h. There was significant sedation in Group C. Conclusion: The TAP catheter technique for postoperative pain control after renal transplant has proved to be effective in relieving the postoperative pain after renal transplant with less pentazocine requirement and less sedation.

Analgesic, anti-inflammatory and anti-platelet activities of Buddleja crispa.

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Bukhari, Ishfaq A; Gilani, Anwar H; Meo, Sultan Ayoub; Saeed, Anjum

2016-02-25

Buddleja crispa Benth (Buddlejaceae) is a dense shrub; several species of genus Buddleja have been used in the management of various health conditions including pain and inflammation. The present study was aimed to investigate the analgesic, anti-inflammatory and anti-platelet properties of B. crispa. Male rats (220-270 gm,) and mice (25-30 gm) were randomly divided into different groups (n = 6). Various doses of plant extract of B. crispa, its fractions and pure compounds isolated from the plant were administered intraperitoneally (i.p). The analgesic, anti-inflammatory and anti-platelet activities were assessed using acetic acid and formalin-induced nociception in mice, carrageenan-induced rat paw edema and arachidonic acid-induced platelets aggregation tests. The intraperitoneal administration of the methanolic extract (50 and 100 mg/kg), hexane fraction (10 and 25 mg/kg i.p) exhibited significant inhibition (P < 0.01) of the acetic acid-induced writhing in mice and attenuated formalin-induced reaction time of animals in second phase of the test. Pure compounds BdI-2, BdI-H3 and BH-3 isolated from B. crispa produced significant (P < 0.01) analgesic activity in acetic acid-induced and formalin tests. The crude extract of B. crispa (50-200 mg/kg i.p.) and its hexane fraction inhibited carrageenan-induced rat paw edema with maximum inhibition of 65 and 71% respectively (P < 0.01). The analgesic and anti-inflammatory effect of the plant extract and isolated pure compounds were comparable to diclofenac sodium. B. crispa plant extract (0.5-2.5 mg/mL) produced significant anti-platelet effect (P < 0.01) with maximum inhibition of 78% at 2.5 mg/ml. The findings from our present study suggest that B. crispa possesses analgesic, anti-inflammatory and anti-platelet properties. B. crispa could serve a potential novel source of compounds effective in pain and inflammatory conditions.

Synthesis and Analgesic Activity of Novel Derivatives of 1,2-Substituted Benzimidazoles

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Shobhit Srivastava

2013-01-01

Full Text Available A series of novel 2-phenylhydrazinomethyl and 2-(2-hydroxyphenyl-benzimidazole derivatives substituted at the N1-position of benzimidazole nucleus were synthesized as well as screened for analgesic activity. Some of these compounds showed promising analgesic activity when compared with the standard drug diclofenac sodium. The incorporation of a phenylhydrazinomethyl nucleus at 2-position of benzimidazole compound gave a biologically active pharmacophore.

Nonsteroidal Anti-Inflammatory Drugs and Analgesics Use by Kidney Transplant Recipients.

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Mulka-Gierek, Maria; Foroncewicz, Bartosz; Pączek, Leszek; Wawiórko, Elżbieta; Kamińska, Joanna; Kosieradzki, Maciej; Małkowski, Piotr; Małczuk, Bianka; Nazarewski, Sławomir; Mucha, Krzysztof

2018-03-02

BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics are the most commonly used drugs and are increasingly available over-the-counter (OTC). In certain groups of patients, including kidney transplant recipients, their use may be complicated by adverse effects or drug interactions. The aim of our study was to assess the causes and frequency of OTC NSAIDs or analgesics use, as well as the awareness of related side effects. MATERIAL AND METHODS We enrolled 94 randomly selected kidney transplant recipients, who represented 5% of all kidney transplant recipients at our center. An anonymous survey consisting of 23 multiple-choice questions was administered voluntarily and anonymously. RESULTS In all, 63% of study patients confirmed taking the OTC painkillers; 22% of these patients took these drugs at least several times a week, and 4% took these drugs daily. For 38% of the study kidney transplant recipients, NSAIDs or analgesics were reported to be the only way to manage their pain. In addition, 30% of study patients were unaware of the risks associated with these drugs, despite the fact that 89% of the study patients consider physicians the best source of information. CONCLUSIONS Our study found that 63% of kidney transplant recipients regularly took OTC painkillers and 30% were unaware of the potential adverse effects. This necessitates continuous, ongoing education of kidney transplant recipients about the risks of OTC NSAIDs or analgesics use.

Comparable effects of exercise and analgesics for pain secondary to knee osteoarthritis

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Henriksen, Marius; Hansen, Julie B; Klokker, Louise

2016-01-01

administered analgesics for pain in patients with knee osteoarthritis. METHODS: The Cochrane Database of systematic reviews was searched for meta-analyses of randomized controlled studies comparing exercise or analgesics with a control group (placebo or usual care) and with pain as an outcome. Individual study......AIM: Evidence of comparative effectiveness of different treatment approaches is important for clinical decision-making, yet absent for most recommended treatments of knee osteoarthritis pain. The objective of this study was to estimate the comparative effectiveness of exercise versus orally...... estimates were identified and effect sizes were calculated from group differences. We combined study-level effects on pain with a random effects meta-analysis and compared effect sizes between exercise trials and trials with analgesic interventions. RESULTS: We included six Cochrane reviews (four...

Comparison of Electroacupuncture and Morphine-Mediated Analgesic Patterns in a Plantar Incision-Induced Pain Model

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Yen-Jing Zeng

2014-01-01

Full Text Available Electroacupuncture (EA is a complementary therapy to improve morphine analgesia for postoperative pain, but underlying mechanism is not well-known. Herein, we investigated EA-induced analgesic effect in a plantar incision (PI model in male Sprague-Dawley rats. PI was performed at the left hind paw. EA of 4 Hz and high intensity or sham needling was conducted at right ST36 prior to PI and repeated for another 2 days. Behavioral responses to mechanical and thermal stimuli, spinal phospho-ERK, and Fos expression were all analyzed. In additional groups, naloxone and morphine were administered to elucidate involvement of opioid receptors and for comparison with EA. EA pretreatment significantly reduced post-PI tactile allodynia for over 1 day; repeated treatments maintained analgesic effect. Intraperitoneal naloxone could reverse EA analgesia. Low-dose subcutaneous morphine (1 mg/kg had stronger inhibitory effect on PI-induced allodynia than EA for 1 h. However, analgesic tolerance appeared after repeated morphine injections. Both EA and morphine could equally inhibit PI-induced p-ERK and Fos inductions. We conclude that though EA and morphine attenuate postincision pain through opioid receptor activations, daily EA treatments result in analgesic accumulation whereas daily morphine injections develop analgesic tolerance. Discrepant pathways and mechanisms underlying two analgesic means may account for the results.

Temporal Trends in Analgesic Use in Long-Term Care Facilities: A Systematic Review of International Prescribing.

Science.gov (United States)

La Frenais, Francesca L; Bedder, Rachel; Vickerstaff, Victoria; Stone, Patrick; Sampson, Elizabeth L

2018-02-01

To explore global changes in the prescription of analgesic drugs over time in the international long-term care (LTC) population. Systematic review. We included original research articles in English, published and unpublished, that included number of participants, country and year(s) of data collection, and prescription of analgesics (analgesics not otherwise specified, opioids, acetaminophen; scheduled only, or scheduled plus as needed (PRN)). LTC residents. We searched PubMed, EMBASE, CINAHL, International Pharmaceutical Abstracts, PsycINFO, Cochrane, Web of Science, Google Scholar, using keywords for LTC facilities and analgesic medication; hand-searched references of eligible papers; correspondence. Studies were quality rated using an adapted Newcastle-Ottawa scale. Pearson correlation coefficients were generated between percentage of residents prescribed an analgesic and year of data collection. If available, we investigated changes in acetaminophen and opioid prescriptions. Forty studies met inclusion criteria. A moderate correlation (0.59) suggested that scheduled prescription rates for analgesics have increased over time. Similar findings were reflected in scheduled prescriptions for acetaminophen and opioids. No increase was seen when analyzing scheduled plus PRN analgesics. Use of opioids (scheduled plus PRN) appears to have increased over time. Worldwide, use of opioids and acetaminophen has increased in LTC residents. Research is needed to explore whether this reflects appropriate pain management for LTC residents and if PRN medication is used effectively. © 2017 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Heterogenic control groups in randomized, controlled, analgesic trials of total hip and knee arthroplasty.

Science.gov (United States)

Karlsen, Anders P; Mathiesen, Ole; Dahl, Jørgen B

2018-03-01

Postoperative analgesic interventions are often tested adjunct to basic non-opioid analgesics in randomized controlled trials (RCTs). Consequently, treatment in control groups, and possible assay sensitivity, differs between trials. We hypothesized that postoperative opioid requirements and pain intensities vary between different control groups in analgesic trials. Control groups from RCTs investigating analgesic interventions after total hip and knee arthroplasty were categorized based on standardized basic analgesic treatment. Morphine consumption 0 to 24 hours postoperatively, and resting pain scores at 6 and 24 hours for subgroups of basic treatments, were compared with ANOVA. In an additional analysis, we compared pain and opioid requirements in trials where a non-steroidal anti-inflammatory drug (NSAID) was administered as an intervention with trial where NSAID was administered in a control group. We included 171 RCTs employing 28 different control groups with large variability in pain scores and opioid requirements. Four types of control groups (comprising 78 trials) were eligible for subgroup comparisons. These subgroups received "opioid" alone, "NSAID + opioid", "acetaminophen + opioid", or "NSAID + acetaminophen + opioid", respectively. Morphine consumption and pain scores varied substantially between these groups, with no consistent superior efficacy in any subgroup. Additionally, trials administering NSAID as an intervention demonstrated lower pain scores and opioid requirements than trials where NSAID was administered in a control group. Analgesic treatment in RCT control groups varies considerably. Control groups receiving various combinations of opioid, NSAID and acetaminophen did not differ consistently in pain and opioid requirements. Pain and opioid requirements were lower in trials administering NSAID as an intervention compared with trials administering NSAID in a control group.

Translational pain research: evaluating analgesic effect in experimental visceral pain models

DEFF Research Database (Denmark)

Olesen, Anne Estrup; Andresen, Trine; Christrup, Lona Louring

2009-01-01

Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can ...... studies and clinical condition in patients suffering from visceral pain, and thus constitute the missing link in translational pain research.......Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can...... facilitate minimizing the gap between knowledge gained in animal and human clinical studies. Combining experimental pain studies and pharmacokinetic studies can improve understanding of the pharmacokinetic-pharmacodynamic relationship of analgesics and, thus, provide valuable insight into optimal clinical...

Analgesic activity of Hibiscus rosa sinensis Linn in rat

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Alka Sawarkar

Full Text Available The plant Hibiscus rosa  sinensis Linn. belongs to family “Malvacecae” and Considering various medicinal properties of this plant, the leaves were collected and studied for Extractability percentage, analgesic. The herb Hibiscus rosa  sinensis  belonging to the family “Malvacecae” and is commonly known as jasvand. It is cultivated in garden throughout India native country probably china. The buds have a sweet odour and bitter taste, cooling, astringent, remove burning sensations of the body and relieve pain. In the present study aqueous, alcoholic Extracts of dried leaves of Hibiscus rosasinensis was prepared. The extractability percentage of leaves was 20%. The extract showed marked analgesic activity in a dose dependent manner. Aqueous and alcoholic extracts produced significant results at both doses (P<0.01, the findings indicated the analgesic activity of the leaves of the plant. [Vet World 2009; 2(9.000: 353-354

Development of Novel Local Analgesics for Management of Acute Tissue Injury Pain

Science.gov (United States)

2017-09-01

Project Manager Boston Biomedical Innovation Center 215 First Street, Suite 500; Cambridge, MA 02142 857-307-2441 | rblackman1@partners.org | b...AWARD NUMBER: W81XWH-15-1-0480 TITLE: Development of Novel Local Analgesics for Management of Acute Tissue Injury Pain PRINCIPAL...31/2017 4. TITLE AND SUBTITLE Development of Novel Local Analgesics for Management of Acute Tissue Injury Pain 5a. CONTRACT NUMBER Tissue Injury

Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

DEFF Research Database (Denmark)

Jensen, Janne Fangel; Gottschau, Mathilde; Siersma, Volkert Dirk

2014-01-01

Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine...... whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child's frequency of pain into account....

Risk perception about medication sharing among patients: a focus group qualitative study on borrowing and lending of prescription analgesics

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Markotic F

2017-02-01

Full Text Available Filipa Markotic,1 Davorka Vrdoljak,2 Marijana Puljiz,3 Livia Puljak,4 1Centre for Clinical Pharmacology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; 2Department of Family Medicine, University of Split School of Medicine, Split, 3Family Medicine Clinic, Health Centre Imotski, Kamenmost, 4Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Background: One form of self-medication is sharing of medications, defined as borrowing or lending medications in situations where the receiver of these drugs is not the individual to whom the medications were allocated. Objective: To explore experiences and opinions of patients about sharing prescription analgesics, reasons for sharing prescription analgesics, the way in which patients choose to share those medications, their awareness of risk regarding sharing prescription analgesics, and how they estimated the potential risk.Methods: This qualitative study was conducted by focus group discussions with 40 participants led by a moderator trained in focus group methodology using a semi-structured moderator guide. Adults aged ≥18 years who had received a prescription for an analgesic at least once in a lifetime were included. Six separate focus groups were conducted to discuss participants’ perception of risks associated with sharing of prescription analgesics among patients. Additionally, participants filled out two questionnaires on demographic data, their own behavior regarding sharing analgesics, and their attitudes about risks associated with sharing prescription analgesics.Results: In a questionnaire, 55% of the participants indicated that they personally shared prescription analgesics, while subsequently in the focus group discussions, 76% confessed to such behavior. Participants recognized certain risks related to sharing of prescription analgesics, mentioned a number of reasons for engaging in such behavior, and indicated certain positive

Analgesic Effect and Immunomodulation Response on Pro ...

African Journals Online (AJOL)

In order to determine qualitatively the chemical components of the extract, thin layer chromatography (TLC) was used. The analgesic activity of the extract at various doses (25, 50, 100 and 200 mg/kg, i.p) was assessed using formalin test while pro-inflammatory cytokines were measured by enzyme-linked immunosorbent ...

Use of medications and resources for treatment of nausea, vomiting, or constipation in hospitalized patients treated with analgesics.

Science.gov (United States)

Suh, Dong-Churl; Kim, Myoung S; Chow, Wing; Jang, Eun-Jin

2011-01-01

Hospitalized patients often experience adverse events of the gastrointestinal tract due to analgesic treatment. The objectives of this study were to estimate use of medications for treatment of nausea, vomiting, or constipation (NVC medications) after initiation of analgesic treatment, and to compare differences in length of stay and treatment costs between patients who received NVC medications and those who did not. This retrospective cohort study used the Premier Perspective data from January 1, 2005 to December 31, 2007 and stratified inpatients into 4 groups based on the first analgesic agent they were given. Patients were observed for 14 days after the first analgesic use until a regimen change, first use of NVC medication, or hospital discharge, whichever occurred first. Data were analyzed using a Cox proportional hazards model and a generalized linear model. This study found that 239,183 (55.1%) of 434,304 patients received NVC medications after analgesic administration. Compared with oral nonopioid analgesics, the risk of using NVC medication was 4.8 times higher for injectable opioid analgesics after controlling for confounders. Patients who received NVC medications were hospitalized 0.26 days longer (P hospital resources.

Parental attitudes regarding analgesic use for children: differences in ethnicity and language.

Science.gov (United States)

Fortier, Michelle A; Martin, Sarah R; Kain, Danielle I; Tan, Edwin T

2011-11-01

The aim of this study was to identify the impact of ethnicity and language on parental attitudes regarding analgesic use to treat children's pain. A total of 206 parents of children undergoing outpatient surgery were recruited to complete the Medication Attitudes Questionnaire, a measure of parental beliefs about using analgesic medications to treat children's pain. Parents were grouped into one of 3 categories according to ethnicity and primary language spoken: English-speaking white, English-speaking Hispanic, and Spanish-speaking Hispanic. Group differences in pain medication attitudes were examined. After controlling for socioeconomic status, English-speaking Hispanic parents endorsed higher levels of misconceptions about pain medication use, including a tendency to avoid analgesic use for children, compared with English-speaking white and Spanish-speaking Hispanic parents. This study highlights parental characteristics, including ethnicity and language, which may place children at higher risk for undertreatment of acute pain based on misconceptions about analgesic use for children. Specifically, English-speaking Hispanic parents may be most likely to undertreat children's pain at home. Future studies are needed to identify the most appropriate means of providing education to counter parental misconceptions and support optimal pain management of children's pain in the home setting. Copyright © 2011 Elsevier Inc. All rights reserved.

Intravenous analgesics for pain management in post- operative ...

African Journals Online (AJOL)

Intravenous analgesics for pain management in post- operative patients: a comparative study of their efficacy and adverse ... patient anxiety, stress, and dissatisfaction. Adequate ... genders who were scheduled to undergo abdominal surgery (hemicolectomy, exploratory ... analysis (n = 48) and separated into three groups.

Screening of Alkaloidal Fraction of Conium maculatum L. Aerial Parts for Analgesic and Antiinflammatory Activity.

Science.gov (United States)

Madaan, Reecha; Kumar, S

2012-09-01

Conium maculatum Linn. (Umbelliferae) has been traditionally used in the treatment of spasmodic disorders, and to relieve nervous excitation, rheumatic pains in the old and feeble, pain in stomach, pain of gastric ulcer, nervousness and restlessness. Alkaloids have long been considered as bioactive group of constituents present in C. maculatum. Despite a long tradition of use, C. maculatum has not been evaluated pharmacologically to validate its traditional claims for analgesic and antiinflammatory activities. Thus, the present investigations were undertaken with an objective to evaluate alkaloidal fraction of C. maculatum aerial parts for analgesic and antiinflammatory activities. Test doses (100 or 200 mg/kg, p.o.) of alkaloidal fraction were evaluated for analgesic activity using tail flick test and antiinflammatory activity using carrageenan-induced paw oedema test in rats. Morphine (5 mg/kg, p.o.) and indomethacin (5 mg/kg, p.o.) were used as standard analgesic and antiinflammatory drugs, respectively. Alkaloidal fraction of the plant exhibited significant analgesic activity at a dose of 200 mg/kg as it showed significant increase in tail flicking reaction time with respect to the control during 2 h intervals of observation. It also exhibited significant antiinflammatory activity at a dose of 200 mg/kg as it inhibited paw oedema in rats to 71% and reduced the paw volume one-fourth to the control during 1(st) h of the study. The present investigations suggest that alkaloids are responsible for analgesic and antiinflammatory activities of C. maculatum.

Screening of Ficus religiosa leaves fractions for analgesic and anti-inflammatory activities

OpenAIRE

Gulecha, Vishal; Sivakumar, T; Upaganlawar, Aman; Mahajan, Manoj; Upasani, Chandrashekhar

2011-01-01

Objective : To evaluate the different fractions of dried leaves of Ficus religiosa Linn for analgesic and anti-inflammatory activity using different models of pain and inflammation Materials and Methods : The analgesic activity of F. religiosa carried out using acetic acid-induced writhing in mice and tail flick test in rats. The anti-inflammatory activity was evaluated using carrageenan-induced rat paw edema and cotton pellet-granuloma formation in rats. Five different fractions (FRI, FR...

Management of cancer pain: 1. Wider implications of orthodox analgesics

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Lee SK

2014-01-01

Full Text Available Susannah K Lee,1 Jill Dawson,2 Jack A Lee,3 Gizem Osman,4 Maria O Levitin,5 Refika Mine Guzel,5 Mustafa BA Djamgoz5,61Pomona College, Claremont, CA, USA; 2Healthcare Communications Consultancy, Danville, CA, USA; 3College of Arts and Sciences, Vanderbilt University, Nashville, TN, USA; 4Department of Chemical Engineering, Loughborough University, Loughborough, UK; 5Division of Cell and Molecular Biology, Neuroscience Solutions to Cancer Research Group, South Kensington Campus, Imperial College London, London, UK; 6Cyprus International University, Biotechnology Research Centre, Haspolat, North Cyprus, Mersin, TurkeyAbstract: In this review, the first of two parts, we first provide an overview of the orthodox analgesics used commonly against cancer pain. Then, we examine in more detail the emerging evidence for the potential impact of analgesic use on cancer risk and disease progression. Increasing findings suggest that long-term use of nonsteroidal anti-inflammatory drugs, particularly aspirin, may reduce cancer occurrence. However, acetaminophen may raise the risk of some hematological malignancies. Drugs acting upon receptors of gamma-aminobutyric acid (GABA and GABA “mimetics” (eg, gabapentin appear generally safe for cancer patients, but there is some evidence of potential carcinogenicity. Some barbiturates appear to slightly raise cancer risks and can affect cancer cell behavior in vitro. For cannabis, studies suggest an increased risk of squamous cell carcinoma of the tongue, larynx, and possibly lung. Morphine may stimulate human microvascular endothelial cell proliferation and angiogenesis; it is not clear whether this might cause harm or produce benefit. The opioid, fentanyl, may promote growth in some tumor cell lines. Opium itself is an emerging risk factor for gastric adenocarcinoma and possibly cancers of the esophagus, bladder, larynx, and lung. It is concluded that analgesics currently prescribed for cancer pain can

Analgesic Effects of Botulinum Toxin in Children with CP

DEFF Research Database (Denmark)

Sandahl Michelsen, Josephine; Normann, Gitte; Wong, Christian

2018-01-01

Experiencing pain is the greatest contributor to a reduced quality of life in children with cerebral palsy (CP). The presence of pain is quite common (~60%) and increases with age. This leads to missed school days, less participation, and reduced ambulation. Despite these alarming consequences...... of disorders and could potentially have an analgesic effect in children with CP as well. Even though most of the studies presented here show promising results, many also have limitations in their methodology as it is unlikely to capture all dimensions of pain in this heterogeneous group using only one...... assessment tool. In this review, we present a new way of examining the analgesic effect of botulinum toxin in children with CP using a variety of pain scores....

Preemptive Analgesic Effect of Ketamine in Children with Lower Abdominal Surgery

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Serbülent Gökhan Beyaz

2011-06-01

Full Text Available Objective: Preemptive analgesic effect of low dose ketamine has been supported by clinical studies in adults. The aim of this study was to evaluate the analgesic effect of ketamine applied at different times in children who underwent lower abdominal surgery.Material and Methods: A total of 90 children having ASAI-II physical status between 3 and 12 was randomly divided into three groups as pre, int and post groups. Ketamine were given to these groups in the following manner respectively; 1mg/kg intravenous ketamine before incision (pre-incisional; the same dose ketamine 10 minutes following the first incision (intraoperative; and ketamine at the end of the surgical operation (postoperative. The pain of patients was assessed by postoperative pain scale (CHIPPS in children and infants; the sedation status of children was assessed by Ramsey’s sedation scale. The first analgesic requirement time was recorded.Results: No significant difference was found in demographic characteristics of the three groups (p>0.05. Lower CHIPPS scores were found in Group Post throughout all measurement periods (p<0.05. Group Post was found to have significantly higher sedation levels compared with the other two groups (p=0.003. Conclusion: No analgesic effect was obtained using by pre-incisional and intraoperative i.v.1mg/kg ketamine, during lower abdominal surgery in children. Further studies with different drugs are needed to clarify this topic.

Screening of analgesic activity of Tunisian Urtica dioica and analysis of its major bioactive compounds by GCMS.

Science.gov (United States)

Dhouibi, Raouia; Moalla, Dorsaf; Ksouda, Kamilia; Ben Salem, Maryem; Hammami, Serria; Sahnoun, Zouheir; Zeghal, Khaled Mounir; Affes, Hanen

2017-11-20

The present study was aimed to evaluate the analgesic properties of Urtica dioica (UD) and to profile phytochemicals by gas chromatography-mass spectrometry (GC-MS). The ethanolic extracts were prepared by maceration method and extraction using rotary evaporator. The analgesic activity was analysed by hot plate method, formalin test, acetic acid-induced writhing test and the tail-flick test with different doses of the ethanolic extract. In all tests, the leaf's ethanolic extract exhibited significant analgesic activity (p analgesic activity with many tests. The GC-MS analysis of the ethanol extract of leaf revealed many compounds; 2-methyltetradecane dodecane, 2,6,11-trimethyl-; 2,6,11-trimethyldodecane, and trimethylhexane which are pharmaceutically the most important. These findings justify that UD can be a valuable natural analgesic source which seemed to provide potential phototherapeutics against various ailments. The analysis of ethanolic extract of UD by GCMS revealed the presence of several compounds including polyphenols, flavonoids, triterpenes which can explain the analgesic effect of UD and its mechanism of action. Hence, UD could be another therapeutic alternative for relieving pain and for minimising the use of drugs that have long-term secondary effects.

A comparison of analgesic effect of intra-articular levobupivacaine with bupivacaine following knee arthroscopy

International Nuclear Information System (INIS)

Karaman, Yucel; Bor, Canan; Kayali, Cemil; Ozturk, Hasan; Kaya, Ahmet

2009-01-01

To compare the postoperative analgesic effects of intra-articular levobupivacaine with bupivacaine following knee arthroscopy. Forty patients, aged between 20-60 years and undergoing elective knee arthroscopy were enrolled into the study protocol that was carried out in Tepecik Education and Research Hospital, Izmir, Turkey between January and June 2007. General anesthesia protocol was the same in all patients. At the end of surgery, the patients were randomly assigned into 2 groups (n=20 in each group). Group L received 20 ml 0.5% levobupivacaine and Group B received 20 ml 0.5% bupivacaine intra-articularly. We evaluated the level of postoperative pain (by visual analoque scale at 1, 2, 4, 6, 12, and 24 hours after surgery), first analgesic requirement time (period measured from the end of the surgery until further analgesia was demanded), and total analgesic consumption during 24 hours. There were no significant difference in the postoperative pain scores of the patients between groups. The first analgesic requirement times were not statistically different. Twelve patients in Group L (60%) and 9 patients in Group B (45%) needed no additional analgesic during the 24 hours (p>0.05). No complications and side effects were found related to the intra-articular treatment. The results of the study show that intra-articular 20 ml 0.5% levobupivacaine provides effective analgesia comparable to that provided by 20 ml 0.5% bupivacaine. (author)

Evaluation of Analgesic Activity of Papaver libanoticum Extract in Mice: Involvement of Opioids Receptors

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Mohamad Ali Hijazi

2017-01-01

Full Text Available Papaver libanoticum is an endemic plant to Lebanese region (family Papaveraceae that has not been investigated before. The present study aimed to explore the analgesic activity of dried ethanolic extract of Papaver libanoticum (PLE using tail flick, hot plate, and acetic acid induced writhing models in mice. The involvement of opioid receptors in the analgesic mechanism was investigated using naloxone antagonism. Results demonstrated that PLE exhibited a potent dose dependent analgesic activity in all tested models for analgesia. The analgesic effect involved activation of opioid receptors in the central nervous system, where both spinal and supraspinal components might be involved. The time course for analgesia revealed maximum activity after three hours in both tail flick and hot plate methods, which was prolonged to 24 hours. Metabolites of PLE could be responsible for activation of opioid receptors. The EC50 of PLE was 79 and 50 mg/kg in tail flick and hot plate tests, respectively. The total coverage of analgesia by PLE was double that of morphine in both tests. In conclusion, PLE proved to have opioid agonistic activity with a novel feature of slow and prolonged effect. The present study could add a potential tool in the armaments of opioid drugs as a natural potent analgesic and for treatment of opioid withdrawal syndrome.

Evaluation of Analgesic and Anti-Inflammatory Effects of Ethanol Extract of Ficus Iteophylla Leaves in Rodents

OpenAIRE

Abdulmalik, IA; Sule, MI; Musa, A M; Yaro, A H; Abdullahi, MI; Abdulkadir, MF; Yusuf, H

2011-01-01

This study was undertaken to investigate the leaf part of the plant for analgesic and anti-inflammatory. The ethanol extract of Ficus iteophylla leaves (100, 200, and 400mgkg−1, i.p) was evaluated for analgesic and anti-inflammatory activities. The analgesic effect was studied using acetic acid-induced abdominal constriction and hot plate test in mice, while the anti-inflammatory effect was investigated using carrageenan induced paw oedema in rats. The ethanol extract at 100mgkg−1, 200mgkg−1,...

Comparative Study of the Analgesic Activity of Two Iraqi Medicinal Plants, Ruta graveolens and Matricaria chamomilla Extracts

Directory of Open Access Journals (Sweden)

Saad Abdulrahman Hussain

2012-04-01

Full Text Available Aims: The study was performed to compare the analgesic activity of different fractions of the extracts of Ruta graveolens and Matricaria chamomilla. Materials and Methods: The plant materials were extracted with 70% ethanol, petroleum ether, ethyl acetate and n-butanol. The ethyl acetate and n-butanol fractions of each plant were evaporated to dryness and analyzed by HPLC. The analgesic activity of these extracts was evaluated using writhing reflex test and compared with that produced by a standard drug (Diclofenac sodium. Results: Flavonoids were found in all fractions of both plants (i.e ethyl acetate and n-butanol, while trace of alkaloids in were found in the ethyl acetate fraction of Ruta. The prepared extracts showed better analgesic activity than the standard drug; when compared with each other, Matricaria extracts showed better analgesic activity compared to Ruta extracts. Conclusion: There is similar efficacy of chamomile and common rue as analgesic agents. [J Intercult Ethnopharmacol 2012; 1(2.000: 79-83

Schiff bases derived from 1-aminoanthraquinone: a new class of analgesic compounds

International Nuclear Information System (INIS)

Fareed, G.; Rizwan, G.H.; Fareed, N.

2017-01-01

A series of Schiff bases 1-17 were synthesised by way of a facile condensation between 1-amino-anthraquinone with a variety of carbonyl compounds in the presence of a catalytic amount of dodeca-tungstosilicic acid/P 2O5 under solvent free conditions at room temperature. These were charachterised by1H- and 13C-NMR, LCMS, FTIR and elemental analyses. All the compounds were screened for their analgesic activity using hot plate thermal stimuli method at dose of 10 and 30 mg/kg. Diclofenac sodium was used as a reference drug. All the compounds at dose of 10 and 30 mg/kg body weight showed the significant (p<0.05) increase in latency time as compared to control (normal saline). Compound 5 showed excellent activity after 120 min of drug administration (10 mg/kg) of body weight. Compound 10 was found to be potent (10.48+-1.19s, 11.27+-1.2s and 10.24+-1.9s) at dose of 30 mg/kg at 30, 60 and 120 min, respectively when compared to the standard drug. Compound 6 (10.13+-0.4s) was also found to be an excellent analgesic compound at a dose of 30 mg/kg at 120 min. However, the studies on analgesic activity revealed that some of the target compounds may be strong candidates as an analgesic drug. (author)

Anti-inflammatory, Analgesic and Antiulcer properties of Porphyra vietnamensis

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Saurabh Bhatia

2014-12-01

Full Text Available Objectives: Aim of the present work was to investigate the anti-inflammatory, analgesic and antiulcer effects of red seaweed Porphyra vietnamensis (P. vietnamenis. Materials and Methods: Aqueous (POR and alcoholic (PE fractions were successfully isolated from P. vietnamenis. Further biological investigations were performed using a classic test of paw edema induced by carrageenan, writhing induced by acetic acid, hot plate method and naproxen induced gastro-duodenal ulcer. Results: Among the fractions POR showed better activity.  POR and PE significantly (p < 0.05 reduced carrageenan induced paw edema in a dose dependent manner. In the writhing test POR significantly (p < 0.05 reduced abdominal writhes than PE.  In hot plate method POR showed better analgesic activity than PE. POR showed comparable ulcers reducing potential (p

Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

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Leah Zallman

2012-01-01

Full Text Available Attitudinal barriers towards analgesic use among primary care patients with chronic pain and substance use disorders (SUDs are not well understood. We evaluated the prevalence of moderate to significant attitudinal barriers to analgesic use among 597 primary care patients with chronic pain and current analgesic use with 3 subscales from the Barriers Questionaire II: concern about side effects, fear of addiction, and worry about reporting pain to physicians. Concern about side effects was a greater barrier for those with opioid use disorders (OUDs and non-opioid SUDs than for those with no SUD (OR (95% CI: 2.30 (1.44–3.68, P<0.001 and 1.64 (1.02–2.65, P=0.041, resp.. Fear of addiction was a greater barrier for those with OUDs as compared to those with non-opioid SUDs (OR (95% CI: 2.12 (1.04–4.30, P=0.038 and no SUD (OR (95% CI: 2.69 (1.44–5.03, P=0.002. Conversely, participants with non-opioid SUDs reported lower levels of worry about reporting pain to physicians than those with no SUD (OR (95% CI: 0.43 (0.24–0.76, P=0.004. Participants with OUDs reported higher levels of worry about reporting pain than those with non-opioid SUDs (OR (95% CI: 1.91 (1.01–3.60, P=0.045. Concerns about side effects and fear of addiction can be barriers to analgesic use, moreso for people with SUDs and OUDs.

Phytochemical and analgesic evaluation of methanol leaf extract of ...

African Journals Online (AJOL)

Phytochemical and analgesic evaluation of methanol leaf extract of ... Thirty minutes prior to intraperitoneal injection with 2 ml of 0.1% acetic acid, animals in groups ... (acetaminophen), aspirin and indomethacin while VII received saline water.

[The Analgesic Sparing Effect of Ketamine for Postoperative Pain Management after Pediatric Surgery on the Body Surface].

Science.gov (United States)

Urabe, Tomoaki; Nakanuno, Ryuichi; Hayase, Kazuma; Sasada, Shogo; Iwamitsu, Reimi; Senami, Masaki

2016-04-01

It is reported that ketamine, a N-methyl-D-aspertate (NMDA) receptor antagonist, can provide analgesic effect improving postoperative pain management and decrease the supplementary analgesic requirement. We investigated the analgesic sparing effect of ketamine for postoperative pain in children undergoing surgery of body surface. Fifty eight patients (0-9 yrs) who had surgery of body surface were divided into two groups (ketamine : n = 27, Group K or control : n = 31, Group N). Postoperative analgesia extracted from charts was retrospectively evaluated by the times patients used analgesics until discharge after the operations. Chi-square and Mann-Whitney U tests were used for statistical analysis. Results : The ketamine group received an intrave- nous bolus of ketamine (1 mg - kg-1) before surgical skin incision. However, there were no significant differ- ences of usage (Group K vs Group N : 4/27 vs 7/31, P=0.45) and frequency of supplementary analgesic us- ages (P=0.85) among groups. In addition, there were also no significant demographic differences between the two groups. Conclusions : Our investigation suggests that the intravenous bolus of ketamine (1 mg - kg-1) before surgical skin incision does not decrease the supple- mentary analgesic requirements on postoperative pain management in pediatric surgery of the body surface.

Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010.

Science.gov (United States)

Bachhuber, Marcus A; Saloner, Brendan; Cunningham, Chinazo O; Barry, Colleen L

2014-10-01

Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. Presence of a law establishing a medical cannabis program in the state. Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, -37.5% to -9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (-19.9%; 95% CI, -30.6% to -7.7%; P = .002), year 2 (-25.2%; 95% CI, -40.6% to -5.9%; P = .01), year 3 (-23.6%; 95% CI, -41.1% to -1.0%; P = .04), year 4 (-20.2%; 95% CI, -33.6% to -4.0%; P = .02), year 5 (-33.7%; 95% CI, -50.9% to -10.4%; P = .008), and year 6 (-33.3%; 95% CI, -44.7% to

Phytochemical, Analgesic And Anti-Inflammatory Effects Of The ...

African Journals Online (AJOL)

Phytochemical screening was carried out on the ethylacetate portion of the ethanolic extract of the leaves of Pseudocedrella kotschyii and then evaluated for its analgesic (acetic acid-induced writhing) and anti-inflammatory (raw egg albumin-induced oedema) activities in mice and rats respectively. Phytochemical screening ...

Evaluation of Analgesic, Anticonvulsant and Hypnotic activities of ...

African Journals Online (AJOL)

AqPs (100-400mg/kg i.p.) also demonstrated a protective effect against strychnine-induced convulsion. The extract potentiated the hypnotic effect of hexobarbitone following i.p. injection at the dose levels studied. The results suggested that AqPs possesses potential analgesic, anticonvulsive and hypnotic properties.

Use of analgesics in young adults as a predictor of health care utilization and pain prevalence: Israel defense forces experience.

Science.gov (United States)

Dorfman, Karina; Komargodski, Olga; Magnezi, Racheli; Lifshitz, Stanislav; Tzur, Dorit; Yavnai, Nirit; Ifergane, Gal

2017-06-01

Pain evaluation in large community studies is difficult. Analgesics can be a useful tool in estimating pain-related conditions in which analgesic use is highly regulated. In this study, we evaluated analgesics consumption patterns of regular Israel Defense Force soldiers. We have performed a historical cohort study of 665,137 young adults during active duty in 2002 to 2012. Analgesics were prescribed to 518,242 (78%) soldiers, mostly for musculoskeletal pain (69.3%), abdominal pain (12.7%), and headache (12.1%). Acute (1-14 days), subacute (15-90), and chronic (>90 days) analgesic use episodes were experienced by 396,987 (59.7%), 74,591 (11.2%), and 46,664 (7%) of the population. In a multivariate model, predictors for chronic analgesics use were as follows: low intelligence, service in a combat supporting unit, previous pain diagnosis, male sex, Israeli nativity, low socioeconomic status, and high body mass index. Low intelligence had the highest odds ratio for chronic analgesic consumption (2.1) compared with other predictors. Chronic analgesic use was associated with a significant increase in health care utilization cost per year (911$ per soldier vs 199$ for nonusers), increased sick leave days per year (7.09 vs 0.67 for nonusers), and higher dropout rate from combat units (25% vs 9.2% for nonusers). Chronic use of analgesics is common among young adults, and it is an important predictor for unsuccessful military service and high health care utilization costs. Further studies in other setups are indicated.

Analgesic effects of lappaconitine in leukemia bone pain in a mouse model

Directory of Open Access Journals (Sweden)

Xiao-Cui Zhu

2015-05-01

Full Text Available Bone pain is a common and severe symptom in cancer patients. The present study employed a mouse model of leukemia bone pain by injection K562 cells into tibia of mouse to evaluate the analgesic effects of lappacontine. Our results showed that the lappaconitine treatment at day 15, 17 and 19 could effectively reduce the spontaneous pain scoring values, restore reduced degree in the inclined-plate test induced by injection of K562 cells, as well as restore paw mechanical withdrawal threshold and paw withdrawal thermal latency induced by injection of K562 cells to the normal levels. Additionally, the molecular mechanisms of lappaconitine’s analgesic effects may be related to affect the expression levels of endogenous opioid system genes (POMC, PENK and MOR, as well as apoptosis-related genes (Xiap, Smac, Bim, NF-κB and p53. Our present results indicated that lappaconitine may become a new analgesic agent for leukemia bone pain management.

N-arylmethylideneaminophthalimide: Design, synthesis and evaluation as analgesic and anti-inflammatory agents.

Science.gov (United States)

Banarouei, Nasimossadat; Davood, Asghar; Shafaroodi, Hamed; Saeedi, Ghazaleh; Shafiee, Abbas

2018-04-23

N-aryl derivatives of phthalimide and 4-nitro phthalimide have demonstrated cyclooxygenase inhibitory activity. Also they possess an excellent analgesic and anti-inflammatory activity. In this work, a new series of N-arylmethylideneamino derivatives of phthalimide and 4-nitro phthalimide were designed and synthesized. The designed compounds were synthesized by condensation of the appropriate aldehyde and N-aminophthalimide in ethanol at room temperature at PH around 3. Their analgesic and anti-inflammatory activity were evaluated by acetic acid-induced pain test and carrageenan-induced paw edema test in mice and rats, respectively. The details of the synthesis and chemical characterization of the analogs are described. In vivo screening showed compounds 3a, 3b, 3f and 3h were the most potent analgesic compounds. In addition compounds 3a, 3c, 3d, 3e and 3j indicated comparable anti-inflammatory activity to indomethacin as reference drug. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

How resistant to tampering are codeine containing analgesics on the market? Assessing the potential for opioid extraction

OpenAIRE

Kimergård, Andreas; Deluca, Paolo; Hindersson, Peter; Breindahl, Torben

2016-01-01

IntroductionMisuse of opioid analgesics, in combination with diversion, dependence, and fatal overdoses, presents a serious problem for public health, which affects many countries worldwide. Within this context, tampering with opioids has been associated with serious harm. The aim of the present study was to assess the tampering potential of codeine combination analgesics on the market (containing codeine/non-opioid analgesics) by the extraction of codeine.MethodsCodeine was extracted from th...

Analgesic synergism of gabapentin and carbamazepine in rat model ...

African Journals Online (AJOL)

Analgesic synergism of gabapentin and carbamazepine in rat model of diabetic neuropathic pain. Sinan Mohammed Abdullah AL-Mahmood, Shahrin Tarmizi Bin Che Abdullah, Nik Nur Fatnoon Nik Ahmad, Abdul Hadi Bin Mohamed, Tariq Abdul Razak ...

ANALGESIC ACTIVITY OF AQUEOUS EXTRACT OF CURCUMA AMADA (MANGO - GINGER IN MALE ALBINO WISTAR RATS

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Kumari Bai

2015-09-01

Full Text Available BACKGROUND: Mango ginger ( Curcuma amada Roxb. has morphological resemblance with ginger, but imparts mango flavour. According to Ayurveda and Unani medicinal systems , the biological activities include antioxidant, antibacterial, antifungal, anti - inflammatory, antiallergic, CNS depressant and analgesic activity. Hence curcuma amada aqueous extract for analgesic activity was evaluated in pain animal models. Pain is a most common complaint of many medical conditions, and pain control is one of t he most important therapeutic priorities. Curcuma Amada suppresses the inflammatory mediators associated with pain. However there is no scientific data suggestive of its analgesic activity. Hence this study was carried out to evaluate its role in central a nd peripheral models of pain. OBJECTIVE: To Evaluate rhizomes of Curcuma Amada for analgesic activity in male albino wistar rats . MATERIALS AND METHODS: Albino rats, the proven models for analgesic studies. They were obtained from the animal house of DR.B. R. Ambedkar Medical College. Animals were maintained as per CPCSEA guidelines . The aqueous extract of curcuma amada was used.4x2 groups of 6 Rats were used to ensure that results obtained were statistically significant using ANOVA test. Analgesic activity was assessed with the help of following screening methods . Acetic Acid Writhing Method using Acetic Acid . Tail Flick Method using the Analgesiometer . Tail Immersion Method using Hot Water (55 0 C . Hot Plate method using Hot Plate . RESULT S: Aqueous extract of curcuma amada significantly suppressed the 1% acetic acid induced writhing response in rats when compared to control group (Gum acacia. In Tail flick test and Hot plate test Curcuma Amada increases the latency period of pain (reaction time. In Tail im mersion test the test drug significantly (P < 0.001 reduces pain at 30 min when compared to control group at 60 min of oral administration. CONCLUSION : The present findings indicate that

Postoperative analgesic efficacy of intravenous dexketoprofen in lumbar disc surgery.

Science.gov (United States)

Yazar, Mehmet Akif; Inan, Nurten; Ceyhan, Aysegul; Sut, Esra; Dikmen, Bayazit

2011-07-01

We investigated the postoperative analgesic efficacy and effect on total tramadol consumption of intravenous dexketoprofen trometamol, a new nonsteroidal anti-inflammatory drug, in patients that had undergone lumbar disc surgery. Sixty patients were included in this placebo-controlled, randomized, double-blind study. General anesthesia was applied to both groups. Group D (n=30) received dexketoprofen (50 mg) intravenously 30 minutes before the end of surgery and at the postoperative 12th hour, whereas group C (n=30) received 2 mL of 0.9% NaCL intravenously at the same time points. All patients received a patient controlled analgesia device with a tramadol, 25 mg bolus, 15 minutes lockout protocol, and were followed with visual analog scale, verbal rating scale, modified Aldrete recovery scoring system, and Ramsay sedation scale in the postoperative period. There was no significant difference between the groups for demographic data, duration of surgery, mean arterial pressure, and heart rate. The time to first postoperative analgesic requirement was significantly longer in group D (151.33±81.98 min) than group C (19±5.78 min) (Pdexketoprofen was an effective analgesic for postdiscectomy pain when used alone or in addition to opioids. It is easy to administer and decreases tramadol consumption and opioid-related side effects.

Anti-inflammatory and analgesic activities of Tunisian Citrullus colocynthis Schrad. immature fruit and seed organic extracts.

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Marzouk, B; Marzouk, Z; Fenina, N; Bouraoui, A; Aouni, M

2011-06-01

Inflammations and immune-related diseases including rheumatoid arthritis are widespread in the entire globe. The treatment of these illnesses is mainly based on the use of synthetic and biotechnological drugs, in recent years. Tunisian traditional medicine is a potential source of new remedies namely Citrullus colocynthis Schrad. (Cucurbitaceae): endemic in southern Tunisia and used in folk medicine to treat many inflammation disorders. Our goal was to assess the in vivo analgesic and anti-inflammatory activities of Tunisian Citrullus colocynthis immature fruit and seed organic extracts (petroleum ether, chloroform, ethyl acetate, acetone and finely methanol extract). Yields of prepared organic extracts are gravimetrically determined. For the analgesic and anti-inflammatory activities, we have used respectively, the acetic acid writhing test in mice and the carrageenan-induced paw edema assay in rats. All extracts displayed an important analgesic and anti-inflammatory activities at different doses without inducing any side effects. This study has demonstrated the analgesic and anti-inflammatory activities of Citrullus colocynthis immature fruit and seed extracts. Experiment results provide scientific insight into the ancient practice of utilizing Citrullus colocynthis Schrad. as analgesic and as anti-inflammatory agents.

Pattern of Self Prescribed Analgesic Use in a Rural Area of Delhi: Exploring the Potential Role of Internet.

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Kochhar, Anjali; Gupta, Tanya

2017-07-01

Analgesics are the most common self prescribed drugs. Although considered to be relatively safe, side effects are often seen when these drugs are used for prolonged period, in high doses or used where contraindicated. Majority of the consumers are not aware of the side effects. These days ample amount of information is available on web, it is important to explore its role in educating the population regarding the safe use of self prescribed analgesics. To explore pattern of analgesic use, to identify population at risk of developing side effects related to analgesic use, awareness of side effects and potential role of internet to bring awareness about safe use of self prescribed analgesic drugs in a rural area of Delhi. A cross-sectional survey based study was done on 500 adults in the age group of 18-65 years of Madanpur Khadar area of South Delhi, India. Data collection was done by conducting visits to pharmacy shops from the people who were buying drugs without prescription and taking face to face interviews using a semi-structured questionnaire. Statistical analysis was performed using descriptive tests with Microsoft office excel 2007. Results of our study showed that among all the self prescribed analgesics paracetamol (57%) was used most frequently followed by aspirin and other NSAIDs. It was found that 9.6% of the consumers were having associated co-morbid illness, 11.4% were simultaneously taking other drugs and 15.2% were alcoholics. Majority (65.4%) of the buyers were not aware about any kind of side effects of the analgesics. Internet friendly consumers were found to be 44%. Ability to use internet and education level were found to be directly related (r=0.802). The pattern of analgesic consumption in the rural population of Delhi shows that a large number of consumers may be at risk of developing side effects of self prescribed analgesics. The awareness about the side effects is limited. A significant number of consumers are internet friendly. Hence

High use of over-the-counter analgesic; possible warnings of reduced quality of life in adolescents - a qualitative study.

Science.gov (United States)

Skarstein, Siv; Lagerløv, Per; Kvarme, Lisbeth Gravdal; Helseth, Sølvi

2016-01-01

Use of over-the-counter analgesics among adolescents has increased markedly. High consumption of over-the-counter analgesics among adolescents is associated with frequent pain, lower self-esteem, reduced sleep, lower educational ambition, binge drinking, higher caffeine consumption, and part-time employment. Knowledge about life experiences of adolescents who frequently use over-the-counter analgesics may be useful to prevent health problems. The purpose of the study was to increase knowledge about adolescents who suffer from frequent pain and have a high consumption of over-the-counter analgesics. A qualitative study, employing one-on-one, in-depth interviews using a thematic interview guide. Data were collected in Norway in 2013-2014. Three boys and sixteen girls; aged 14-16 years, who continuously consumed over-the-counter analgesics were recruited from ten high schools in urban and suburban districts. Candidate participants were excluded if they were medically diagnosed with an acute or chronic illness, requiring extended use of over-the-counter analgesics within the last year. The interviews were taped, transcribed and analysed as text according to Kvale's three contexts of interpretation: self-understanding, common sense and theory. All participants disclosed unresolved physical and psychosocial distress characterized as pain. Frequent pain from various body parts made everyday life challenging. Methods of pain self-appraisal and over-the-counter analgesics use often mimicked maternal patterns. Participants reported being raised under unpredictable circumstances that contributed to long lasting family conflicts and peer-group problems. Participants wanted to feel appreciated and to be socially and academically successful. However, pain reduced their ability to manage everyday life, hampered experienced possibilities for success, and made social settings difficult. Childhood experiences influence how adolescents experience pain and use over

Analgesic compounds from Scorzonera latifolia (Fisch. and Mey.) DC

Czech Academy of Sciences Publication Activity Database

Bahadir, Ö.; Citoglu, G. S.; Šmejkal, K.; Dall Acqua, S.; Özbek, H.; Cvačka, Josef; Žemlička, M.

2010-01-01

Roč. 131, č. 1 (2010), s. 83-87 ISSN 0378-8741 Institutional research plan: CEZ:AV0Z40550506 Keywords : Scorzonera latifolia * analgesic activity * triterpenes Subject RIV: CC - Organic Chemistry Impact factor: 2.466, year: 2010

The analgesic effect of diclofenac sodium administered via the ...

African Journals Online (AJOL)

2016-02-08

Feb 8, 2016 ... to food and water, feeding, temperature, environment, diurnal, and nocturnal .... to detect the potency of substances that have analgesic potential.[10,11] In this ... Figure 8: Leakage control with Hamilton's syringe. Figure 9: ...

Analgesic effects of Marasmius androsaceus mycelia ethanol extract and possible mechanisms in mice

Directory of Open Access Journals (Sweden)

Jia Song

2018-03-01

Full Text Available Marasmius androsaceus is a medicinal fungus mainly used to treat various forms of pain in China. This study investigated the analgesic effects of an ethanol extract of M. androsaceus (MAE and its potential molecular mechanisms. Oral administration of MAE (50, 200, and 1000 mg/kg had significant analgesic effects in an acid-induced writhing test, a formalin test, and a hot-plate test, with effectiveness similar to tramadol (the positive control drug. The autonomic activity test showed that MAE had no harmful effects on the central nervous system in mice. MAE resulted in significantly enhanced levels of noradrenalin and 5-hydroxytryptamine in serum but suppressed both of these neurotransmitters in the hypothalamus after 30 s of hot-plate stimulation. Co-administration with nimodipine (10 mg/kg; a Ca2+ channel blocker strongly enhanced the analgesic effect in the hot-plate test compared to MAE alone. Moreover, MAE down-regulated the expression of calmodulin-dependent protein kinase II (CaMKII in the hypothalamus after a 30-s thermal stimulus. These results suggested that the analgesic ability of MAE is related to the regulation of metabolism by monoamine neurotransmitters and Ca2+/CaMKII-mediated signaling, which can potentially aid the development of peripheral neuropathic pain treatments obtained from M. androsaceus.

Stress and use of over-the-counter analgesics

DEFF Research Database (Denmark)

Koushede, Vibeke Jenny; Ekholm, Ola; Holstein, Bjørn E

2011-01-01

To examine the prevalence of over-the-counter analgesic (OTCA) use and perceived stress among 25 to 44-year-old men and women from 1994 to 2005; to examine the association between stress and OTCA use over time, and to explore whether the association attenuates when controlled by stress...

The analgesic, haematological and some physiological effects of ...

African Journals Online (AJOL)

The aim of this research is to investigate the analgesic, haematologic and some physiological effects of extradural bupivacaine on dogs using six clinically healthy adult male dogs. The method used is by obtaining baseline data for physiological variables from each dogs using the multiparameter patient monitors (GD3, ...

Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Bachhuber, Marcus A; Nash, Denis; Southern, William N; Heo, Moonseong; Berger, Matthew; Schepis, Mark; Cunningham, Chinazo O

2018-04-20

As opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing. This study is a prospective cluster randomised controlled trial with two parallel arms. Primary care sites (n=32) and emergency departments (n=4) will be randomised in matched pairs to either a modification of the EHR so that new opioid analgesic prescriptions default to a dispense quantity of 10 tablets (intervention) or to no EHR change (control). The dispense quantity will remain fully modifiable by providers in both arms. From 6 months preintervention to 18 months postintervention, patient-level data will be analysed (ie, the patient is the unit of inference). Patient eligibility criteria are: (A) received a new opioid analgesic prescription, defined as no other opioid analgesic prescription in the prior 6 months; (B) age ≥18 years; and (C) no cancer diagnosis within 1 year prior to the new opioid analgesic prescription. The primary outcome will be the quantity of opioid analgesics prescribed in the initial prescription. Secondary outcomes will include opioid analgesic reorders and health service utilisation within 30 days after the initial prescription. Outcomes will be compared between study arms using a difference-in-differences analysis. This study has been approved by the Montefiore Medical Center/Albert Einstein College of Medicine Institutional Review Board with a waiver of informed consent (2016-6036) and is registered on ClinicalTrials.gov (NCT03003832, 6 December 2016). Findings will be disseminated through publication, conferences and meetings

The Use of Analgesic and Other Pain-Relief Drugs to Manage Chronic Low Back Pain: Results from a National Survey.

Science.gov (United States)

Gouveia, Nélia; Rodrigues, Ana; Ramiro, Sofia; Eusébio, Mónica; Machado, Pedro M; Canhão, Helena; Branco, Jaime C

2017-03-01

To analyze and characterize the intake profile of pain-relief drugs in a population-based study of adults with chronic low back pain (CLBP). EpiReumaPt was a cross-sectional Portuguese population-based study (10,661 subjects). Self-reported active CLBP was considered to be low back pain on the day of enrollment and for ≥ 90 days. Prevalence and profile of analgesic intake was characterized among those self-reporting active CLBP, taking into account the intensity of pain and the World Health Organization (WHO) analgesic ladder. We further investigated whether the presence of active CLBP was a factor independently associated with the intake of analgesics (adjusted for potential confounders). Among 1,487 subjects with active CLBP, only 18.7% were using analgesic/pain-relief drugs. Estimated prevalence was anxiolytics, 14.1%; nonsteroidal anti-inflammatory drugs (NSAIDs), 12.3%; antidepressants, 10.1%; analgesic, antipyretics, 6.6%; anticonvulsants, 3.4%; central muscle relaxants, 2.6%; and analgesic opioids, 1.6%. Most subjects with severe pain were in the first step of the WHO analgesic ladder: NSAIDs plus anxiolytics (4.6%), NSAIDs plus antidepressants (3.2%), or NSAIDs plus muscle relaxants (2.5%). The presence of active CLBP was significantly associated with the intake of all therapeutic groups: antidepressants (odds ratio [OR] = 12.56; P pain-relief drug intake in patients with active CLBP was very low, even for those with severe pain. The WHO analgesic ladder was carefully followed, with an extremely conservative use of analgesic opioids even for those with severe pain. © 2016 World Institute of Pain.

Use of common analgesic medications and ovarian cancer survival

DEFF Research Database (Denmark)

Dixon, Suzanne C; Nagle, Christina M; Wentzensen, Nicolas

2017-01-01

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with improved survival in some cancers, but evidence for ovarian cancer is limited. METHODS: Pooling individual-level data from 12 Ovarian Cancer Association Consortium studies, we evaluated the association between self......-reported, pre-diagnosis use of common analgesics and overall/progression-free/disease-specific survival among 7694 women with invasive epithelial ovarian cancer (4273 deaths). RESULTS: Regular analgesic use (at least once per week) was not associated with overall survival (pooled hazard ratios, pHRs (95......% confidence intervals): aspirin 0.96 (0.88-1.04); non-aspirin NSAIDs 0.97 (0.89-1.05); acetaminophen 1.01 (0.93-1.10)), nor with progression-free/disease-specific survival. There was however a survival advantage for users of any NSAIDs in studies clearly defining non-use as less than once per week (pHR=0...

Hair analysis to monitor abuse of analgesic combinations containing butalbital and propyphenazone.

Science.gov (United States)

Ferrari, Anna; Tiraferri, Ilaria; Palazzoli, Federica; Verri, Patrizia; Vandelli, Daniele; Marchesi, Filippo; Ciccarese, Michela; Licata, Manuela

2015-11-10

Butalbital, a barbiturate, is present in analgesic combinations used by headache sufferers. Overuse/abuse of these combinations may cause dependence, chronic migraine, and medication-overuse headache (MOH). MOH is difficult to manage: it improves interrupting analgesic overuse, but requires monitoring, because relapses are frequent. A gas chromatography-mass spectrometry (GC-MS) method for hair analysis has been developed and validated to document abuse of an analgesic combination containing butalbital and propyphenazone by a patient with MOH. For over ten years the patient managed her headache using eight suppositories/day of an analgesic combination containing butalbital 150mg, caffeine 75mg, and propyphenazone 375mg per suppository. An outpatient detoxification treatment was carried out. After three weeks, the patient reduced the consumption to one suppository/day. At the first control visit, after three months from the beginning of detoxification, the patient increased the use of the combination to four suppositories/day and at the second control visit, after seven months from the beginning of detoxification, she was back to eight suppositories/day. At the two control visits, a hair sample was taken for determination of butalbital and propyphenazone. Moreover blood and urine samples for determination of butalbital were drawn at the beginning of detoxification treatment and at the two control visits. With the segmental analysis of two hair samples the medication history of ten months could be estimated. In the first hair sample, collected at the first control visit, in the distal segment, butalbital and propyphenazone concentrations were, respectively, 17.5ng/mg and 56.0ng/mg, confirming the prolonged abuse; in the proximal segment, concurrently with the detoxification treatment, butalbital and propyphenazone concentrations had reduced respectively to 5.45ng/mg and 11.1ng/mg. The second hair sample, collected at the second control visit, proved the fair course

Analgesic and Anti-Inflammatory Activities of the Methanol Extract from Pogostemon cablin

Directory of Open Access Journals (Sweden)

Tsung-Chun Lu

2011-01-01

Full Text Available Pogostemon cablin (PC is a herbal medicine traditionally applied to treat not only common cold, nausea and diarrhea but also headache and fever. The aim of this study was to investigate the analgesic and anti-inflammatory properties of standardized PC methanol extract (PCMeOH in vivo. Investigations were performed in mice with two analgesic models. One was acetic acid-induced writhing response and the other formalin-induced paw licking. The anti-inflammatory effect was tested by λ-carrageenan (Carr-induced mice paw edema. These analgesic experimental results indicated that PCMeOH (1.0 g/kg decreased the acetic acid-induced writhing responses and PCMeOH (0.5 and 1.0 g/kg decreased the licking time in the second phase of the formalin test. Moreover, Carr-induced paw edema inflammation was significantly reduced in a dose-dependent manner when PCMeOH (0.5 and 1.0 g/kg was administered 3 and 4 h after the Carr injection. Mechanistic studies showed that PCMeOH decreased the levels of malondialdehyde in the edema paw by increasing the activities of anti-oxidant enzymes, such as superoxide dismutase, glutathione peroxidase and glutathione reductase, in the liver and decreasing the cyclooxygenase 2 and tumor necrosis factor-α activities in the edema paw. This study has demonstrated the analgesic and anti-inflammatory effects of PCMeOH, thus verifying its popular use in traditional medicine.

Anti-inflammatory and analgesic activities of leaf extracts of ...

African Journals Online (AJOL)

The aqueous, methanol and chloroform extracts of Landolphia owariensis ... rats and the nociception induced by Tail immersion in hot water (50.0 ± 1.00C) and ... (acetic acid) MELO produced the highest and comparable analgesic activity to ...

Impulsivity but not sensation seeking is associated with opioid analgesic misuse risk in patients with chronic pain.

Science.gov (United States)

Marino, Elise N; Rosen, Kristen D; Gutierrez, Antonio; Eckmann, Maxim; Ramamurthy, Somayaji; Potter, Jennifer Sharpe

2013-05-01

Impulsivity and sensation seeking have been associated with substance use disorders, including opioid use disorders. This pilot study sought to examine whether impulsivity and sensation seeking, as measured by the Barratt Impulsiveness Scale (BIS) and Sensation Seeking Scale (SSS), were associated with opioid analgesic misuse risk in chronic, low-back pain patients prescribed opioid analgesics. Participants were 42 chronic, low-back pain patients enrolled in a larger study examining problematic opioid analgesic use. Impulsivity was assessed using the BIS, sensation seeking was measured using the SSS, and opioid analgesic misuse risk was assessed using the Current Opioid Misuse Measure (COMM). Significant bivariate associations were found between the COMM and the following predictor variables: age and the three BIS subscales: Attentional Impulsiveness, Non-planning Impulsiveness, and Motor Impulsiveness. Using a multivariate linear regression, after controlling for age, the BIS subscales accounted for 29.0% of the variance in the COMM. Attentional Impulsiveness was the only significant BIS subscale. These results suggest a potential relationship between impulsivity, but not sensation seeking, and risk for opioid analgesic misuse. Impulsivity is not a prominent trait observed in chronic pain patients; however, it may be an important risk factor for opioid analgesic misuse for a subset of individuals with chronic pain. As such, these findings suggest that additional exploration of this potential risk factor is warranted. Published by Elsevier Ltd.

Cannabis Use is Associated with Lower Odds of Prescription Opioid Analgesic Use Among HIV-Infected Individuals with Chronic Pain.

Science.gov (United States)

Sohler, Nancy L; Starrels, Joanna L; Khalid, Laila; Bachhuber, Marcus A; Arnsten, Julia H; Nahvi, Shadi; Jost, John; Cunningham, Chinazo O

2018-01-17

Chronic pain is common in the United States and prescribed opioid analgesics use for noncancer pain has increased dramatically in the past two decades, possibly accounting for the current opioid addiction epidemic. Co-morbid drug use in those prescribed opioid analgesics is common, but there are few data on polysubstance use patterns. We explored patterns of use of cigarette, alcohol, and illicit drugs in HIV-infected people with chronic pain who were prescribed opioid analgesics. We conducted a secondary data analysis of screening interviews conducted as part of a parent randomized trial of financial incentives to improve HIV outcomes among drug users. In a convenience sample of people with HIV and chronic pain, we collected self-report data on demographic characteristics; pain; patterns of opioid analgesic use (both prescribed and illicit); cigarette, alcohol, and illicit drug use (including cannabis, heroin, and cocaine) within the past 30 days; and current treatment for drug use and HIV. Almost half of the sample of people with HIV and chronic pain reported current prescribed opioid analgesic use (N = 372, 47.1%). Illicit drug use was common (N = 505, 63.9%), and cannabis was the most commonly used illicit substance (N = 311, 39.4%). In multivariate analyses, only cannabis use was significantly associated with lower odds of prescribed opioid analgesic use (adjusted odds ratio = 0.57; 95% confidence interval: 0.38-0.87). Conclusions/Importance: Our data suggest that new medical cannabis legislation might reduce the need for opioid analgesics for pain management, which could help to address adverse events associated with opioid analgesic use.

Clinical Analysis of Analgesics and Steroids Use for Extraction of Teeth in Patients with Intellectual Disability Under General Anesthesia.

Science.gov (United States)

Maeda, Shigeru; Honda, Yuka; Tanimura, Hiroshi; Tomoyasu, Yumiko; Higuchi, Hitoshi; Murata, Naomichi; Egusa, Masahiko; Miyawaki, Takuya

2017-01-01

The extraction of lower wisdom teeth is often performed under general anesthesia in patients with intellectual disabilities. However, the choice of analgesics has not yet been investigated. To analyze the use of analgesics during general anesthesia for extraction including lower wisdom teeth in patients with intellectual disabilities. This research is a retrospective observational study. The study population was composed of all patients presenting for extraction of lower wisdom teeth under ambulatory general anesthesia in the clinic of Special Needs Dentistry in Okayama University Hospital from April 2011 to March 2016. The distribution of the combination of analgesics and the relationship between the use of analgesics and the type of extraction were investigated. One hundred and twelve cases were enrolled in this study. Intravenous injections of flurbiprofen, acetaminophen and betamethasone were used in 96 (85.7%), 12 (10.7%) and 26 cases (23.2%), respectively. Flurbiprofen is a non-steroid anti-inflammatory drugs (NSAIDs). Acetaminophen is an old analgesic, but an injection of acetaminophen is new, which was released in 2013 in Japan. And betamethasone is not an analgesic, but a steroid. Betamethasone was used in combination with other analgesics, and was used at a higher dose in a case in which four wisdom teeth were extracted. Flurbiprofen was the main analgesic used for extraction of wisdom teeth under general anesthesia in patients with intellectual disabilities. Betamethasone was used to support flurbiprofen or acetaminophen for extractions of multiple wisdom teeth, with the aim of controlling swelling rather than relieving pain.

The anti-inflammatory and analgesic properties of prosopis chilenses in rats.

Science.gov (United States)

Abodola, M A; Lutfi, M F; Bakhiet, A O; Mohamed, A H

2015-07-01

Prosopis chilensis is used locally in Sudan for inflammatory conditions of joints; however, literature lacks scientific evidence for anti-inflammatory effect of this plant. To evaluate anti-inflammatory and analgesic effects of prosopis chilenses. Edema inhibition percent (EI %) and hot plate method were used to evaluate anti-inflammatory and analgesic effects of Prosopis chilenses in Wistar albino rats. Anti-inflammatory and analgesic effects of Prosopis chilenses were compared to indomethacin and acetylsalicylic acid respectively. Ethanolic extract of prosopis chilensis at a dose of 200 and 100mg/kg body weight achieved peak EI% (EI% = 96.1%) and (EI% = 94.4%) three and four hours after oral dosing respectively. The maximum EI% for indomethacin was 97.0% and was recorded after 4 hours following oral administration of the drug at a dose of 5 mg/kg body weight. Prosopis chilensis extracts at doses of 100 and 200 mg/kg body weight significantly increased the rats' response time to hot plate compared to acetylsalicylic acid at a dose rate of 100mg/kg body weight (Pprosopis chilenses. Relevance of these effects to prosopis chilenses phy-to-constituents was discussed.

Analgesic effect of butorphanol and levomethadone in detomidine sedated horses.

Science.gov (United States)

Schatzman, U; Armbruster, S; Stucki, F; Busato, A; Kohler, I

2001-08-01

The analgesic potency of butorphanol 25 microg/kg bodyweight (BW) and levomethadone 100 microg/kg BW, administered together with detomidine 10 microg/kg BW, was measured in twelve Warmblood horses in a randomized, blinded cross-over study. Detomidine with saline 10 ml 0.9% was used as placebo. The nociceptive threshold was determined using a constant current and a pneumatic pressure model for somatic pair Detomidine alone and in combination with butorphanol or levomethadone caused a significant temporary increase (P detomidine alone to both test methods. No significant difference between butorphanol and levomethadone was registered. It is concluded that the addition of butorphanol or levomethadone to detomidine increases the nociceptive threshold to somatic pain and prolongs the analgesic effect of detomidine in the horse.

PolyMorphine provides extended analgesic-like effects in mice with spared nerve injury

OpenAIRE

Lax, Neil C; Chen, Renxun; Leep, Sarah R; Uhrich, Kathryn E; Yu, Lei; Kolber, Benedict J

2017-01-01

Morphine is a well-characterized and effective analgesic commonly used to provide pain relief to patients suffering from both acute and chronic pain conditions. Despite its widespread use and effectiveness, one of the major drawbacks of morphine is its relatively short half-life of approximately 4 h. This short half-life often necessitates multiple administrations of the drug each day, which may contribute to both dependence and tolerance to morphine. Here, we tested the analgesic properties ...

Analgesic effects of oligonol, acupuncture and quantum light therapy on chronic nonbacterial prostatitis.

Science.gov (United States)

Akdere, Hakan; Oztekin, Ilhan; Arda, Ersan; Aktoz, Tevfik; Turan, Fatma Nesrin; Burgazli, Kamil Mehmet

2015-04-01

Chronic Nonbacterial Prostatitis (CNBP) is a condition that frequently causes long-term pain and a significant decrease in the quality of life. The present study aimed to examine the analgesic effects of oligonol, acupuncture, quantum light therapy and their combinations on estrogen-induced CNBP in rats. This experimental study was conducted in Edirne, Turkey, using a simple randomized allocation. A total of 90 adult male Wistar rats were randomized into 9 groups of 10 rats each: Group I, control; Group II, CNBP, Group III, oligonol only, Group IV, acupuncture only; Group V, quantum only; Group VI, oligonol + quantum; Group VII, acupuncture + oligonol; Group VIII, quantum + acupuncture; Group IX, acupuncture + quantum + oligonol. Oligonol treatment was given at a dose of 60 mg/day for 6 weeks. Conceptual vessels (CV) 3 and 4, and bilaterally urinary bladder (Bl) 32 and 34 points were targeted with 1-hour acupuncture stimulation. The quantum light therapy was applied in 5-minute sessions for 6 weeks (3-times/a week). For pain measurements, mechanical pressure was applied to a point 2 cm distal to the root of the tail to elicit pain and consequent parameters (peak force, latency time of response and total length of measurement) were assessed. Analgesic effects were observed with all treatment regimens; however, the most prominent median analgesic effect was shown in the quantum light therapy in combination with acupuncture for estrogen-induced CNBP (PF1 = 663.9, PF2 = 403.4) (P = 0.012). Furthermore, we observed that monotherapy with quantum light showed a better analgesic efficacy as compared to oligonol and acupuncture monotherapies (PF1 = 1044.6, PF2 = 661.2) (P = 0.018, P = 0.008, P = 0.018; respectively). All treatment modalities showed a significant analgesic effect on CNBP in rats, being most prominent with the quantum light therapy.

Comparative Rates of Mortality and Serious Adverse Effects Among Commonly Prescribed Opioid Analgesics.

Science.gov (United States)

Murphy, David L; Lebin, Jacob A; Severtson, Stevan G; Olsen, Heather A; Dasgupta, Nabarun; Dart, Richard C

2018-03-26

The epidemic of prescription opioid overdose and mortality parallels the dispensing rates of prescription opioids, and the availability of increasingly potent opioid analgesics. The common assumption that more potent opioid analgesics are associated with higher rates of adverse outcomes has not been adequately substantiated. We compared the rate of serious adverse events among commonly prescribed opioid analgesics of varying potency. Serious adverse events (SAEs; defined as death, major medical effect, or hospitalization) resulting from exposure to tablets containing seven opioid analgesics (oxycodone, hydrocodone, morphine, hydromorphone, oxymorphone, tapentadol, and tramadol) captured by the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS ® ) System Poison Center Program were evaluated from 2010 through 2016. Rates of SAEs were adjusted for availability through outpatient dispensing data and regressed on morphine milligram equivalents (MME). There were 19,480 cases of SAE during the 7-year study period. Hydrocodone and oxycodone contributed to 77% of SAE cases. Comparing rates of outcome by relative potency, a hierarchy was observed with hydromorphone (8.02 SAEs/100 kg) and tapentadol (0.27 SAE/100 kg) as the highest and lowest rates, reflecting a 30-fold difference among individual opioid products. SAE rate and potency were related linearly-SAEs increased 2.04 per 100 kg drug dispensed for each 1-unit rise in MME (p = 0.004). Linear regression of SAE/100 kg drug dispensed and drug potency identified that MME comprised 96% of the variation observed. In contrast, potency did not explain variation seen using other study denominators (prescriptions dispensed, dosage units dispensed, and the number of individuals filling a prescription). Potency of a prescription opioid analgesic demonstrates a significant, highly positive linear relationship with exposures resulting in SAEs per 100 kg drug dispensed reported to poison centers

Do analgesics improve functioning in patients with chronic low back pain? An explorative triple-blinded RCT

NARCIS (Netherlands)

Schiphorst Preuper, Henrica; Geertzen, Jan. H. B.; van Wijhe, Marten; Boonstra, Anne M.; Molmans, Barbara H. W.; Dijkstra, Pieter U.; Reneman, Michiel F.

Treatment of patients with chronic low back pain (CLBP) aims to reduce disability, improve functional capacity, and participation. Time contingent prescription of analgesics is a treatment modality in CLBP. The impact of analgesics on functional capacity is unknown. Aim of the study was to explore

Phytochemical, analgesic and anti-inflammatory studies of the ...

African Journals Online (AJOL)

Results: The preliminary phytochemical screening of the methanol leaf extract revealed the presence of terpenes, flavonoids, tannins, saponins and ... The analgesic studies were carried out at doses of 75, 150 and 300 mg/kg body weight i.p. using acetic acid-induced writhing and thermally-induced pain in mice. The extract ...

Comparative Chemical And Analgesic Properties Of Essential Oils ...

African Journals Online (AJOL)

The chemical and analgesic comparison of essential oils of Cymbopogon nardus (L) Rendle of Benin and Congo was investigated. The Chemical analysis wa carried out by using GS/MS for identification of components of the two essential oils while acetic acid-induced writhings, hot plate and tail flick test models were used ...

Anti-inflammatory and Analgesic Activities of Amorphophallus bulbifer

African Journals Online (AJOL)

Purpose: To investigate the anti-inflammatory and analgesic activities of the Amorphophallus Bulbifer in Wistar rats and mice. Methods: The anti-inflammatory activity of the hydroalcohol extract of A. bulbifer whole plant at dose levels of 100 and 200 mg/kg p.o. in rats was determined with a plethysmograph paw volume ...

Evaluation of analgesic and anti-inflammatory effects of ethanol extract of Ficus iteophylla leaves in rodents.

Science.gov (United States)

Abdulmalik, I A; Sule, M I; Musa, A M; Yaro, A H; Abdullahi, M I; Abdulkadir, M F; Yusuf, H

2011-01-01

This study was undertaken to investigate the leaf part of the plant for analgesic and anti-inflammatory. The ethanol extract of Ficus iteophylla leaves (100, 200, and 400 mg kg(-1), i.p) was evaluated for analgesic and anti-inflammatory activities. The analgesic effect was studied using acetic acid-induced abdominal constriction and hot plate test in mice, while the anti-inflammatory effect was investigated using carrageenan induced paw oedema in rats. The ethanol extract at 100 mg kg(-1), 200 mg kg(-1), and 400 mg kg(-1) significantly (Pacetic acid induced writhes by 1.50 ± 0.43, 3.0 ± 0.82 and 1.0 ± 0.82 respectively. It also exhibited significantly (Pscreening of the plant extract revealed the presence of flavonoids, steroids, tannins and saponins while the effect of flavonoids, steroids and tannins on analgesic and inflammatory has been reported. The intraperitoneal median lethal dose (LD(50)) value of the extract was found to be 3807.8 mgkg(-1) body weights. The result obtained from this study shows that the extract of Ficus iteophylla contained phytochemical constituents with analgesic and anti-inflammatory activities, therefore the leaf part of the plant could be used in the management of pain and inflammatory conditions.

Descriptive study of perioperative analgesic medications associated with general anesthesia for dental rehabilitation of children.

Science.gov (United States)

Carter, Laura; Wilson, Stephen; Tumer, Erwin G

2010-01-01

The purpose of this retrospective chart review was to document sedation and analgesic medications administered preoperotively, intraoperatively, and during postanesthesia care for children undergoing dental rehabilitation using general anesthesia (GA). Patient gender, age, procedure type performed, and ASA status were recorded from the medical charts of children undergoing GA for dental rehabilitation. The sedative and analgesic drugs administered pre-, intra-, and postoperatively were recorded. Statistical analysis included descriptive statistics and cross-tabulation. A sample of 115 patients with a mean age of 64 (+/-30) months was studied; 47% were females, and 71% were healthy. Over 80% of the patients were administered medications primarily during pre- and intraoperative phases, with fewer than 25% receiving medications postoperatively. Morphine and fentanyl were the most frequently administered agents intraoperatively. The procedure type, gender, and health status were not statistically associated with the number of agents administered. Younger patients, however, were statistically more likely to receive additional analgesic medications. Our study suggests that a minority of patients have postoperative discomfort in the postanesthesia care unit; mild to moderate analgesics were administered during intraoperative phases of dental rehabilitation.

Use of analgesic and sedative drugs in the NICU: integrating clinical trials and laboratory data.

Science.gov (United States)

Durrmeyer, Xavier; Vutskits, Laszlo; Anand, Kanwaljeet J S; Rimensberger, Peter C

2010-02-01

Recent advances in neonatal intensive care include and are partly attributable to growing attention for comfort and pain control in the term and preterm infant requiring intensive care.Limitation of painful procedures is certainly possible, but most critically ill infants require unavoidable painful or stressful procedures such as intubation, mechanical ventilation, or catheterization.Many analgesics (opioids and nonsteroidal anti-inflammatory drugs)and sedatives (benzodiazepines and other anesthetic agents) are available but their use varies considerably among units. This review summarizes current experimental knowledge on the effects of sedative and analgesic drugs on brain development and reviews clinical evidence that speaks for or against the use of common analgesic and sedative drugs in the NICU but avoids any discussion of anesthesia during surgery. Risk/benefit ratios of intermittent boluses or continuous infusions for the commonly used sedative and analgesic agents are discussed in the light of clinical and experimental studies. The limitations of extrapolating experimental results from animals to humans must be considered while making practical recommendations based on the currently available evidence.

Preemptive analgesic effects of midazolam and diclofenac in rat model

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Antigona Hasani

2011-05-01

Full Text Available The aim of the present study was to investigate the preemptive analgesic effects of intraperitoneally administrated midazolam and diclofenac, before acute and inflammatory induced pain in rat model.One hundred twenty-eight (n=8 in each group male Sprague Dawley rats were included in the study. Paw movements in response to thermal stimulation or paw flinching in response to formalin injection were compared after midazolam (0.1, 1, 5 and 10 mg/kg and diclofenac (10 mg/kg, intraperitoneal administration. Saline was used as a control.Preemptive analgesic effect was significant in both tests when diclofenac and midazolam was administrated before the pain stimuli (p<0.01 and p<0.001. Intraperitoneal injection of midazolam in doses 5 and 10 mg/kg, increase the response time in hot plate test and decrease the number of flinches in formalin test (p<0.01 vs. p<0.001. ED50 of midazolam (with diclofenac in hot plate test was 2.02 mg/kg (CI95% =-3.47-5.03 mg; and, 0.9 mg/kg (CI95% =-0.87-4.09 mg in phase I and 0.7 mg/kg (CI95% = 0.48-6.63 mg in phase II, in formalin test.Intraperitoneally administered midazolam and diclofenac had preemptive analgesic effects on acute thermal, and inflammatory induced pain in rats.

Screening of Ficus religiosa leaves fractions for analgesic and anti-inflammatory activities.

Science.gov (United States)

Gulecha, Vishal; Sivakumar, T; Upaganlawar, Aman; Mahajan, Manoj; Upasani, Chandrashekhar

2011-11-01

To evaluate the different fractions of dried leaves of Ficus religiosa Linn for analgesic and anti-inflammatory activity using different models of pain and inflammation The analgesic activity of F. religiosa carried out using acetic acid-induced writhing in mice and tail flick test in rats. The anti-inflammatory activity was evaluated using carrageenan-induced rat paw edema and cotton pellet-granuloma formation in rats. Five different fractions (FRI, FRII, FRIII, FRIV and FRV) of F. religiosa at the dose level of 20 and 40 mg/kg, p.o were tested. The fraction FRI (40 mg/kg, p.o.) and FRIII (40 mg/kg, p.o) were found to be more effective (Pacetic acid induced writhing compared to the other fractions. FRI (20 mg/kg, p.o.) and FRIII (20 mg/kg, p.o.) were also found to be more effective in increasing latency period in tail flick method. Out of five different fractions of F. religiosa leaves tested, FRI and FRIII possess potent analgesic and anti-inflammatory activities against different models of inflammation and pain.

Antisecretory and analgesic activities of Terminalia bellerica | Khan ...

African Journals Online (AJOL)

This study describes the antisecretory and analgesic activities of the crude extract of Terminalia bellerica (Tb.Cr). T. bellerica extract inhibited the castor oil-induced intestinal fluid secretion in mice at the dose range of 300 - 1000 mg/kg. The extract also dose-dependently (50 - 100 mg/kg) reduced the numbers of acetic ...

Evaluation of analgesic and anti-inflammatory activities of ...

African Journals Online (AJOL)

Background: Bovine mastitis is one of the most relevant and problematic diseases to treat and control in practice. Puxing Yinyang San (PYS) is a compound of herbs to treat bovine mastitis in China. This study was performed to evaluate the analgesic and anti-inflammatory activities of PYS in mice and rats. Materials and ...

Sedative and Analgesic Drugs Online: A Content Analysis of the Supply and Demand Information Available in Thailand.

Science.gov (United States)

Pinyopornpanish, Kanokporn; Jiraporncharoen, Wichuda; Thaikla, Kanittha; Yoonut, Kulyapa; Angkurawaranon, Chaisiri

2018-03-21

Evidence from other countries has suggested that many controlled drugs are also offered online, even though it is illegal to sell these drugs without a license. To evaluate the current contents related to the supply and demand of sedatives and analgesic drugs available online in Thailand, with a particular focus on Facebook. A team of reviewers manually searched for data by entering keywords related to analgesic drugs and sedatives. The contents of the website were screened for supply and demand-related information. A total of 5,352 websites were found publicly available. The number of websites and Facebook pages containing the information potentially related to the supply and demand of analgesic drugs and sedatives was limited. Nine websites sold sedatives, and six websites sold analgesics directly. Fourteen Facebook pages were found, including 7 sedative pages and 7 analgesic pages. Within one year, the three remaining active pages multiplied in the number of followers by three- to nine-fold. The most popular Facebook page had over 2,900 followers. Both the internet and social media contain sites and pages where sedatives and analgesics are illegally advertised. These websites are searchable through common search engines. Although the number of websites is limited, the number of followers on these Facebook pages does suggest a growing number of people who are interested in such pages. Our study emphasized the importance of monitoring and developing potential plans relative to the online marketing of prescription drugs in Thailand.

Local analgesic effect of tramadol is not mediated by opioid receptors in early postoperative pain in rats

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Angela Maria Sousa

2015-06-01

Full Text Available BACKGROUND AND OBJECTIVES: Tramadol is known as a central acting analgesic drug, used for the treatment of moderate to severe pain. Local analgesic effect has been demonstrated, in part due to local anesthetic-like effect, but other mechanisms remain unclear. The role of peripheral opioid receptors in the local analgesic effect is not known. In this study, we examined role of peripheral opioid receptors in the local analgesic effect of tramadol in the plantar incision model. METHODS: Young male Wistar rats were divided into seven groups: control, intraplantar tramadol, intravenous tramadol, intravenous naloxone-intraplantar tramadol, intraplantar naloxone-intraplantar tramadol, intravenous naloxone-intravenous tramadol, and intravenous naloxone. After receiving the assigned drugs (tramadol 5 mg, naloxone 200 µg or 0.9% NaCl, rats were submitted to plantar incision, and withdrawal thresholds after mechanical stimuli with von Frey filaments were assessed at baseline, 10, 15, 30, 45 and 60 min after incision. RESULTS: Plantar incision led to marked mechanical hyperalgesia during the whole period of observation in the control group, no mechanical hyperalgesia were observed in intraplantar tramadol group, intraplantar naloxone-intraplantar tramadol group and intravenous naloxone-intraplantar tramadol. In the intravenous tramadol group a late increase in withdrawal thresholds (after 45 min was observed, the intravenous naloxone-intravenous tramadol group and intravenous naloxone remained hyperalgesic during the whole period. CONCLUSIONS: Tramadol presented an early local analgesic effect decreasing mechanical hyperalgesia induced by plantar incision. This analgesic effect was not mediated by peripheral opioid receptors.

Intrauterine exposure to mild analgesics is a risk factor for development of male reproductive disorders in human and rat

DEFF Research Database (Denmark)

Kristensen, David Møbjerg; Hass, Ulla; Lesné, Laurianne

2011-01-01

; BACKGROUND: More than half of pregnant women in the Western world report intake of mild analgesics, and some of these drugs have been associated with anti-androgenic effects in animal experiments. Intrauterine exposure to anti-androgens is suspected to contribute to the recent increase in male ...... results suggest that intrauterine exposure to mild analgesics is a risk factor for development of male reproductive disorders.......; BACKGROUND: More than half of pregnant women in the Western world report intake of mild analgesics, and some of these drugs have been associated with anti-androgenic effects in animal experiments. Intrauterine exposure to anti-androgens is suspected to contribute to the recent increase in male...... reproductive problems, and many of the anti-androgenic compounds are like the mild analgesics potent inhibitors of prostaglandin synthesis. Therefore, it appears imperative to further investigate the potential endocrine disrupting properties of mild analgesics. ; METHODS: In a prospective birth cohort study...

Studies on anti-ulcer, analgesic and antipyretic properties of the ...

African Journals Online (AJOL)

ulcer, analgesic and anti pyretic activities in rats and mice. Ethanol-induced gastric ulceration, acetic acid-induced writhing and formalin-induced nociception were used. Yeast-induced hyperpyrexia was used to investigate the antipyretic activity.

NSAID and other analgesic use by endurance runners during ...

African Journals Online (AJOL)

Background. An increasing popularity of ultra-endurance events coupled with excessive or inappropriate non-steroidal anti-inflammatory drug (NSAID) use during such events could pose considerable potential risks to runners' health. Objective. To evaluate the incidence of NSAID and other analgesic use in distance ...

Analgesic and Antipyretic Activities of Drymaria cordata (Linn.) Willd ...

African Journals Online (AJOL)

Also, D. cordata produced significant (p<0.05) dose-dependent inhibition of temperature elevation in the 2,4-DNP and yeast-induced hyperthermia models with ... that the aqueous whole plant extract of Drymaria cordata possesses analgesic and antipyretic properties mediated through peripheral and central mechanisms.

Patterns and predictors of analgesic use in pregnancy: a longitudinal drug utilization study with special focus on women with migraine.

Science.gov (United States)

Harris, Gerd-Marie Eskerud; Wood, Mollie; Eberhard-Gran, Malin; Lundqvist, Christofer; Nordeng, Hedvig

2017-07-14

Few studies have investigated the drug utilization patterns and factors predicting drug use in pregnant women with migraine. This longitudinal drug utilization study aimed to describe patterns of analgesic use in a sample of Norwegian pregnant women according to their migraine history, and to identify predictors for analgesic use among these women. Pregnant women giving birth at Akershus University Hospital between 2008 and 2010 were recruited at ultrasound examination in gestational week 17. Data were collected by questionnaires in gestational weeks 17 and 32, and at 8 weeks postpartum, and linked to birth records. Women were grouped into four categories according to migraine history: no migraine history, previous migraine history, recent migraine history (within 1 year prior to pregnancy) and migraine in pregnancy. Patterns of use of analgesics were analyzed descriptively. Multivariable logistic regression was used to identify factors predicting analgesic use. Out of 1981 women, 5.0% reported having migraine in pregnancy, 13.2% had a recent history of migraine, 11.5% had a previous history of migraine, and 68.8% reported no history of migraine. Analgesic use declined during pregnancy. Many women switched from triptans and non-steroidal anti-inflammatory drugs to paracetamol, which constituted most of the analgesic use. Factors associated with analgesic use included recent migraine history (OR 1.6, 95% CI 1.2-2.2), more severe headache intensity (OR 1.3, 95% CI 1.3-1.4), smoking (OR 1.9, 95% CI 1.1-3.3) and multiparity (OR 1.4, 95% CI 1.1-1.7). Women with migraine stop or switch medications during pregnancy. Analgesic use in pregnancy is affected by migraine characteristics and intensity, and also by socio-demographic factors. Clinicians should bear this in mind when giving advice on adequate management of migraine in pregnancy and safe analgesic use.

General anesthesia and postoperative pain management in analgesic intolerant patients with/without asthma: is it safe?

Science.gov (United States)

Celiker, V; Basgül, E; Karakaya, G; Oguzalp, H; Bozkurt, B; Kalyoncu, A F

2004-01-01

Analgesic intolerance (AI) appears in approximately 1 % of the general population. The triad of bronchial asthma, nasal polyposis, and analgesic intolerance is called analgesic-induced asthma (AIA). These patients are frequently referred to adult allergy clinics for preoperative evaluation for possible analgesic cross reactivity and intolerance to anesthetic agents. To determine allergic problems related to anesthesia and postoperative pain management in AI patients with and without asthma. The medical records of 45 patients who had been diagnosed with AI between January 1991 and December 2002 in the adult allergy unit and who underwent surgery in the same hospital in the last 4 years were retrospectively analyzed. The mean age of the patients was 44.4 13.4 years and 30 (66.6 %) were female. Thirty-six (80 %) had AIA, 34 (75.6 %) had persistent allergic rhinitis and 21 (46.7 %) had nasal polyps. Fifty-one surgical procedures were performed in 45 patients, in whom ear, nose and throat surgery was the main procedure (64.7 %). Anesthesia was induced with propofol, fentanyl, and vecuronium and was maintained by sevoflurane or isoflurane. Fentanyl was used for early postoperative pain relief. No complications appeared in relation to anesthesia or early pain management except in a 44-year-old AIA woman who had a reaction in the postoperative period after receiving an inappropriate analgesic. None of the patients had anesthesia-related allergic problems. Atropine and diazepam in the premedication, propofol and fentanyl during induction, muscle relaxation facilitation by vecuronium, and sevoflurane or isoflurane for maintenance seem to be a safe general anesthetic choice for analgesic intolerant patients with and without asthma.

[Immediate analgesic effect of wrist-ankle acupuncture for acute lumbago: a randomized controlled trial].

Science.gov (United States)

Su, Jiang-tao; Zhou, Qing-hui; Li, Rui; Zhang, Jie; Li, Wei-hong; Wang, Qiong

2010-08-01

To assess the immediate analgesic effect of wrist-ankle acupuncture on acute lumbago and the relationship between the analgesic effect and the expectation of patients. A randomized, single-blind, sham-controlled trial was designed. Sixty cases of acute lumbago were randomly divided into two groups, 30 cases in each one. In observation group, wrist-ankle acupuncture was adopted to the Lower 5 and Lower 6 bilaterally, no requirement of Deqi (arrival of qi). In control group, sham acupuncture was adopted. The treatment was applied once in either group, with the needles retained for 30 min. The Short-form McGill Pain Questionnaire (SF-MPQ) and the Modified-Modified Schober (MMS) test were used to assess the motion related pain and the situation of spinal flexion in 3 min before treatment and 5 min, 10 min, 15 min, during treatment and 30 min (needle removed), respectively. The Expectation and Treatment Credibility Scale (ETCS) was applied to analyze the relationship between the expectation of patients and the analgesic effect. The adverse reaction was recorded. There were no statistically significant differences in SF-MPQ, MMS and ETCS before treatment between two groups (all P>0.05). In 5 min after needles insertion, the scores of the items in SF-MPQ in observation group were lower than those in control group (P0.05). No adverse reaction was reported. Wrist-ankle acupuncture can reduce acute lumbago immediately and significantly. The higher the expectation on the analgesic effect of wrist-ankle acupuncture the patients have, the better the analgesic effect will be. This therapy is highly safe in the treatment.

Analgesic effect of intra-articular magnesium sulphate compared with bupivacaine after knee arthroscopic menisectomy

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Yasser A. Radwan

2013-07-01

Full Text Available This work aimed to evaluate the analgesic efficacy of intra-articular injection of magnesium sulphate (4% compared with equivalent volume of bupivacaine (0.5% after outpatient knee arthroscopic meniscectomy. Forty patients were randomly assigned to two groups. Group M (n = 20 received intra-articular magnesium sulphate 4%, group B (n = 20 received bupivacaine (0.5%. Analgesic effect was evaluated by analgesic duration, and by measuring pain intensity at 1, 2, 4, 6, 12, 24 h both at rest and on knee movement to 90°. The primary outcome variable was pain intensity on the VAS at 1, 2, 4, 6, 12, 24 h post arthroscopy at rest and on movement (flexion of knee to 90°, although the magnesium group had lower time weighted averages (TWAs at rest and on movement, these TWAs were not statistically significant. The median duration of postoperative analgesia was significantly longer in the patients treated with magnesium sulphate (528 min than in the bupivacaine group (317 min (p < 0.0001, with less number of patients needing supplementary analgesia in magnesium group (8/20 than those of the bupivacaine group (16/20 (p < 0.022. Also analgesic consumption was significantly lower in the magnesium sulphate group (p < 0.002. We concluded that the use of magnesium sulphate is rational and effective in reducing pain, and is more physiological and shortens convalescence after outpatient arthroscopic meniscectomy, however our hypotheses that analgesic efficacy of intra-articular isotonic magnesium sulphate would be superior to intra-articular local anaesthetic cannot be supported with this study.

Analgesic and anti-inflammatory activity of the aqueous extract of Rheedia longifolia Planch & Triana

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Valber da Silva Frutuoso

2007-02-01

Full Text Available Rheedia longifolia Planch et Triana belongs to the Clusiaceae family. This plant is widely distributed in Brazil, but its chemical and pharmacological properties have not yet been studied. We report here that leaves aqueous extract of R. longifolia (LAE shows analgesic and anti-inflammatory effects. Oral or intraperitoneal administration of this extract dose-dependently inhibited the abdominal constrictions induced by acetic acid in mice. The analgesic effect and the duration of action were similar to those observed with sodium diclofenac, a classical non-steroidal analgesic. In addition to the effect seen in the abdominal constriction model, LAE was also able to inhibit the hyperalgesia induced by lipopolysaccharide from gram-negative bacteria (LPS in rats. We also found that R. longifolia LAE inhibited an inflammatory reaction induced by LPS in the pleural cavity of mice. Acute toxicity was evaluated in mice treated with the extract for seven days with 50 mg/kg/day. Neither death, nor alterations in weight, blood leukocyte counts or hematocrit were noted. Our results suggest that aqueous extract from R. longifolia leaves has analgesic and anti-inflammatory activity with minimal toxicity and are therefore endowed with a potential for pharmacological control of pain and inflammation.

Anti-Inflammatory and Analgesic Activities of a Novel Biflavonoid from Shells of Camellia oleifera

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Yong Ye

2012-09-01

Full Text Available Shells are by-products of oil production from Camellia oleifera which have not been harnessed effectively. The purpose of this research is to isolate flavonoid from shells of Camellia oleifera and evaluate its anti-inflammatory and analgesic effects. The flavonoid was identified as bimolecular kaempferol structure by UV, MS, 1H NMR and 13C NMR spectra, which is a new biflavonoid and first found in Camellia oleifera. It showed dose-dependent anti-inflammatory activity by carrageenin-induced paw oedema in rats and croton oil induced ear inflammation in mice, and analgesic activity by hot plate test and acetic acid induced writhing. The mechanism of anti-inflammation of biflavonoid is related to both bradykinin and prostaglandins synthesis inhibition. The biflavonoid showed both central and peripheral analgesic effects different from aspirin, inhibition of the synthesis or action of prostaglandins may contribute to analgesic effect of biflavonoid. The biflavonoid significantly decreased malonaldehyde (MDA and increased superoxidase dismutase (SOD and Glutathione peroxidase (GSH-Px activity in serum (p < 0.01, revealed strong free radical scavenging activity in vivo. It indicates the biflavonoid can control inflammation and pain by eliminating free radical so as to inhibit the mediators and decrease the prostaglandins. The biflavonoid can be used as a prospective medicine for inflammation and pain.

Analgesic Potential of Essential Oils

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José Ferreira Sarmento-Neto

2015-12-01

Full Text Available Pain is an unpleasant sensation associated with a wide range of injuries and diseases, and affects approximately 20% of adults in the world. The discovery of new and more effective drugs that can relieve pain is an important research goal in both the pharmaceutical industry and academia. This review describes studies involving antinociceptive activity of essential oils from 31 plant species. Botanical aspects of aromatic plants, mechanisms of action in pain models and chemical composition profiles of the essential oils are discussed. The data obtained in these studies demonstrate the analgesic potential of this group of natural products for therapeutic purposes.

Analgesic Microneedle Patch for Neuropathic Pain Therapy.

Science.gov (United States)

Xie, Xi; Pascual, Conrado; Lieu, Christopher; Oh, Seajin; Wang, Ji; Zou, Bende; Xie, Julian; Li, Zhaohui; Xie, James; Yeomans, David C; Wu, Mei X; Xie, Xinmin Simon

2017-01-24

Neuropathic pain caused by nerve injury is debilitating and difficult to treat. Current systemic pharmacological therapeutics for neuropathic pain produce limited pain relief and have undesirable side effects, while current local anesthetics tend to nonspecifically block both sensory and motor functions. Calcitonin gene related peptide (CGRP), a neuropeptide released from sensory nerve endings, appears to play a significant role in chronic neuropathic pain. In this study, an analgesic microneedle (AMN) patch was developed using dissolvable microneedles to transdermally deliver selective CGRP antagonist peptide in a painless manner for the treatment of localized neuropathic pain. Local analgesic effects were evaluated in rats by testing behavioral pain sensitivity in response to thermal and mechanical stimuli using neuropathic pain models such as spared-nerve injury and diabetic neuropathy pain, as well as neurogenic inflammatory pain model induced by ultraviolet B (UVB) radiation. Unlike several conventional therapies, the AMN patches produced effective analgesia on neuropathic pain without disturbing the normal nociception and motor function of the rat, resulting from the high specificity of the delivered peptide against CGRP receptors. The AMN patches did not cause skin irritation or systemic side effects. These results demonstrate that dissolvable microneedle patches delivering CGRP antagonist peptide provide an effective, safe, and simple approach to mitigate neuropathic pain with significant advantages over current treatments.

Anti-inflammatory and analgesic activity of ononitol monohydrate isolated from Cassia tora L. in animal models

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Paulrayer Antonisamy

2017-12-01

Full Text Available Ononitol monohydrate (OM was isolated from Cassia tora L. leaves. The anti-inflammatory and analgesic activities of OM have been examined in male Wistar rats and mice. The efficacy of OM against inflammation was studied by using carrageenan-induced paw oedema, croton oil-induced ear oedema, acetic acid-induced vascular permeability, cotton pellet-induced granuloma and adjuvant-induced arthritis. The analgesic activity of OM was assessed using the acetic acid-induced abdominal constriction response, formalin-induced paw licking response and the hot-plate test. In acute type inflammation models, maximum inhibitions of 50.69 and 61.06% (P < .05 were noted with 20 mg/kg of OM in carrageenan-induced hind paw oedema and croton oil-induced ear oedema, respectively. Treatment of OM (20 mg/kg meaningfully (P < .05 reduced the granuloma tissue formation by cotton pellet study at a rate of 36.25%. OM (20 mg/kg inhibited 53.64% of paw thickness in adjuvant-induced arthritis model. OM has also been produced significant (P < .05 analgesic activity in acetic acid-induced abdominal constriction response, formalin-induced paw licking response and in hot-plate test suggesting its peripheral and central analgesic potential. The outcomes of the present study proposed that OM influenced on the anti-inflammatory and analgesic activities.

Analgesic and anti-inflammatory effects of ethanol extracted leaves of selected medicinal plants in animal model

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Mohammad M. Hassan

2013-04-01

Full Text Available Aim: The research was carried out to investigate the analgesic and anti-inflammatory effects of ethanol extract of Desmodium pauciflorum, Mangifera indica and Andrographis paniculata leaves. Materials and Methods: In order to assess the analgesic and anti-inflammatory effects acetic acid induced writhing response model and carrageenan induced paw edema model were used in Swiss albino mice and Wistar albino rats, respectively. In both cases, leaves extract were administered (2gm/kg body weight and the obtained effects were compared with commercially available analgesic and anti-inflammatory drug Dclofenac sodium (40mg/kg body weight. Distilled water (2ml/kg body weight was used as a control for the study. Results: In analgesic bioassay, oral administration of the ethanol extract of leaves were significantly (p<0.01 reduced the writhing response. The efficacy of leaves extract were almost 35% in Desmodium pauciflorum, 56% in Mangifera indica and 34% in Andrographis paniculata which is found comparable to the effect of standard analgesic drug diclofenac sodium (76%. Leaves extract reduced paw edema in variable percentages but they did not show any significant difference among the leaves. Conclusion: We recommend further research on these plant leaves for possible isolation and characterization of the various active chemical substances which has the toxic and medicinal values. [Vet World 2013; 6(2.000: 68-71

Studies on anti-ulcer, analgesic and antipyretic properties of the ...

African Journals Online (AJOL)

STORAGESEVER

2010-03-15

Mar 15, 2010 ... Yeast-induced hyperpyrexia was used to investigate the antipyretic ... be important in establishing a pharmacological basis for some of the ..... Koster R, Anderson M, De Beer EJ (1959) Acetic acid for analgesic screening.

analgesic and anti-inflammatory activities of ethanolic extract of ...

African Journals Online (AJOL)

2015-04-30

Apr 30, 2015 ... The analgesic and anti-inflammatory activities of the ethanolic extract of Rheumatic Tea Formula ... Salix alba were studied in mice and rats using acetic acid induced writhing, hot plate method, ... albino mice, while the phytochemical screening showed the presence of alkaloids, tannins and glycosides.

Post- operative analgesic effect of epidural bupivacaine alone and ...

African Journals Online (AJOL)

The study was conducted from December, 2013 to May, 2014 on 12 healthy bitches presented to the University of Gondar Teaching Veterinary Clinic for ovariohysterectomy to compare the epidural analgesic efficacy of bupivacaine alone and bupivacaine with tramadol to relieve postoperative pain and asses changes on ...

Photoresponsive nanocapsulation of cobra neurotoxin and enhancement of its central analgesic effects under red light

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Yang Q

2017-05-01

Full Text Available Qian Yang, Chuang Zhao, Jun Zhao, Yong Ye Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, People’s Republic of China Abstract: Cobra neurotoxin (CNT, a peptide isolated from snake venom of Naja naja atra, shows central analgesic effects in our previous research. In order to help CNT pass through blood–brain barrier (BBB and improve its central analgesic effects, a new kind of CNT nanocapsules were prepared by double emulsification with soybean lecithin and cholesterol as the shell, and pheophorbide as the photosensitizer added to make it photoresponsive. The analgesic effects were evaluated by hot plate test and acetic acid-induced writhing in mice. The CNT nanocapsules had an average particle size of 229.55 nm, zeta potential of -53.00 mV, encapsulation efficiency of 84.81% and drug loading of 2.98%, when the pheophorbide content was 1% of lecithin weight. Pheophorbide was mainly distributed in outer layer of the CNT nanocapsules and increased the release of the CNT nanocapsules after 650 nm illumination. The central analgesic effects were improved after intraperitoneal injection of CNT at 25 and 50 µg·kg-1 under 650 nm irradiation for 30 min in the nasal cavity. Activation of pheophorbide by red light generated reactive oxygen species which opened the nanocapsules and BBB and helped the CNT enter the brain. This research provides a new drug delivery for treatment of central pain. Keywords: cobra neurotoxin, nanocapsules, photoresponsive, central analgesic effects, red light, drug delivery, photosensitizer

Intraoperative esmolol infusion reduces postoperative analgesic consumption and anaesthetic use during septorhinoplasty: a randomized trial

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Nalan Celebi

2014-09-01

Full Text Available Background and objectives: Esmolol is known to have no analgesic activity and no anaesthetic properties; however, it could potentiate the reduction in anaesthetic requirements and reduce postoperative analgesic use. The objective of this study is to evaluate the effect of intravenous esmolol infusion on intraoperative and postoperative analgesic consumptions as well as its effect on depth of anaesthesia. Methods: This randomized-controlled double blind study was conducted in a tertiary care hospital between March and June 2010. Sixty patients undergoing septorhinoplasty were randomized into two groups. History of allergy to drugs used in the study, ischaemic heart disease, heart block, bronchial asthma, hepatic or renal dysfunction, obesity and a history of chronic use of analgesic or β-blockers were considered cause for exclusion from the study. Thirty patients received esmolol and remifentanil (esmolol group and 30 patients received normal saline and remifentanil (control group as an intravenous infusion during the procedure. Mean arterial pressure, heart rate, and bispectral index values were recorded every 10min. Total remifentanil consumption, visual analogue scale scores, time to first analgesia and total postoperative morphine consumption were recorded. Results: The total remifentanil consumption, visual analogue scale scores at 0, 20 and 60 min, total morphine consumption, time to first analgesia and the number of patients who needed an intravenous morphine were lower in the esmolol group. Conclusions: Intravenous infusion of esmolol reduced the intraoperative and postoperative analgesic consumption, reduced visual analogue scale scores in the early postoperative period and prolonged the time to first analgesia; however it did not influence the depth of anaesthesia.

Studies on the anti-inflammatory, analgesic and antipyrexic activities ...

African Journals Online (AJOL)

The bioactivity of this compound was assessed using carrageenan-induced paw oedema in rats and carrageenan-induced pulmonary oedema in mice for the antiinflammatory activity, while acetic acid-induced writhing test in mice and zymosan-induced fever in rats were used for analgesic test. Materials and Methods: Rats ...

Anti-inflammatory, analgesic and antipyretic activities of the aqueous ...

African Journals Online (AJOL)

The aqueous extract of Hippobromus pauciflorus (L.f) Radlk leaves at 50, 100 and 200 mg/kg body weight were evaluated for anti-inflammatory, analgesic and antipyretic activities in male rats. Antiinflammatory activity was studied by using carrageenan and histamine induced oedema right hind paw volume while the ...

Evaluation of anti-inflammatory, analgesic, and antipyretic effects of ...

African Journals Online (AJOL)

This study investigated the possible anti-inflammatory, analgesic, and antipyretic effects of ethanolic extract of Pedalium murex Linn. fruits in selected experimental animal models. Anti-inflammatory activity of Pedalium murex Linn., with doses of 200 mg/kg and 400 mg/kg, p.o., was evaluated by Lambda-carrageenan ...

Analgesic and anti-inflammatory effects of Cyphostemma vogelii (Hook

African Journals Online (AJOL)

Rita

2013-04-24

Apr 24, 2013 ... Key words: Analgesic, anti-inflammatory, mice, Cyphostemma vogelii, nociception. ... steroidal anti- inflammatory drugs (NSAIDs) are considered the drugs of ..... 44-55. Hughes H, Lang M (1983). Control of pain in dogs and cats In: Kitchell. R, Erickson H (eds.) Animal pain. Baltimore Waverly press. pp. 207-.

The analgesic effect of diclofenac sodium administered via the ...

African Journals Online (AJOL)

... investigate the characteristics of the analgesic effect of diclofenac sodium injected epidurally in single or repeated doses and whether tolerance develops in long‑term use. Materials and Methods: A total of 30 rats were included in the study. The rats were anesthetized using intraperitoneal ketamine hydrochloride and an ...

Evaluation of analgesic and anti-inflammatory activity of a combination of tramadol-ibuprofen in experimental animals.

Science.gov (United States)

Suthakaran, Chidambarann; Kayalvizhi, Muniyagounder K; Nithya, Karnam; Raja, Thozhudalangudy Ar

2017-01-01

Pain is the major concern of patients attending dental clinics, and satisfactory pain relief has always been difficult to achieve. Since the pathophysiology of pain is a complex, central and peripheral nervous system process, combined analgesic regimens with different mechanisms of action as a multimodal approach are becoming popular among the clinicians and dentists. The aim of the present study was to evaluate the analgesic and anti-inflammatory activity of ibuprofen and tramadol when used alone or in combination in animal models of pain and inflammation. The animals were divided into six groups with six animals in each group. Analgesic activity was assessed by hot plate method in rats and by acetic acid-induced writhing test in mice. Paw edema model in rats after induction with 0.1 mL of 1% carrageenan was used to assess the anti-inflammatory activity. Analysis of variance followed by Tukey's honestly significant difference post hoc test was used for statistical analysis. Combined use of tramadol and ibuprofen provided enhanced analgesic and anti-inflammatory effects in animal models of pain and inflammation.

Analgesic and Anti-inflammatory Activity of Teucrium chamaedrys Leaves Aqueous Extract in Male Rats

OpenAIRE

Ali Pourmotabbed; Amir Farshchi; Golbarg Ghiasi; Peyman Malek Khatabi

2010-01-01

Objective(s)Current study was undertaken to investigate the analgesic and anti-inflammatory effects of the aqueous extract of Teucrium chamaedrys in mice and rats. Materials and MethodsFor evaluating of analgesic and anti-inflammatory activity, we used the carrageenan- and dextran-induced paw oedema, acetic acid-induced writhing, tail flick and formalin pain tests.ResultsThe extract of T. chamaedrys (50–200 mg/kg) and acetylsalicylic acid (100 mg/kg) produced a significant (P< 0.01) inhibitio...

ANALGESIC ACTIVITY OF FICUS ARNOTTIANA (MIQ) LEAVES EXTRACT

OpenAIRE

Chandaker Amol; Saha Rajsekhar

2011-01-01

The methanolic extract of leaves of Ficus arnottiana was used to evaluate the analgesic activity. The above activity was evaluated using the eddy’s hot plate and heat conduction method and acetic acid induced writing in mice. The dose used for the test of activity (100, 200. 400 mg/kg i.p). The extract at all doses tested significantly (P

Does Acupuncture Needling Induce Analgesic Effects Comparable to Diffuse Noxious Inhibitory Controls?

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Juerg Schliessbach

2012-01-01

Full Text Available Diffuse noxious inhibitory control (DNIC is described as one possible mechanism of acupuncture analgesia. This study investigated the analgesic effect of acupuncture without stimulation compared to nonpenetrating sham acupuncture (NPSA and cold-pressor-induced DNIC. Forty-five subjects received each of the three interventions in a randomized order. The analgesic effect was measured using pressure algometry at the second toe before and after each of the interventions. Pressure pain detection threshold (PPDT rose from 299 kPa (SD 112 kPa to 364 kPa (SD 144, 353 kPa (SD 135, and 467 kPa (SD 168 after acupuncture, NPSA, and DNIC test, respectively. There was no statistically significant difference between acupuncture and NPSA at any time, but a significantly higher increase of PPDT in the DNIC test compared to acupuncture and NPSA. PPDT decreased after the DNIC test, whereas it remained stable after acupuncture and NPSA. Acupuncture needling at low pain stimulus intensity showed a small analgesic effect which did not significantly differ from placebo response and was significantly less than a DNIC-like effect of a painful noninvasive stimulus.

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010

Science.gov (United States)

Bachhuber, Marcus A.; Saloner, Brendan; Cunningham, Chinazo O.; Barry, Colleen L.

2015-01-01

IMPORTANCE Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND PARTICIPANTS A time-series analysis was conducted of medical cannabis laws and state-level death certificate data in the United States from 1999 to 2010; all 50 states were included. EXPOSURES Presence of a law establishing a medical cannabis program in the state. MAIN OUTCOMES AND MEASURES Age-adjusted opioid analgesic overdose death rate per 100 000 population in each state. Regression models were developed including state and year fixed effects, the presence of 3 different policies regarding opioid analgesics, and the state-specific unemployment rate. RESULTS Three states (California, Oregon, and Washington) had medical cannabis laws effective prior to 1999. Ten states (Alaska, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Rhode Island, and Vermont) enacted medical cannabis laws between 1999 and 2010. States with medical cannabis laws had a 24.8% lower mean annual opioid overdose mortality rate (95% CI, −37.5% to −9.5%; P = .003) compared with states without medical cannabis laws. Examination of the association between medical cannabis laws and opioid analgesic overdose mortality in each year after implementation of the law showed that such laws were associated with a lower rate of overdose mortality that generally strengthened over time: year 1 (−19.9%; 95% CI, −30.6% to −7.7%; P = .002), year 2 (−25.2%; 95% CI, −40.6% to −5.9%; P = .01), year 3 (−23.6%; 95% CI, −41.1% to −1.0%; P = .04), year 4 (−20.2%; 95% CI, −33.6% to −4

In Vivo and In Vitro Elution of Analgesics from Multilayered Poly(D,L-lactide-co-glycolide Nanofibers Incorporated Ureteral Stents

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Yi-Chia Lin

2018-01-01

Full Text Available We develop novel analgesic-eluting nanofiber-incorporated ureteral stents that offer sustained release of lidocaine and ketorolac for local drug delivery. Lidocaine and poly(D,L-lactide-co-glycolide (PLGA were dissolved in hexafluoroisopropanol and were electrospun into nonwoven nanofibers onto the surface of ureteral stents. This was followed by electrospinning of another layer of PLGA nanofibers containing ketorolac. Electrospun drug-loaded nanofibers were then characterized using scanning electron microscopy, Fourier transform infrared spectroscopy, and water contact angle analysis. In addition, the elution behavior characteristics of the analgesics, both in vivo and in vitro, from the nanofiber-incorporated stents were evaluated. Experimental results indicate that the analgesic-eluting ureteral stents could liberate high strengths of analgesics in vitro and in vivo for at least 50 and 30 days, respectively. The analgesic-eluting nanofiber-incorporated ureteral stents are potentially applicable for alleviating the discomfort associated with stent implant.

Activity-based costing analysis of the analgesic treatments used in postoperative pain management in Italy.

Science.gov (United States)

Fanelli, Andrea; Ruggeri, Matteo; Basile, Michele; Cicchetti, Americo; Coluzzi, Flaminia; Della Rocca, Giorgio; Di Marco, Pierangelo; Esposito, Clelia; Fanelli, Guido; Grossi, Paolo; Leykin, Yigal; Lorini, Ferdinando Luca; Paolicchi, Adriana; Scardino, Marco; Corcione, Antonio

2016-02-01

The aim of this analysis is to evaluate the costs of 72-hour postoperative pain treatment in patients undergoing major abdominal, orthopedic and thoracic procedures in nine different Italian hospitals, defined as the cumulative cost of drugs, consumable materials and time required for anesthesiologists, surgeons and nurses to administer each analgesic technique. Nine Italian hospitals have been involved in this study through the administration of a questionnaire aimed to acquire information about the Italian clinical practice in terms of analgesia. This study uses activity-based costing (ABC) analysis to identify, measure and give value to the resources required to provide the therapeutic treatment used in Italy to manage the postoperative pain patients face after surgery. A deterministic sensitivity analysis (DSA) has been performed to identify the cost determinants mainly affecting the final cost of each treatment analyzed. Costs have been reclassified according to three surgical macro-areas (abdominal, orthopedic and thoracic) with the aim to recognize the cost associated not only to the analgesic technique adopted but also to the type of surgery the patient faced before undergoing the analgesic pathway. Fifteen different analgesic techniques have been identified for the treatment of moderate to severe pain in patients who underwent a major abdominal, orthopedic or thoracic surgery. The cheapest treatment actually employed is the oral administration "around the clock" (€ 8.23), whilst the most expensive is continuous peripheral nerve block (€ 223.46). The intravenous patient-controlled analgesia costs € 277.63. In terms of resources absorbed, the non-continuous administration via bolus is the gold standard in terms of cost-related to the drugs used (€ 1.28), and when administered pro re nata it also absorbs the lowest amount of consumables (€0.58€) compared to all other therapies requiring a delivery device. The oral analgesic administration pro re

Analgesic and antipyretic activity of Curcuma longa rhizome extracts in wister rats

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S. Neha

Full Text Available The study was carried out to ascertain analgesic and antipyretic activities of rhizome extracts of Curcuma longa in Wister rats. Both aqueous and alcoholic extracts at 100 and 200 mg/kg by oral, single dose treatment for seven days revealed significant difference (P<0.05, 0.01 in reaction time in terms of analgesic activity before and after treatments which was comparable to analgin (10 mg/kg b wt. and were ineffective in reversal of brewers yeast induced pyrexia. Solvent yield of these extracts was 20 percent and color dark brown and reddish brown with solid and semisolid consistency respectively. [Vet World 2009; 2(8.000: 304-306

Adult emergency department patients with sickle cell pain crisis: a learning collaborative model to improve analgesic management.

Science.gov (United States)

Tanabe, Paula; Artz, Nicole; Mark Courtney, D; Martinovich, Zoran; Weiss, Kevin B; Zvirbulis, Elena; Hafner, John W

2010-04-01

The objectives were to report the baseline (prior to quality improvement interventions) patient and visit characteristics and analgesic management practices for each site participating in an emergency department (ED) sickle cell learning collaborative. A prospective, multisite longitudinal cohort study in the context of a learning-collaborative model was performed in three midwestern EDs. Each site formed a multidisciplinary team charged with improving analgesic management for patients with sickle cell disease (SCD). Each team developed a nurse-initiated analgesic protocol for SCD patients (implemented after a baseline data collection period of 3.5 months at one site and 10 months at the other two sites). All sites prospectively enrolled adults with an acute pain crisis and SCD. All medical records for patients meeting study criteria were reviewed. Demographic, health services, and analgesic management data were abstracted, including ED visit frequency data, ED disposition, arrival and discharge pain score, and name and route of initial analgesic administered. Ten interviews per quarter per site were conducted with patients within 14 days of their ED discharge, and subjects were queried about the highest level of pain acceptable at discharge. The primary outcome variable was the time to initial analgesic administration. Variable data were described as means and standard deviations (SDs) or medians and interquartile ranges (IQR) for nonnormal data. A total of 155 patients met study criteria (median age = 32 years, IQR = 24-40 years) with a total of 701 ED visits. Eighty-six interviews were conducted. Most patients (71.6%) had between one and three visits to the ED during the study period. However, after removing Site 3 from the analysis because of the short data enrollment period (3.5 months), which influenced the mean number of visits for the entire cohort, 52% of patients had between one and three ED visits over 10 months, 21% had four to nine visits, and 27% had

Analgesic and anti-inflammatory activities of ethanolic extract of ...

African Journals Online (AJOL)

The analgesic and anti-inflammatory activities of the ethanolic extract of Rheumatic Tea Formula (RTF) a polyherbal tea consisting the leaves of Eucalyptus globulus, Albizia chevalieri and bark of Salix alba were studied in mice and rats using acetic acid induced writhing, hot plate method, formalin induced pain and ...

Determination of percentage of caffeine content in some analgesic ...

African Journals Online (AJOL)

Two methods were employed for the determination of percentage Caffeine content in three brands of analgesic tablets which are; Extraction using only water as a solvent and Extraction using both water and chloroform as solvents, watch glass has been used as the weighing apparatus and the percentage of Caffeine ...

Analgesic and anti-inflammatory activity of root bark of Grewia asiatica Linn. in rodents.

Science.gov (United States)

Paviaya, Udaybhan Singh; Kumar, Parveen; Wanjari, Manish M; Thenmozhi, S; Balakrishnan, B R

2013-01-01

Grewia asiatica Linn. (Family: Tiliaceae), called Phalsa in Hindi is an Indian medicinal plant used for a variety of therapeutic and nutritional uses. The root bark of the plant is traditionally used in rheumatism (painful chronic inflammatory condition). The present study demonstrates the analgesic and anti-inflammatory activity of root bark of G. asiatica in rodents. The methanolic extract of Grewia asiatica (MEGA) and aqueous extract of Grewia asiatica (AEGA) of the bark were prepared and subjected to phytochemical tests and pharmacological screening for analgesic and anti-inflammatory effect in rodents. Analgesic effect was studied using acetic acid-induced writhing in mice and hot plate analgesia in rats while anti-inflammatory activity was investigated using carrageenan-induced paw oedema in rats. The MEGA or AEGA was administered orally in doses of 200 and 400 mg/kg/day of body weight. Data were analysed by one-way analysis of variance followed by Dunnett's test. The extracts showed a significant inhibition of writhing response and increase in hot plate reaction time and also caused a decrease in paw oedema. The effects were comparable with the standard drugs used. The present study indicates that root bark of G. asiatica exhibits peripheral and central analgesic effect and anti-inflammatory activity, which may be attributed to the various phytochemicals present in root bark of G. asiatica.

Analgesic and Anti-Inflammatory Activities of Resveratrol through Classic Models in Mice and Rats

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Guangxi Wang

2017-01-01

Full Text Available Background. Inflammation and pain are closely related to humans’ and animals’ health. Resveratrol (RSV is a natural compound with various biological activities. The current study is aimed to evaluate the analgesic and anti-inflammatory activities of RSV in vivo. Materials and Methods. The analgesic effects were assessed by the acetic acid-induced writhing and hot plate tests. The anti-inflammatory effects were determined using the xylene-induced mouse ear oedema, the acetic acid-induced rat pleurisy, and carrageenan-induced rat synovitis tests, respectively. Results. The analgesic results showed that RSV could significantly inhibit the number of writhes and improve the time and pain threshold of mice standing on hot plate. The anti-inflammatory results showed that RSV could inhibit the ear oedema of mice. In acetic acid-induced pleurisy test, RSV could significantly inhibit the WBC and pleurisy exudates, could decrease the production of NO, and elevate the activity of SOD in serum. In carrageenan-induced synovitis test, RSV could reduce the content of MDA and elevate the T-SOD activity in serum; RSV could inhibit the expressions of TP, PGE2, NO, and MDA. Conclusion. Shortly, these results indicated that RSV had potent analgesic and anti-inflammatory activities and could be a potential new drug candidate for the treatment of inflammation and pain.

Synthesis, Analgesic and Anti-inflammatory Activities of 3- Ethyl-2 ...

African Journals Online (AJOL)

4(3H)-ones and evaluate them for their analgesic and anti-inflammatory activities. Methods: The compounds, 3-ethyl-2-substituted amino-quinazolin-4(3H)-ones, were synthesized by reacting the amino group of 3-ethyl-2-hydrazino ...

The impact of socioeconomic and clinical factors on purchase of prescribed analgesics before and after hysterectomy on benign indication

DEFF Research Database (Denmark)

Daugbjerg, Signe Bennedbæk; Brandsborg, Birgitte; Ottesen, Bent Smedegaard

2014-01-01

OBJECTIVE:: Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. METHODS:: Nearly...... socioeconomic factors and changes in analgesic purchase were assessed. RESULTS:: Analgesic purchase after hysterectomy was independently predicted by age below 35 or above 65 years, body mass index >29.9, high American Society of Anesthesiologists (ASA) score, uterus weight...

Prescription pattern of antibiotic and analgesic in endodontic treatment in Kuwaiti population: A self-administered Survey

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Manal J Al-Maslamani

2014-01-01

Full Text Available Introduction: Surgical and non-surgical endodontic treatment of involved teeth can necessitate prescription of analgesics and antimicrobials. The literature suggests confusion amongst practitioners regarding the need for adjunctive medication, mainly during non-surgical endodontic treatment, often leading to over-prescription. Aim: The aim of this study was to determine the current clinical practice of dentists participated in this study with respect to antibiotic and analgesic prescription patterns in their endodontic treatment management in Kuwait. Materials and Methods: Prescription patterns for antibiotics and analgesics were analyzed based on the responses to self-administered questionnaire (n = 169. Information was collected based on different clinical endodontic diagnostic scenarios. Statistical analysis was performed with SPSS software version 17.0 to determine relationships between prescription patterns, age, gender, and dental qualification (specialists and general dentists. Results: Ninety-two percent of dentists prescribed analgesics for the management of endodontic pain. While 16% prescribed antibiotics for severe dental pain; 62% prescribed antibiotics for acute apical abscesses. Significantly more male dentists prescribed antibiotics for dental pain than female dentists. No significant difference was found between general dental practitioners′ and specialists′ attitude toward drug prescriptions. Amoxicillin and ibuprofen were the most commonly prescribed medications. Conclusion: While the majority of dentists appeared to prescribe antibiotics and analgesics appropriately, some did not. This research confirmed previous studies and established a need for imparting information of evidence-based prescriptions protocols for the dentists surveyed in this study in Kuwait.

Analgesics and sedatives in vascular interventionist radiologic

International Nuclear Information System (INIS)

Gregorio, M.A. de; Opta, J.M.; Pulido, J.M.; Encarnacion, C.E.; Arino, I., Fernandez, J.A.; Alfonso, E.R.

1993-01-01

Interventionist radiology routinely requires the use of different drugs (analgesics and sedatives) in the course of a procedure. Aside from their therapeutic action, these drugs can produce secondary or undesirable effects, making necessary an in-depth knowledge of them to assure their safe and efficient management. The aim of this work is to provide the vascular interventionist radiologist with additional information on the management of those drugs that contribute to minimizing patient discomfort and pain in interventionist procedures. Author

Analgesic effect of leaf extract from Ageratina glabrata in the hot plate test

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Guadalupe García P

2011-10-01

Full Text Available Ageratina glabrata (Kunth R.M. King & H. Rob., Asteraceae (syn. Eupatorium glabratum Kunth is widely distributed throughout Mexico and popularly known as "chamizo blanco" and "hierba del golpe" for its traditional use as external analgesic remedy. Though glabrata species has been chemically studied, there are no experimentally asserted reports about possible analgesic effects which can be inferred from its genus Ageratina. To fill the gap, we evaluated A. glabrata extracts in an animal model of nociception exploiting thermal stimuli. NMR and mass analyses identified a new thymol derivative, 10-benzoiloxy-6,8,9-trihydroxy-thymol isobutyrate (1, which was computationally converted into a ring-closed structure to explain interaction with the COX-2 enzyme in a ligand-receptor docking study. The resulting docked pose is in line with reported crystal complexes of COX-2 with chromene ligands. Based on the present results of dichloromethane extracts from its dried leaves, it is safe to utter that the plant possesses analgesic effects in animal tests which are mediated through inhibition of COX-2 enzyme.

Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain : An In-Season Randomized Clinical Trial

NARCIS (Netherlands)

Rio, Ebonie; van Ark, Mathijs; Docking, Sean; Moseley, G. Lorimer; Kidgell, Dawson; Gaida, Jamie E.; van den Akker-Scheek, Inge; Zwerver, Johannes; Cook, Jill

Objective: This study aimed to compare the immediate analgesic effects of 2 resistance programs in in-season athletes with patellar tendinopathy (PT). Resistance training is noninvasive, a principle stimulus for corticospinal and neuromuscular adaptation, and may be analgesic. Design: Within-season

Evaluation of analgesic, antipyretic and anti-inflammatory activity on Cordia dichotoma G. Forst. Leaf.

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Gupta, Richa; Kaur, Jagjit

2015-01-01

Cordia dichotoma G. Forst. is an important medicinal plant of family Boraginaceae. Traditionally, its leaves are used to treat fever, headache, and joint pain but its medicinal activities have not been proven by research. To evaluate the analgesic, anti-inflammatory, and antipyretic activity of C. dichotoma G. Forst. leaf extract. The various extracts of leaf powder were prepared by using soxhlet apparatus. The methanol extract was selected for pharmacological study. To evaluate analgesic activity, Eddy's hot plate method, to study anti-inflammatory activity, carageenan-induced rat paw edema method, and to study antipyretic activity, yeast-induced pyrexia method was used. SD female rats (180-200 g) were used for the study. In all three tests, the methanol extract high dose (400 mg/kg) was found to be highly significant as compared to standard drug. This study proved the traditional uses of plant leaves and concluded the analgesic, anti-inflammatory, and antipyretic activity of the leaf methanol extract.

Leaves extract of Murraya Koenigii linn for anti--inflammatory and analgesic activity in animal models

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Shailly Gupta

2010-01-01

Full Text Available This work has been done for the investigation of the anti-inflammatory and analgesic activity of methanol extract of dried leaves of Murraya koenigii Linn by oral administration at dose of 100, 200 and 400 mg/kg body weight, to healthy animals. Extract was studied for its anti-inflammatory activity by using carrageenan-induced hind paw edema in albino rats and the mean increase in paw volume and % inhibition in paw volume were measured plethysmometrically at different time intervals after carrageenan (1% w/v injection. Extract was also evaluated for analgesic activity using Eddy′s hot plate method and formalin induced paw licking method in albino rats. The methanol extract showed significant (P < 0.001 reduction in the carrageenan-induced paw edema and analgesic activity evidenced by increase in the reaction time by eddy′s hot plate method and percentage increase in pain in formalin test. The methanol extract showed anti-inflammatory and analgesic effect in dose dependent manner when compared with the control and standard drug, diclofenac sodium (10mg/kg, p.o. These inhibitions were statistically significant (P < 0.05. Thus our investigation suggests a potential benefit of Murraya koenigii in treating conditions associated with inflammatory pain.

Factors associated with a continuous regular analgesic use - a population-based study of more than 45,000 Danish women and men 18-45 years of age.

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Hargreave, Marie; Andersen, Tina Veje; Nielsen, Ann; Munk, Christian; Liaw, Kai-Li; Kjaer, Susanne K

2010-01-01

Widespread use of and serious adverse effects associated with use of analgesics accentuates the need to consider factors related to analgesic use. The objective of this study was to describe continuous regular analgesics use and examine factors associated with a continuous regular analgesic use. The study was based on data from two surveys and included a random sample of women and men aged 18-45 years from the general Danish population. Information on analgesics use, self-rated health, demographic and lifestyle factors was collected using a self-administered questionnaire. A total of 28,000 women and 33 000 men were invited to participate and 22,199 women (response-rate 81.4%) and 23,080 men (response-rate 71.0%), respectively, were included in the study. Data were analyzed using multivariate logistic regression. We found that 27% of the women and 18% of the men reported a regular monthly use of at least seven analgesic tablets during the last year (continuous regular analgesics use). Besides poor self-rated health we found in both sexes that increasing age, poor self-rated fitness, and smoking were related to a continuous regular analgesics use. Nulliparity, low level of education, overweight/obesity, binge drinking, and abstinence were associated with a continuous regular analgesics use for women, while underweight and marital/cohabiting status were associated with a continuous regular analgesics use only for men. Regular monthly analgesic use during the last year was generally prevalent. Besides self-rated health, several socio-demographic and lifestyle factors were associated with a continuous regular analgesic use, although with some gender differences.

Nitrogen, oxygen or sulfur containing heterocyclic compounds as analgesic drugs used as modulators of the nitroxidative stress.

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Salat, Kinga; Moniczewski, Andrzej; Librowski, Tadeusz

2013-03-01

Numerous lines of evidence suggest that heterocyclic compounds used as analgesic, anti-inflammatory and anti-migraine agents can be potent regulators of the nitroxidative stress and targeting free nitrogen and oxygen radicals is a very promising strategy for future pain management. Both classical analgesics (nonsteroidal anti-inflammatory drugs, opioid drugs) and many analgesic adjuvants, including desipramine, duloxetine, fluoxetine, paroxetine, escitalopram, phenytoin or carbamazepine and α-lipoic acid can modulate the balance between pro-oxidant and antioxidant processes in the mammalian tissues and these properties of drugs such as indomethacin, meloxicam, tenoxicam, valdecoxib or some metabolites of analgesic drugs formed by the activity of tissue peroxidases may contribute to their clinical efficacy and drug-related toxic effects, including gastrointestinal ulcers, hepatic failure, agranulocytosis, aplastic anemia, neutropenia, opiate-induced hyperalgesia and tolerance. The antioxidant capacities of novel heterocyclic compounds, including the compounds acting either by prevention of formation or catalyzed decomposition of peroxynitrite anion (ONOO-), namely the peroxynitrite decomposition catalysts or as superoxide (O2 •-)-scavengers which are the functional mimetics of superoxide dismutase (SOD) enzymes (SODm), as well as the derivatives of 6-nitro-3,4-methylenedioxyphenyl-Nacylhydrazone (LASSBio-881) or γ-butyrolactone (LPP1, BM113, BM113A, BM138 and BM138A) are also discussed as potent and promising future heterocyclic analgesics.

Evaluation of Analgesic Activity of the Methanol Extract from the Galls of Quercus infectoria (Olivier in Rats

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Sook-Ha Fan

2014-01-01

Full Text Available The present study aims to investigate the analgesic activity of the methanol extract of the galls of Quercus infectoria in rats using hot plate and tail-flick methods. The extract was administered intraperitoneally at a dose of 20 mg/kg while morphine sulfate and sodium salicylate (10 mg/kg served as standards. The methanol extract exhibited significant analgesic activity in the tail-flick model (P<0.05 by increasing the reaction time of the rats to 8.0 sec at 30 min after treatment in comparison to control (4.4 sec. Morphine sulfate produced a reaction time of 11.9 sec in the same test. At the peak of activity (30 min, the extract produced maximum possible analgesia (MPA of 34.2%, whilst morphine sulfate achieved a peak MPA of 70.9%. No analgesic effects have been observed using sodium salicylate in the tail-flick model. In the same model, the extract and sodium salicylate demonstrated comparable reaction times. Tail-flick is a better method to evaluate analgesic activity as no significant results were observed for all treatments using hot plate with the exception of morphine sulfate, which showed significant results only at 45 and 60 min after treatment. In conclusion, the methanol extract of the galls of Quercus infectoria displayed analgesic activity.

Factors associated with a continuous regular analgesic use - a population-based study of more than 45,000 Danish women and men 18-45 years of age

DEFF Research Database (Denmark)

Hargreave, Marie; Andersen, Tina Veje; Nielsen, Ann

2010-01-01

Widespread use of and serious adverse effects associated with use of analgesics accentuates the need to consider factors related to analgesic use. The objective of this study was to describe continuous regular analgesics use and examine factors associated with a continuous regular analgesic use....

In ova angiogenesis analgesic and anti inflammatory potency of Aerva monsoniae (Amaranthaceae

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Sandhya S

2012-10-01

Full Text Available Objective: To evaluate the wound healing potency of aqueous extract of Aerva monsoniae (A. monsoniae by in vitro method using fertilized eggs, in vivo analgesic and anti inflammatory activity in rodents and the anti bacterial activity on the bacterial strains that infect the wound. Methods: The whole plant of A. monsoniae was extracted with water and then subjected to preliminary chemical screening. It was then evaluated for in ova angiogenesis on fertilized white leg horn eggs using the concentrations of 200-600 毺 g/mL. The analgesic activity was evaluated in mice using the dose 100 and 250 mg/kg. The anti inflammatory activity was evaluated in rats using the dose 250 mg/kg and 500 mg/kg. In both the parameters water was used as the control and diclofenac was used the standard. The anti bacterial activity on Staphylococcus aureus and Pseudomonas aerugenosa was performed. Results: The phytochemical screening revealed the presence of tannins, flavonoids and saponins. The in ova angiogenesis revealed a dose dependent activity which proves the wound healing claim of the plant as more number of blood capillaries were formed at the site of the drug. The plant proved to be a potent analgesic and anti inflammatory agent at doses 1 00 mg/kg and 250 mg/kg. The anti bacterial activity was present but at higher doses. Conclusions: The parameters studied in the present investigation proved that the plant is a potent wound healer. Further in vivo wound healing studies on animal model is desired. As the extract showed potent analgesic, anti inflammatory and anti bacterial properties, it can be considered that when formulated into suitable formulation, and it can reduce the pain, inflammation and infections related to wound very well.

Comparative study of the analgesic efficacy of rectal tramadol versus intravenous tramadol for adult tonsillectomy

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Gadani, Hina N.; Chaudhary, Virendra Pratap

2010-01-01

Background: The optimal method for intra- and post-operative analgesia for adult tonsillectomy is uncertain. Tramadol hydrochloride is an analgesic with mixed mu and nonopioid activities, having less/no respiratory depression. Aim: The aim of our study was to compare the analgesic efficacy and nausea/vomiting produced by tramadol via intravenous and rectal administration during the first 24 h after anesthesia for adult tonsillectomy. Materials and Methods: The study design was prospective, ra...

Evaluation of analgesic and anti-inflammatory activity of a combination of tramadol-ibuprofen in experimental animals

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Chidambarann Suthakaran

2017-01-01

Full Text Available Background: Pain is the major concern of patients attending dental clinics, and satisfactory pain relief has always been difficult to achieve. Since the pathophysiology of pain is a complex, central and peripheral nervous system process, combined analgesic regimens with different mechanisms of action as a multimodal approach are becoming popular among the clinicians and dentists. Objectives: The aim of the present study was to evaluate the analgesic and anti-inflammatory activity of ibuprofen and tramadol when used alone or in combination in animal models of pain and inflammation. Animals and Methods: The animals were divided into six groups with six animals in each group. Analgesic activity was assessed by hot plate method in rats and by acetic acid-induced writhing test in mice. Paw edema model in rats after induction with 0.1 mL of 1% carrageenan was used to assess the anti-inflammatory activity. Statistical Analysis: Analysis of variance followed by Tukey's honestly significant difference post hoc test was used for statistical analysis. Results and Conclusion: Combined use of tramadol and ibuprofen provided enhanced analgesic and anti-inflammatory effects in animal models of pain and inflammation.

Analgesic Effect of Indian Gooseberry (Emblica officinalis Fruit Extracts on Postoperative and Neuropathic Pain in Rats

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Dong Wook Lim

2016-11-01

Full Text Available Indian gooseberry (Emblica officinalis fruit, also known as “Amla” is one of the oldest edible fruits known in India. It has also traditionally been used to treat inflammation, and as an analgesic to treat wounds. However, experimental evidence for the analgesic effects of E. officinalis has been lacking. The present study investigated whether E. officinalis extracts exhibit analgesic effects in the plantar incision (PI and spared nerve injury (SNI pain-model rats. We evaluated the mechanical withdrawal threshold (MWT using von Frey filaments, and pain-related behavior was determined after surgery based on ultrasonic vocalization (USV. The group treated with E. officinalis extracts at 300 mg/kg had significantly increased MWT values at 6 h and 24 h after the PI, and had a significantly reduced number of 22–27-kHz USVs at 6 h and 24 h after PI. Moreover, after 15 days of continuous treatment with E. officinalis extracts, the treated group showed significantly alleviated SNI-induced hypersensitivity and reduced pro-inflammatory cytokine levels. Thus, E. officinalis extracts have potential analgesic effects in both postoperative and neuropathic pain models in vivo.

Impact of analgesics on executive function and memory in the Alzheimer's Disease Neuroimaging Initiative Database.

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Doan, Lisa; Choi, Daniel; Kline, Richard

2017-10-01

Pain is common in older adults but may be undertreated in part due to concerns about medication toxicity. Analgesics may affect cognition. In this retrospective cohort study, we used the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to examine the interaction of cognitive status and medications, especially non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesized NSAID use would be associated with cognition and that this could be mediated through changes in brain structure. In this post hoc analysis of the ADNI database, subjects were selected by searching the "concurrent medications log" for analgesic medications. Subjects were included if the analgesic was listed on the medication log prior to enrollment in ADNI and throughout the study. Subjects taking analgesics, particularly NSAIDs, at each study visit were compared to control subjects taking no analgesics. Using descriptive statistics as well as univariate, multivariate and repeated measure ANOVA, we explored the relationship between NSAID use and scores for executive function and memory related cognitive activities. We further took advantage of the extensive magnetic resonance imaging (MRI) data available in ADNI to test whether cognitive change was associated with brain structure. The multitude of imaging variables was compressed into a small number of features (five eigenvectors (EV)) using principal component analysis. There were 87 NSAID users, 373 controls, and 71 taking other analgesics. NSAID use was associated with higher executive function scores for cognitively normal (NL) subjects as well as subjects with mild cognitive impairment (MCI). NSAID use was also associated with higher memory scores, but for NL females only. We analysed MRI data using principal component analysis to generate a set of five EVs. Examining NL and MCI subjects, one EV had significantly larger values in subjects taking NSAIDs versus control. This EV was one of two EVs which significantly correlated with

Avicenna's Canon of Medicine: a review of analgesics and anti-inflammatory substances

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Shahla Mahdizadeh

2015-04-01

Full Text Available Naturally occurring substances mentioned in medieval medical literatures currently have, and will continue to have, a crucial place in drug discovery. Avicenna was a Persian physician who is known as the most influential medical writers in the Middle ages. Avicenna`s Canon of Medicine, the most famous books in the history of medicine, presents a clear and organized summary of all the medical knowledge of the time, including a long list of drugs. Several hundred substances and receipts from different sources are mentioned for treatment of different illnesses in this book. The aim of the present study was to provide a descriptive review of all anti-inflammatory and analgesic drugs presented in this comprehensive encyclopedia of medicine. Data for this review were provided by searches of different sections of this book. Long lists of anti-inflammatory and analgesic substances used in the treatment of various diseases are provided. The efficacy of some of these drugs, such as opium, willow oil, curcuma, and garlic, was investigated by modern medicine; pointed to their potent anti-inflammatory and analgesic properties. This review will help further research into the clinical benefits of new drugs for treatment of inflammatory diseases and pain.

Evaluation of the antiulcerogenic and analgesic activities of Cordia verbenacea DC. (Boraginaceae).

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Roldão, Erika de Freitas; Witaicenis, Aline; Seito, Leonardo Noboru; Hiruma-Lima, Clélia Akiko; Di Stasi, Luiz Claudio

2008-09-02

Cordia verbenacea is a medicinal plant popularly used in Brazil as anti-inflammatory, antiulcer and anti-rheumatic agent without detailed pharmacological and toxicological studies. The study was aimed to investigate the effects of Cordia verbenacea in antiulcer, analgesic and antioxidant assays, as well as to evaluate its toxic effects and phytochemical profile. Antiulcer activity of plant extract was evaluated using ethanol/HCl, ethanol and piroxican-induced gastric lesions methods. The pH, volume and total acid of gastric juice were determined by pylorus-ligated assay. Analgesic activity was evaluated by writhing, tail-flick and hot-plate tests. Antioxidant activity was determined by in vitro lipoperoxidation assay. Acute toxicity and number of deaths were evaluated by Hippocratic screening. The ethanol leaf extract shows a potent antiulcer activity in the ethanol/HCl and absolute ethanol-induced gastric lesions. The IC(50) value of plant extract on the lipid peroxidation was 76.11mug/ml. Preliminary phytochemical tests were positive for flavonoids, steroids, saponins, fixed acids, alkaloids and phenols. In the analgesic models the extract did not present any activity. Cordial verbenaceae showed a potent antiulcer activity at the dose of 125mg/kg and this effect may be associated with an improvement in stomach antioxidant mechanisms.

Analgesic and Anti-inflammatory Activity of Teucrium chamaedrys Leaves Aqueous Extract in Male Rats

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Ali Pourmotabbed

2010-06-01

Full Text Available Objective(sCurrent study was undertaken to investigate the analgesic and anti-inflammatory effects of the aqueous extract of Teucrium chamaedrys in mice and rats. Materials and MethodsFor evaluating of analgesic and anti-inflammatory activity, we used the carrageenan- and dextran-induced paw oedema, acetic acid-induced writhing, tail flick and formalin pain tests.ResultsThe extract of T. chamaedrys (50–200 mg/kg and acetylsalicylic acid (100 mg/kg produced a significant (P< 0.01 inhibition of the second phase response in the formalin pain model, while only the high dose (200 mg/kg of the extract showed an analgesic effect in the first phase. The extract also inhibited acetic acid-induced abdominal writhes in a dose-dependent manner. The tail flick latency was dose dependently enhanced by the extract but this was significantly (P< 0.05 lower than that produced by morphine (10 mg/kg. The extract (25–250 mg/kg administered 1 hr before carrageenan-induced paw swelling produced a dose dependent inhibition of the oedema. No effect was observed with the dextran-induced oedema model. Results of the phytochemical screening show the presence of alkaloids, flavonoids and triterpenoids in the extract.ConclusionThe data obtained also suggest that the anti-inflammatory and analgesic effects of the extract may be mediated via both peripheral and central mechanisms. The role of alkaloids, flavonoids and triterpenoids will evaluate in future studies.

ANALGESIC EFFECT OF INTRATHECAL BACLOFEN BOLUS ON NEUROPATHIC PAIN IN SPINAL CORD INJURY PATIENTS.

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Kumru, Hatice; Benito-Penalva, Jesus; Kofler, Markus; Vidal, Joan

2018-05-18

GABA-ergic neurons are widely distributed throughout the central nervous system, including the spinal cord which is important for the transmission of pain impulses to the brain. Here we hypothesized that intrathecal baclofen (ITB) which is a GABA analogue might exert analgesic effects on neuropathic pain, which could be related to subtypes of pain in spinal cord injury (SCI). SCI patients with a cervical or thoracic lesion and neuropathic pain were randomized to receive either a single ITB bolus or placebo. Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory (NPSI), and Brief Pain Inventory (BPI) were obtained for assessment of neuropathic pain. Spasticity was assessed using Modified Ashworth Scale and visual analogue scale. Evaluations were performed at baseline, and 4, 8, and 24 hours after application of ITB or placebo. Eight patients received ITB, 5 placebo. Neuropathic pain improved significantly in the ITB group based on NRS, BPI, and NPSI, which revealed an effect on all subtypes of pain. Spasticity declined significantly. In the placebo group, there was neither significant change in pain nor in spasticity. An ITB bolus exerted a significant analgesic effect on all subtypes of neuropathic pain in SCI patients. ITB has analgesic effects on all subtypes of neuropathic pain and can improve interference of neuropathic pain with activities of daily living. ITB might be a promising analgesic treatment to control neuropathic pain. Copyright © 2018. Published by Elsevier Inc.

Evaluation of the analgesic and anti-inflammatory activity of fixed dose combination: Non-steroidal anti-inflammatory drugs in experimental animals

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Amit Lahoti

2014-01-01

Conclusion: Combining paracetamol with ibuprofen enhances analgesic/anti-inflammatory activity over their individual component but potentiation of analgesic activity of diclofenac was not seen when paracetamol was added to it.

Analgesic efficacy of ultrasound guided versus landmark-based bilateral superficial cervical plexus block for thyroid surgery

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Rasha M. Hassan

2017-10-01

Full Text Available Background: The use of bilateral superficial cervical plexus block (BSCPB to provide analgesia for thyroid operations remains debatable. This study was done to assess the analgesic efficacy and safety of ultrasound (US guided or landmark-based BSCPB, performed under general anesthesia, compared to systemic narcotics in thyroid surgery. Patients and methods: A total of 69 patients ASA I and II scheduled for thyroid surgery were randomly assigned into three groups (23 patients each: Group (US received US guided BSCPB. Group (LM received landmark-based BSCPB. In both groups, the block was performed under general anesthesia and before surgery using 0.5% bupivacaine 12 ml on each side. Group (C who didn’t receive any block. We measured intra-operative hemodynamics and fentanyl requirements. We also measured postoperative analgesia within 24 h of surgery as regard: pethidine consumption, visual analogue scale (VAS pain scores and time to first rescue analgesic demand. Postoperative nausea and vomiting (PONV and other adverse events were noted as well. Results: There was a significant reduction in systolic blood pressure (SBP and heart rate (HR in groups US and LM compared with group C. Intra-operative fentanyl requirements were significantly increased in group C compared to groups US and LM. Time to first analgesic request was significantly longer in groups US and LM than in group C. Postoperative pethidine consumption and VAS scores, measured during the first postoperative day, were significantly higher in group C than groups US and LM. No significant difference was noted between the three groups regarding PONV. No other adverse events were recorded. No significant differences were noted between groups US and LM. Conclusion: BSCPB (US guided or landmark-based, performed under general anesthesia, effectively decreased peri-operative analgesic requirements in thyroid operations. However, there was no significant difference in analgesic efficacy or

Evaluation of the Analgesic Activity of the Methanolic Stem Bark Extract of Dialium Guineense (Wild)

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Ezeja, MI; Omeh, YS; Ezeigbo, II; Ekechukwu, A

2011-01-01

Background: Dialium guineense is a medicinal plant used by some communities of Enugu-Ezike in Enugu State, Nigeria for treatment of fever, headache and other diverse ailments. Objectives: The present study evaluated the analgesic activity of the methanolic stem bark extract of the plant. Method: Acetic acid-induced abdominal constriction or writhing, tail immersion and hot plate analgesic models in albino Wistar mice were used for the study. Three test doses (250, 500, 1000 mg/kg body weight)...

Conotoxins Targeting Neuronal Voltage-Gated Sodium Channel Subtypes: Potential Analgesics?

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Jeffrey R. McArthur

2012-11-01

Full Text Available Voltage-gated sodium channels (VGSC are the primary mediators of electrical signal amplification and propagation in excitable cells. VGSC subtypes are diverse, with different biophysical and pharmacological properties, and varied tissue distribution. Altered VGSC expression and/or increased VGSC activity in sensory neurons is characteristic of inflammatory and neuropathic pain states. Therefore, VGSC modulators could be used in prospective analgesic compounds. VGSCs have specific binding sites for four conotoxin families: μ-, μO-, δ- and ί-conotoxins. Various studies have identified that the binding site of these peptide toxins is restricted to well-defined areas or domains. To date, only the μ- and μO-family exhibit analgesic properties in animal pain models. This review will focus on conotoxins from the μ- and μO-families that act on neuronal VGSCs. Examples of how these conotoxins target various pharmacologically important neuronal ion channels, as well as potential problems with the development of drugs from conotoxins, will be discussed.

Psychological and drug abuse symptoms associated with nonmedical use of opioid analgesics among adolescents.

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Boyd, Carol J; Young, Amy; McCabe, Sean E

2014-01-01

Approximately 18% of US adolescents engaged in prescription opioid abuse in 2013. However, this estimate may be misleading because it includes both medical misusers and nonmedical users, and there is evidence that these are 2 groups that differ relative to substance abuse and criminal risk. Thus, this study does not combine medical and nonmedical users; rather, it seeks to better understand the characteristics of nonmedical users. This was a school-based, cross-sectional study that was conducted during 2009-2010 in southeastern Michigan with a sample of 2627 adolescents using a Web-based survey. Three mutually exclusive groups were created based on responses regarding medical and nonmedical use of opioid analgesics. Group 1 had never used an opioid analgesic, Group 2 used an opioid analgesic only as prescribed, and Group 3 nonmedically used an opioid analgesic. In addition, Group 3 was divided into 2 mutually exclusive subgroups (self-treaters and sensation-seekers) based on reasons for nonmedical use. A series of multinomial logistic regressions were conducted to determine if the groups differed on the presence of pain, psychological symptoms (e.g., affective disorder, conduct disorder, attention-deficit/hyperactivity disorder [ADHD]), and drug abuse. Sixty-five percent (65.0%) of the sample was white/Caucasian and 29.5% was African American. The average age was 14.8 years (SD = 1.9). Seventy percent (70.4%; n = 1850) reported no lifetime opioid use, 24.5% (n = 644) were medical users, 3.5% (n = 92) were nonmedical users who used for pain relief only, and 1.6% (n = 41) were classified as nonmedical users for reasons other than for pain relief (e.g., to get high). Both medical users and nonmedical users reported more pain and substance abuse symptoms compared with never users. Those nonmedical users who used opioids for sensation-seeking motivations had greater odds of having psychological symptoms. These data support the need to further consider subgroups of

Investigation of the Anti-Inflammatory and Analgesic Activities of Ethanol Extract of Stem Bark of Sonapatha Oroxylum indicum In Vivo

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K. Lalrinzuali

2016-01-01

Full Text Available Inflammation is all a pervasive phenomenon, which is elicited by the body in response to obnoxious stimuli as a protective measure. However, sustained inflammation leads to several diseases including cancer. Therefore it is necessary to neutralize inflammation. Sonapatha (Oroxylum indicum, a medicinal plant, is traditionally used as a medicine in Ayurveda and other folk systems of medicine. It is commonly used to treat inflammatory diseases including rheumatoid arthritis and asthma. Despite this fact its anti-inflammatory and analgesic effects are not evaluated scientifically. Therefore, the anti-inflammatory and analgesic activities of Sonapatha (Oroxylum indicum were studied in Swiss albino mice by different methods. The hot plate, acetic acid, and tail immersion tests were used to evaluate the analgesic activity whereas xylene-induced ear edema and formalin induced paw edema tests were used to study the anti-inflammatory activity of Sonapatha. The administration of mice with 250 and 300 mg/kg b.wt. of O. indicum reduced pain and inflammation indicating that Sonapatha possesses analgesic and anti-inflammatory activities. The maximum analgesic and anti-inflammatory activities were observed in mice receiving 300 mg/kg b.wt. of O. indicum ethanol extract. Our study indicates that O. indicum possesses both anti-inflammatory and analgesic activities and it may be useful as an anti-inflammatory agent in the inflammation related disorders.

The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic donor nephrectomy: A randomized controlled study

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Beena K Parikh

2013-01-01

Full Text Available Background: Transversus abdominis plane (TAP block is suitable for lower abdominal surgeries. Blind TAP block has many complications and uncertainty of its effects. Use of ultrasonography increases the safety and efficacy. This study was conducted to evaluate the analgesic efficacy of ultrasound (USG-guided TAP block for retroperitoneoscopic donor nephrectomy (RDN. Methods: In a prospective randomized double-blind study, 60 patients undergoing laparoscopic donor nephrectomy were randomly divided into two groups by closed envelope method. At the end of surgery, USG-guided TAP block was given to the patients of both the groups. Study group (group S received inj. Bupivacaine (0.375%, whereas control group (group C received normal saline. Inj. Tramadol (1 mg/kg was given as rescue analgesic at visual analog scale (VAS more than 3 in any group at rest or on movement. The analgesic efficacy was judged by VAS both at rest and on movement, time to first dose of rescue analgesic, cumulative dose of tramadol, sedation score, and nausea score, which were also noted at 30 min, 2, 4, 6, 12, 18, and 24 h postoperatively. Total tramadol consumption at 24 h was also assessed. Results: Patients in group S had significantly lower VAS score, longer time to first dose of rescue analgesic (547.13±266.96 min vs. 49.17±24.95 min and lower tramadol consumption (103.8±32.18 mg vs. 235.8±47.5 mg in 24 h. Conclusion: The USG-guided TAP block is easy to perform and effective as a postoperative analgesic regimen in RDN, with opioids-sparing effect and without any complications.

Analgesic activity of a triterpene isolated from Scoparia dulcis L. (Vassourinha).

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Freire, S M; Torres, L M; Roque, N F; Souccar, C; Lapa, A J

1991-01-01

Analgesic and anti-inflammatory activities of water (WE) and ethanolic (EE) extracts of Scoparia dulcis L. were investigated in rats and mice, and compared to the effects induced by Glutinol, a triterpene isolated by purification of EE. Oral administration (p.o.) of either WE or EE (up to 2 g/kg) did not alter the normal spontaneous activity of mice and rats. The sleeping time induced by sodium pentobarbital (50 mg/kg, i.p.) was prolonged by 2 fold in mice pretreated with 0.5 g/kg EE, p.o. Neither extract altered the tail flick response of mice in immersion test, but previous administration of EE (0.5 g/kg, p.o.) reduced writhings induced by 0.8% acetic acid (0.1 ml/10 g, i.p.) in mice by 47%. EE (0.5 and 1 g/kg, p.o.) inhibited the paw edema induced by carrageenan in rats by respectively 46% and 58% after 2 h, being ineffective on the paw edema induced by dextran. No significant analgesic or anti-edema effects were detected in animals pretreated with WE (1 g/kg, p.o.). Administration of Glutinol (30 mg/kg, p.o.) reduced writhing induced by acetic acid in mice by 40% and the carrageenan induced paw edema in rats by 73%. The results indicate that the analgesic activity of S. dulcis L. may be explained by an anti-inflammatory activity probably related to the triterpene Glutinol.

Analgesic activity of a triterpene isolated from Scoparia dulcis L. (vassourinha

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Sonia M. F. Freire

1991-01-01

Full Text Available Analgesic and anti-inflammatory activities of water (WE and ethanolic (EE extracts of Scoparia dulcis L. were investigated in rats and mice, and compared to the effects induced by Glutinol, a triterpene isolated by purification of EE. Oral adminsitration (p.o. of either WE or EE (up to 2 g/Kg did not alter the normal spontaneous activity of mice and rats. The sleeping time induced by sodium pentobarbital (50 mg/Kg, i.p. was prolonged by 2 fold in mice pretreated with 0.5 g/Kg EE, p.o. Neither extract altered the tail flick response of mice in immersion test, but previous administration of EE (0.5 g/Kg, p.o. reduced writhings induced by 0.8% acetic acid (0.1 ml/10 g, i.p. in mice by 47% EE (0.5 and 1 g/Kg, p.o. inhibited the paw edema induced by carrageenan in rats by respectively 46% and 58% after 2 h, being ineffective on the paw edema induced by dextran. No significant analgesic or anti-edema effects were detected in animals pretreated with WE (1 g/Kg, p.o.. Administration of Glutinol (30 mg/Kg, p.o. reduced writhing induced by acetic acid in mice by 40% and the carrageenan induced paw edema in rats by 73%. The results indicate that the analgesic activity of S dulcis L. may be explained by explained by an anti-inflammatory activity probably related to the triterpene Glutinol.

Analgesic Activity of Some 1,2,4-Triazole Heterocycles Clubbed with Pyrazole, Tetrazole, Isoxazole and Pyrimidine

OpenAIRE

Gajanan Khanage, Shantaram; Raju, Appala; Baban Mohite, Popat; Bhanudas Pandhare, Ramdas

2013-01-01

Purpose: In the present study in vivo analgesic activity of some previously synthesized 1,2,4-triazole derivatives containing pyrazole, tetrazole, isoxazole and pyrimidine ring have been evaluated. Methods: Acetic acid induced writhing method and Hot plate method has been described to study analgesic activity of some 1,2,4-triazole derivatives containing pyrazole, tetrazole, isoxazole and pyrimidine as a pharmacological active lead. Results: Thirty six different derivatives con...

Analgesic, anti-inflammatory and anti-pyretic activities of aqueous ethanolic extract of Tamarix aphylla L. (Saltcedar) in mice.

Science.gov (United States)

Qadir, Muhammad Imran; Abbas, Khizar; Hamayun, Rahma; Ali, Muhammad

2014-11-01

The objective of the study was to investigate the analgesic, anti-inflammatory and anti-pyretic activity of aqueous ethanolic extracts of Tamarix aphylla. The powdered plant was extracted by the method of cold maceration using aqueous ethanol (70:30) as solvents. Analgesic activity was assessed by Eddy's hot plate method, formalin-induced paw licking and acetic acid-induced writhing in mice. Anti-inflammatory activity was evaluated by carageenan-induced mice paw edema. The anti-pyretic activity was determined by yeast-induced pyrexia in mice. The aqueous ethanolic extract of Tamarix aphylla showed 42% inhibition (pTamarix aphylla exhibit analgesic and antipyretic activity but lacks anti-inflammatory activity.

Analgesic and anti-inflammatory activities of the water extract from ...

African Journals Online (AJOL)

Background: In ayurvedic and Thai traditional medicine, the fruit of T. chebula is useful in arthritic disorders, inflammation, tumor, pains, chronic and recurrent fever. The study investigated the analgesic and anti-inflammatory activities in animal models. Materials and methods: The water extract of T. chebula fruit was ...

Anti-inflammatory and analgesic effects of Careya arborea stem bark ...

African Journals Online (AJOL)

The present study was carried out to evaluate the anti-inflammatory and analgesic activities of methanol extract of Careya arborea (MECA). The effects of MECA on the acute and chronic phases of inflammation were studied in carrageenan, dextran and mediators (histamine and serotonin) induced paw oedema and cotton ...

Analgesic and anti-inflammatory activities of the n-butanol fraction of ...

African Journals Online (AJOL)

BF) using standard procedures. The median lethal dose (LD50) of the fraction was determined using Lorke's method and the analgesic effect was evaluated using acetic acid-induced writhing test in mice, while the anti-inflammatory activity was ...

An ethnobotanical study of medicinal plants with narcotic, sedative and analgesic effects in west of Iran.

Science.gov (United States)

Saki, K; Bahmani, M; Rafieianb-Kopaei, M D; Asadollahi, K; Emaneini, M; Taherikalani, M

2016-01-01

The first step for identification of medicinal plants and their therapeutic effects is to determine their use by local people, traditional medicine books and personal experiences. The aim of this study was to document the medicinal plants used as analgesic, sedative or narcotic agents by local residents of Dehloran, Iran. Interviews conducted with 53 informants (38 male and 15 female) revealed that a total of 32 medicinal plants belonging to 22 families are used in Dehloran as narcotic, sedative and analgesic agents. The most utilized plant families were Asteraceae, Rosaceae and Fabaceae. Approximately 74% of the utilized plants was attributed to herbs, followed by trees (13%) and shrubs (13%). Sixty-six percent of the medicinal plants used in the study area were perennial and the rest were annual or biannual. The most widely used plant parts were flowers (34%) followed by leaves (24%) and fruits (14%). Thirty-nine percent of the medicinal plants were used as sedatives, 39% as analgesics, and 24% as narcotics. Recommended plants in this study can be good candidates for further clinical and laboratory trials on diseases that are associated with pain, suffering, stress and depression. They also can be used to develop new sedative, narcotic and analgesic drugs.

Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States, 1998-2012.

Science.gov (United States)

McGinty, Emma E; Kennedy-Hendricks, Alene; Baller, Julia; Niederdeppe, Jeff; Gollust, Sarah; Barry, Colleen L

2016-04-01

Opioid analgesic abuse is a complex and relatively new public health problem, and to date little is known about how the news media frame the issue. To better understand how this issue has been framed in public discourse, an analysis was conducted of the volume and content of news media coverage of opioid analgesic abuse over a 15-year period from 1998 to 2012 (N=673 news stories). A 70-item structured coding instrument was used to measure items in four domains that prior research suggests can influence public attitudes about health and social issues: causes, solutions, and consequences of the problem and individual depictions of persons who abuse opioid analgesics. Although experts have deemed opioid analgesic abuse a public health crisis, results of our study suggest that the news media more often frame the problem as a criminal justice issue. The most frequently mentioned cause of the problem was illegal drug dealing, and the most frequently mentioned solutions were law enforcement solutions designed to arrest and prosecute the individuals responsible for diverting opioid analgesics onto the illegal market. Prevention-oriented approaches, such as prescription drug-monitoring programs, were mentioned more frequently in the latter years of the study period, but less than 5% of news stories overall mentioned expanding substance abuse treatment, and even fewer mentioned expanding access to evidence-based medication-assisted treatments, such as buprenorphine. Findings underscore the need for a concerted effort to reframe opioid analgesic abuse as a treatable condition addressable via well-established public and behavioral health approaches.

A study of anti-inflammatory and analgesic activity of new 2,4,6-trisubstituted pyrimidines.

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Yejella, Rajendra Prasad; Atla, Srinivasa Rao

2011-01-01

Chalcone derivatives (3a-m) were prepared by condensing 4-aminoacetophenone with various substituted aromatic and hetero aromatic aldehydes according to Claisen-Schmidt condensation. These chalcones, on reaction with guanidine hydrochloride under basic alcoholic conditions gave 2,4,6-trisubstituted pyrimidines (5a-m) in quantitative yields. All the newly synthesized pyrimidines were characterized by means of IR, ¹H- and ¹³C-NMR, Electron Ionization (EI)-mass and elemental analyses and screened for anti-inflammatory and analgesic activities by in vivo. 2-amino-4-(4-aminophenyl)-6-(2,4-dichlorophenyl)pyrimidine (5b) and 2-amino-4-(4-aminophenyl)-6-(3-bromophenyl) pyrimidine (5d) were found to be the most potent anti-inflammatory and analgesic activity compared with ibuprofen, reference standard. And also it was found that compound 5b identified as lead structure among all in both the activities. Pyrimidines which showed good anti-inflammatory activity also displayed better analgesic activity.

In vivo analgesic activity and safety assessment of Vitis vinifera L ...

African Journals Online (AJOL)

grape) and Punica granatum (pomegranate) in Albino mal mice. Methods: The analgesic activity of fruit extracts of V. vinifera and P. granatum were examined in vivo using thermal stimulus assays (i.e., tail immersion and hot plate) and acetic ...

The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis.

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Alvin Ho Yeung Au

Full Text Available To run a systematic review and meta-analysis of randomized clinical trials aiming to answer the clinical question "which analgesic combination and dosage is potentially the most effective and safe for acute post-operative pain control after third molar surgery?".A systematic search of computer databases and journals was performed. The search and the evaluations of articles were performed by 2 independent reviewers in 3 rounds. Randomized clinical trials related to analgesic combinations for acute post-operative pain control after lower third molar surgery that matched the selection criteria were evaluated to enter in the final review.Fourteen studies with 3521 subjects, with 10 groups (17 dosages of analgesic combinations were included in the final review. The analgesic efficacy were presented by the objective pain measurements including sum of pain intensity at 6 hours (SPID6 and total pain relief at 6 hours (TOTPAR6. The SPID6 scores and TOTPAR6 scores of the reported analgesic combinations were ranged from 1.46 to 6.44 and 3.24 - 10.3, respectively. Ibuprofen 400mg with oxycodone HCL 5mg had superior efficacy (SPID6: 6.44, TOTPAR6: 9.31. Nausea was the most common adverse effect, with prevalence ranging from 0-55%. Ibuprofen 200mg with caffeine 100mg or 200mg had a reasonable analgesic effect with fewer side effects.This systematic review and meta-analysis may help clinicians in their choices of prescribing an analgesic combination for acute post-operative pain control after lower third molar surgery. It was found in this systematic review Ibuprofen 400mg combined with oxycodone HCL 5mg has superior analgesic efficacy when compared to the other analgesic combinations included in this study.

Molecular docking and analgesic studies of Erythrina variegata׳s derived phytochemicals with COX enzymes.

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Uddin, Mir Muhammad Nasir; Emran, Talha Bin; Mahib, Muhammad Mamunur Rashid; Dash, Raju

2014-01-01

Secondary metabolites from plants are a good source for the NSAID drug development. We studied the analgesic activity of ethanolic extract of Erythrina variegata L. (Fabaceae) followed by molecular docking analysis. The analgesic activity of Erythrina variegata L. is evaluated by various methods viz., acetic acid-induced writhing test, hot plate and tail immersion test. Subsequently, molecular docking analysis has been performed to identify compounds having activity against COX-1 and COX-2 enzymes by using GOLD docking fitness. The result of preliminary phytochemical screening revealed that the extract contains alkaloids and flavonoids. In analgesic activity tests, the extract at the doses of 50, 100 and 200 mg/kg body weight (b.w.) produced a increase in pain threshold in a dose dependent manner. In acetic acid induced writhing test, the inhibitory effect was similar to the reference drug diclofenac sodium. The extract showed 18.89% writhing inhibitory effect at the dose 200 mg/kg b.w., whereas diclofenac sodium showed 79.42% inhibition of writhing at a dose of 10 mg/kg b.w. The results of tail immersion and hot plate test also showed potential analgesic activity of the extract which is also comparable to the standard drug morphine (5 mg/kg b.w.). Docking studies shows that phaseollin of Erythrina variegata L. has the best fitness score against the COX-1 which is 56.64 and 59.63 for COX- 2 enzyme. Phaseollin of Erythrina variegata L. detected with significant fitness score and hydrogen bonding against COX-1 and COX-2 is reported for further validation.

Investigation of the in vitro metabolism of the analgesic flupirtine

Czech Academy of Sciences Publication Activity Database

Methling, K.; Reszka, P.; Lalk, M.; Vrána, Oldřich; Scheuch, E.; Siegmund, W.; Terhaag, B.; Bednarski, P.J.

2009-01-01

Roč. 37, č. 3 (2009), s. 479-493 ISSN 0090-9556 R&D Projects: GA AV ČR(CZ) 1QS500040581 Institutional research plan: CEZ:AV0Z50040507; CEZ:AV0Z50040702 Keywords : flupirtine * analgesic * metabolism Subject RIV: BO - Biophysics Impact factor: 3.743, year: 2009

Anti-inflammatory and analgesic activities of the aqueous extract of ...

African Journals Online (AJOL)

Carrageenan and histamine-induced rat paw oedema were conducted to evaluate anti-inflammatory activity, while acetic acid-induced writhing test was conducted to assess the analgesic activity of the plant. The extract was administered intraperitoneally (i.p) to rats at graded doses of 50, 100, 200 mg/kg body weight (BWt).

Analgesic and Anti-inflammatory Effects of the Aqueous Leaf Extract ...

African Journals Online (AJOL)

ADOWIE PERE

suggest that the extract possesses anti-inflammatory and analgesic effects, which may be mediated solely by ... were then carefully separated from the stem; air dried for 7 days and pulverized using an electric mill. ... venier caliper, baseline measurement of the right hind .... to the release of mast cell autacoids like histamine.

In vivo analgesic activity, toxicity and phytochemical screening of the hydroalcoholic extract from the leaves of Psidium cattleianum Sabine.

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Alvarenga, Felipe Queiroz; Mota, Bárbara C F; Leite, Marcel N; Fonseca, Jaciara M S; Oliveira, Dario A; Royo, Vanessa de Andrade; e Silva, Márcio L A; Esperandim, Viviane; Borges, Alexandre; Laurentiz, Rosangela S

2013-10-28

Psidium cattleianum Sabine is extensively used in Brazilian traditional medicine to treat several diseases including painful disorders. Aim of the study to investigate the toxicity and the possible analgesic activities of the hydroalcoholic extract from the leaves of Psidium cattleianum Sabine (ELPCS), to support its use in folk medicine. To screen the major phytochemical constituents of this extract and evaluate their antioxidant activity. ELPCS was assessed for its antioxidant activity using the DPPH model. Its analgesic activity was examined using mouse models of acetic acid-induced writhing and hot plate paw licking models. The major phytochemical constituents of the extract were screened; their toxicity on LLC-MK2 mammalian cells was evaluated. ELPCS exhibited significant peripheral analgesic activity at doses of 60, 80, 100, 200 and 400mg/kg in mice, but it did not display central analgesic activity and not was toxic to LLC-MK2 cell (LD50>400 µg/mL). The extract exhibited free radical scavenging activity as evidenced by IC50 values (15.9 µg/mL) obtained by the DPPH method. Phytochemical screening detected flavonoids, saponins, cardiac glycosides, anthraquinones, and tannins. The results of the experimental studies proved the analgesic activity of ELPCS and supported the traditional use of this plant. © 2013 Elsevier Ireland Ltd. All rights reserved.

Chronic daily headache with analgesics overuse in professional women breath-hold divers.

Science.gov (United States)

Choi, Jay Chol; Lee, Jung Seok; Kang, Sa-Yoon; Kang, Ji-Hoon; Bae, Jong-Myon

2008-07-01

The object of this study is to investigate the prevalence and characteristics of headache in Korean professional women breath-hold divers, including their overuse of analgesics. Headache is a common problem encountered in clinical practice, and undersea divers exhibit unique causes of headache in addition to other common primary headaches. Many scuba divers are known to use various types of drugs to overcome dive-related symptoms or to enhance their underwater performance. The target population of this study was women divers in the northern district of Jeju Island who were registered in the divers' union. Data were collected using telephone interviews with a structured questionnaire. Headache was diagnosed and classified according to criteria of the International Headache Society. Nine hundred and eleven (80.3%) divers responded to the telephone interview. The prevalence rates of headache were 21.4% for tension-type headache and 9.1% for migraine. One hundred and four divers (11.4%) fulfilled the criteria for chronic daily headache (CDH). Overuse of combination analgesics was reported by 70.7% of divers. Women divers with CDH were significantly older and they complained more of tinnitus and dizziness, and had a greater history of hypertension than divers without headache. The prevalence of CDH is high in Korean professional women breath-hold divers, with many of them being combination-analgesics overusers.

Analgesic activity of Gleditsia triacanthos methanolic fruit extract and its saponin-containing fraction.

Science.gov (United States)

Saleh, Dalia Osama; Kassem, Iman; Melek, Farouk Rasmy

2016-01-01

Gleditsia triacanthos L. (Leguminosae) pods are used in folk medicine for pain relief as anodyne and narcotic. The objective of this study is to evaluate analgesic activity of Gleditsia triacanthos methanolic fruit extract (MEGT) and its saponin-containing fraction (SFGT). Peripheral analgesic activity was assessed using the acetic acid-induced writhing model in mice at doses of 140, 280, and 560 mg/kg and formalin test in rats at 100, 200, and 400 mg/kg doses. Central analgesic activity was evaluated using the hotplate method in rats (100, 200, and 400 mg/kg). In the writhing test, six mice groups treated with MEGT and SFGT found ED50 values 268.2 and 161.2 mg/kg, respectively, displayed a significant decrease in writhing count compared with the group treated with standard drug indomethacin (14 mg/kg). SFGT (280 and 560 mg/kg) showed 64.94 and 70.78% protection, respectively, which are more than double % protection caused by indomethacin (31.82%). In the formalin test, MEGT and SFGT (ED50 values 287.6 and 283.4 mg/kg for phase I as well as 295.1 and 290.4 mg/kg for phase II, respectively) at 400 mg/kg showed significant % inhibition in both phase I (18.86 and 52.57%) and phase II (39.36 and 44.29%) with reference to 10 mg/kg indomethacin (56.0 and 32.29%). MEGT and SFGT caused significant delay in responses in hotplate model (ED50 values 155.4 and 200.6 mg/kg, respectively) compared with that of 10 mg/kg indomethacin at 30, 60, and 120 min. Central and peripheral analgesic activities induced by Gleditsia triacanthos fruits might account for its uses in folk medicine.

Down-regulation of NR2B receptors partially contributes to analgesic effects of Gentiopicroside in persistent inflammatory pain.

Science.gov (United States)

Chen, Lei; Liu, Jin-cheng; Zhang, Xiao-nan; Guo, Yan-yan; Xu, Zhao-hui; Cao, Wei; Sun, Xiao-li; Sun, Wen-ji; Zhao, Ming-Gao

2008-06-01

Gentiopicroside is one of the secoiridoid compound isolated from Gentiana lutea. It exhibits analgesic activities in the mice. The anterior cingulate cortex (ACC) is a forebrain structure known for its roles in pain transmission and modulation. Painful stimuli potentiate the prefrontal synaptic transmission and induce glutamate NMDA NR2B receptor expression in the ACC. But little is known about Gentiopicroside on the persistent inflammatory pain and chronic pain-induced synaptic transmission changes in the ACC. The present study was undertaken to investigate its analgesic activities and central synaptic modulation to the peripheral painful inflammation. Gentiopicroside produced significant analgesic effects against persistent inflammatory pain stimuli in mice. Systemic administration of Gentiopicroside significantly reversed NR2B over-expression during the chronic phases of persistent inflammation caused by hind-paw administration of complete Freunds adjuvant (CFA) in mice. Whole-cell patch clamp recordings revealed that Gentiopicroside significantly reduced NR2B receptors mediated postsynaptic currents in the ACC. Our findings provide strong evidence that analgesic effects of Gentiopicroside involve down-regulation of NR2B receptors in the ACC to persistent inflammatory pain.

Comparison of analgesic efficacy of flupirtine maleate and ibuprofen in gynaecological ambulatory surgeries: A randomized controlled trial

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Vanita Ahuja

2015-01-01

Full Text Available Background and Aims: Flupirtine maleate is a centrally acting, non-opioid analgesic with unique muscle relaxant properties as compared to common analgesics. The aim of this study was to compare post-operative analgesic efficacy of flupirtine maleate and ibuprofen in patients undergoing gynaecological ambulatory surgeries. Methods: This prospective, randomised controlled study was conducted in 60 women of American Society of Anesthesiologists physical status I/II, 18-70 years of age and scheduled to undergo gynaecological ambulatory surgeries. The participants were randomised to receive either 100 mg oral flupirtine maleate (group flupirtine, n = 30 or 800 mg oral ibuprofen (group ibuprofen, n = 30, 1 h prior to surgery and then every 8 h for 48 h. Verbal Numerical Rating Scale (VNRS on movement was assessed at 0, 2, 4, 6 and 8 h following surgery. Following discharge from hospital, the patients were interviewed telephonically at 12, 24 and 48 h post-operatively. VNRS was statistically analysed using Mann-Whitney test. Results: VNRS on movement was statistically reduced at 2 h after surgery (P = 0.04 in group flupirtine as compared to group ibuprofen. The analgesic efficacy was similar in both the groups at 4, 6, 8, 12, 24 and 48 h after surgery. The satisfaction scores at 24 and 48 h post-operatively were superior in group flupirtine as compared to group ibuprofen (P < 0.001. Conclusion: Analgesic efficacy of flupirtine maleate was comparable with ibuprofen in patients in ambulatory gynaecological patients up to 48 h postoperatively with superior satisfaction scores.

Antipyretic and Analgesic Effects of the Aqueous Extract of the Fruit ...

African Journals Online (AJOL)

The analgesic effect of the extract was evaluated using acetic acid-induced mouse writhing test. The extract was tested for antimicrobial activity against Staphylococcus aureus, Klebsiella pnuemoniae, Escherichia coli, and Psuedomonas aeruginosa using agar diffusion method. Phytochemical screening of the plant extract ...

Role of Magnesium Sulfate in Prolonging the Analgesic Effect of ...

African Journals Online (AJOL)

antinociceptive effect in animal and human pain models. i.v magnesium ... about 30 min prior to surgery followed by continuous infusion at the rate of 10 mg/kg/h for the next 24 h while the other group received similar ... of analgesia and reduces postoperative analgesic consumption without any significant side effects.

Analgesic and Anti-inflammatory Profile of n-Hexane Fraction of ...

African Journals Online (AJOL)

HP

inflammatory activities (carrageenan-induced and histamine-induced edema models) in BALB/c mice. Results: VBHF exhibited significant (p ... The analgesic effect of VBHF was dose-dependent in acetic acid pain model while the extract was a weak ... In Pakistan, it is found in Swat, Hazara and. Dir and used as antipyretic, ...

Analgesic and anti-inflammatory effects of kaviiron (a Garcinia kola ...

African Journals Online (AJOL)

Kolaviron is a defatted ethanol extract from the seeds of Garcinia Kola. In the present study, the analgesic and anti-inflammatory properties of Kolaviron is investigated using both thermal and chemical models of pain assessment in mice and rats. Varying doses of Kolaviron were given 30 minutes prior to the induction of ...

THE EFFECTS OF INTRATHECAL NEOSTIGMINE ADDED TO BUPIVACAINE ON POSTOPERATIVE ANALGESIC REQUIREMENT IN PATIENTS UNDERGOING LOWER LIMB ORTHOPEDIC SURGERY.

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Kayalha, Hamid; Mousavi, Zinat; Sadat Barikani, Ameneh; Yaghoobi, Siamak; Khezri, Marzieh Beigom

2015-06-01

Several additives have been suggested to enhance analgesic effect of local anesthetic agents to decrease the adverse effects of them and increase the degree of satisfaction. We designed this randomized double-blind controlled study to evaluate the analgesic efficacy of the neostigmine added to bupivacaine using spinal anesthesia in patients undergoing lower limb orthopedic surgery. Sixty patients 18-80 yr old American Society of Anesthesiologists (ASA) physical status I or II, scheduled for femur surgery under spinal anesthesia, were recruited in a prospective, double-blinded, randomized way. The patients were randomly allocated to one of two groups of 30 each. The neostigmine group (group N) received bupivacaine 20 mg combined with 25 µg neostigmine, and the placebo group (group C) received bupivacaine 20 mg combined with 0.5ml distilled water (intrathecally) 5 minutes prior to surgery. The time to the first analgesic request, analgesic requirement in the first 12 hours after surgery, the duration of sensory and motor blockade, the incidence of adverse effects such as nausea,vomiting,hypotension, ephedrine requirements, bradycardia, and hypoxemia were recorded. Patients receiving neostigmine had a significantly prolonged duration of motor block (C95% CI 30.27 to 87.65; P < 0.001) and sensory block (C95% CI 101.04 to 224.64; P < 0.001) compared to the control group. The difference of the mean time to the first analgesic request was also significantly longer in neostigmine group (C95% CI 83.139 to 208.526; P < 0.001). The total analgesic consumption during the first 12 hours after surgery was devoid of any significant difference between groups N and C (p = 0.41).The two groups were not significantly different in terms of intraoperative and postoperative side effects. Intrathecal neostigmine 25 µg with bupivacaine caused a prolonged time to the first analgesic request and its use was not associated with any side effects.

[Nootropic and analgesic effects of Semax following different routes of administration].

Science.gov (United States)

Manchenko, D M; Glazova, N Iu; Levitskaia, N G; Andreeva, L A; Kamenskiĭ, A A; Miasoedov, N F

2010-10-01

Heptapeptide Semax (MEHFPGP) is the fragment of ACTH(4-10) analogue with prolonged neurotropic activity. The aim of the present work was to study the Semax effects on learning capability and pain sensitivity in white rats following intraperitoneal and intranasal administration in different doses. Semax nootropic effects were studied in the test of acquisition of passive avoidance task. Pain sensitivity was estimated in Randall-Selitto paw-withdrawal test. It was shown that Semax exerts nootropic and analgesic activities following intraperitoneal administration. Analysis of dependence of these effects on dose resulted in different dose-response curves. Following intranasal administration, Semax was more potent in learning improvement compared to intraperitoneal administration. The peptide failed to affect the animal pain sensitivity following intranasal administration as opposed to intraperitoneal administration. The data obtained suggest different mechanisms and brain structures involved in realization of the nootropic and analgesic effects of Semax.

Analgesic stairway in the treatment of oncological pain

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Sarah María Regueira Betancourt

2015-10-01

Full Text Available Pain represents the main symptom in an important group of patients who are in active treatment for cancer and in sick people in a very advanced stage. The objective of this article is to review the basic pharmacology of the nonsteroidal antiinflammatory drugs, weak opioids, bigger opioids, as well as the different special pharmacological and non- pharmacological techniques that constitute the analgesic stairway in the management of patients who are suffering from oncological pain.

Influence of serotonin on the analgesic effect of granisetron on temporomandibular joint arthritis.

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Voog, Ulle; Alstergren, Per; Leibur, Edvitar; Kallikorm, Riina; Kopp, Sigvard

2004-01-01

The influence of circulating serotonin (5-HT) on the effects of intra-articular administration of granisetron on temporomandibular joint (TMJ) pain was investigated in 11 patients with chronic polyarthritides. An analgesic effect superior to placebo has been shown previously. The change in TMJ movement pain intensity was negatively correlated to circulating 5-HT; that is, the higher the 5-HT before injection, the greater the reduction of pain intensity. The resting pain intensity reduction was not related to 5-HT. In conclusion, this study indicates a stronger short-term analgesic effect on TMJ movement pain by intra-articular administration of the 5-HT3 receptor antagonist granisetron in patients with high levels of circulating 5-HT. PMID:15770056

Biophysical parameters of erythrocyte membranes and mechanisms of interaction with non-opioid analgesics under acute pain syndrome

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Yu. I. Gubskyi

2014-06-01

Full Text Available Methods of fluorescent probing, spectrophotometry and microcalorimetry were applied to investigate the alterations in biophysical parameters of erythrocytes membranes, and specifically microviscosity, surface charge, molecular organization of lipid bilayer and lipid-protein interactions under conditions of acute pain syndrome produced by experimental chemical lesion. The distinctive features of non-opiod analgesics interactions and binding to the erythrocytes membranes of rats subjected to acute nociceptive pain accompanied with oxidative stress development were investigated. The abilities of analgesics under research, and namely paracetamol, aspirin, phenazone, ketorolac, pyrodazole, ketoprofenum, natrium mefenaminate, indometacin, nimesulide to make up physico-chemical complexes with lipoperoxidation modified erythrocytes surface and protein-lipid bilayer showed marked changes. The significance of oxidative damage of biophase under conditions of acute pain syndrome for analgesics effective pharmacodynamics and pharmacokinetics realization is under consideration.

Analgesic, diuretic, and anti-inflammatory principle from Scoparia dulcis.

Science.gov (United States)

Ahmed, M; Shikha, H A; Sadhu, S K; Rahman, M T; Datta, B K

2001-08-01

Scoparinol, a diterpene, isolated from Scoparia dulcis showed significant analgesic (p < 0.001) and anti-inflammatory activity (p < 0.01) in animals. A sedative action of scoparinol was demonstrated by a marked potentiation of pentobarbital-induced sedation with a significant effect on both onset and duration of sleep (p < 0.05). Measurement of urine volume after administration of scoparinol indicated its significant diuretic action.

Analgesic effect of coconut shell (Cocos nucifera L liquid smoke on mice

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Meircurius Dwi C.S

2012-09-01

Full Text Available Background: Drugs can be used to eliminate pain by inhibiting the activity of conversing arachidonic acid into prostaglandin. The chemical compositions of coconut shell are cellulose, pentosan, lignin, solvent extraction, uronat anhydrous, nitrogen, and water. One active ingredient in coconut shell is phenyl propanoid (consisting in lignin structure and guaicol. Phenyl propanoid and guaicol are phenolic compounds that can be used as antioxidant, antiseptic, anti-inflammatory, anesthetic and analgesic. Liquid smoke of coconut shell (Cocos nucifera L contains phenolic compound is believed able to bind a component conversing arachidonic acid into prostaglandin. Purpose: The study was aimed to examine the analgesic effect of liquid smoke of coconut shell (Cocos nucifera L. Methods: The study was a laboratory experimental research, conducted on 2-3 months old male mice (Mus musculus with 20-30 grams of weight. There were control group and treatment groups each of which had seven mice. Control group was orally given 0.01 ml/weight (ml/gr of distilled water, after 30 minutes 0.01 ml/weight (ml/gr of acetic acid 0.6% was delivered via intraperitoneal injection. The treatment groups were given liquid smoke of coconut shell (Cocos nucifera L with the concentrations of 25%, 50%, and 100% respectively. The analgesic effect was then determined by decreasing of writhing reflex on mice recorded every 5 minutes for 30 minutes. Results: There were significant differences of writhing reflexes in the treatment groups given liquid smoke of coconut shell with the concentrations of 25%, 50%, and 100%. The higher concentration of liquid smoke the higher its analgesic effect. Conclusion: Liquid smoke of coconut shell (Cocos nucifera L has analgesic effect.Latar belakang: Salah satu mekanisme obat yang digunakan untuk menghilangkan rasa nyeri adalah menghambat aktivitas konversi asam arakhidonat menjadi prostaglandin. Komposisi kimia tempurung kelapa terdiri dari

Analgesic, Anti-Inflammatory, and Antioxidant Activities of Byrsonima duckeana W. R. Anderson (Malpighiaceae

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Maria Christina dos Santos Verdam

2017-01-01

Full Text Available Background. Byrsonima is a promising neotropical genus, rich in flavonoids and triterpenes, with several proven pharmacological properties. Nevertheless, Byrsonima duckeana W. R. Anderson is an Amazonian species almost not studied. Objective. To assess the antioxidant, anti-inflammatory, and analgesic activities of Byrsonima duckeana leaves. Materials and Methods. We analyzed an ethanol extract and its fractions for polyphenol content and UHPLC-MS/MS, phosphomolybdenum, DPPH, TBARS antioxidant tests, formalin-induced pain, carrageenan-induced peritonitis, acetic acid-induced abdominal writhings, and hot plate assays. Results. All the samples showed high polyphenol content and antioxidant capacity in the phosphomolybdenum, DPPH, and TBARS tests. We identified ethyl gallate, quinic acid, gallic acid, catechin, epicatechin, quercetrin, and quercetin in the samples. B. duckeana was able to reduce leukocyte migration in the carrageenan-induced peritonitis by 43% and the licking time in the formalin test by 57%. In the acetic acid-induced writhing test, the chloroform (FCL and ethyl acetate (FEA fractions were the most active samples. FEA was selected for the hot plate test, where all the dosages tested (5, 50, and 200 mg·kg−1 showed significant analgesic activity. Conclusion. B. duckeana has interesting analgesic and antioxidant activities, due to its high phenolic content, especially phenolic acids.

Cocrystal of Ibuprofen–Nicotinamide: Solid-State Characterization and In Vivo Analgesic Activity Evaluation

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Yori Yuliandra

2018-06-01

Full Text Available Ibuprofen is classified as a BCS class II drug which has low solubility and high permeability. We conducted the formation of the cocrystalline phase of ibuprofen with coformer nicotinamide to increase its solubility. The purpose of this study was to characterize the solid state of cocrystalline phase of ibuprofen-nicotinamide, determine the solubility, and evaluate its in vivo analgesic activity. The cocrystal of ibuprofen-nicotinamide was prepared by a slow evaporation method. The solid-state characterization was conducted by powder X-ray diffraction (PXRD analysis, differential thermal analysis (DTA, and scanning electron microscopy (SEM. To investigate the in vivo analgesic activity, 28 male Swiss-Webster mice were injected with acetic acid 0.5% following oral administration of intact ibuprofen, physical mixture, and its cocrystalline phase with nicotinamide (equivalent to 26 mg/kg ibuprofen. The number of writhes was counted, and pain inhibition was calculated. All data were analyzed with one-way ANOVA followed by Duncan’s Multiple Range Test (95% confidence interval. The results revealed that a new cocrystalline phase was successfully formed. The solubility testing showed that the cocrystal formation enhanced the solubility significantly as compared with the physical mixture and intact ibuprofen. A significant increase in the analgesic activity of cocrystal ibuprofen-nicotinamide was also confirmed.

Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations.

Science.gov (United States)

Gasior, Maciej; Bond, Mary; Malamut, Richard

2016-01-01

Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.

Patient-reported opioid analgesic requirements after elective inguinal hernia repair: A call for procedure-specific opioid-administration strategies.

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Mylonas, Konstantinos S; Reinhorn, Michael; Ott, Lauren R; Westfal, Maggie L; Masiakos, Peter T

2017-11-01

A better understanding of the analgesia needs of patients who undergo common operative procedures is necessary as we address the growing opioid public health crisis in the United States. The aim of this study was to evaluate patient experience with our opioid prescribing practice after elective inguinal hernia repairs. A prospective, observational study was conducted between October 1, 2015, and September 30, 2016, in a single-surgeon, high-volume, practice of inguinal hernia operation. Adult patients undergoing elective inguinal herniorrhaphy under local anesthesia with intravenous sedation were invited to participate. All patients were prescribed 10 opioid analgesic tablets postoperatively and were counseled to reserve opioids for pain not controlled by nonopioid analgesics. Their experience was captured by completing a questionnaire 2 to 3 weeks postoperatively during their postoperative visit. A total of 185 patients were surveyed. The majority of the participants were males (177, 95.7%) and ≥60 years old (96, 51.9%). Of the 185 patients, 159 (85.9%) reported using ≤4 opioid tablets; 110 patients (59.5%) reported that they used no opioid analgesics postoperatively. None of the patients was taking opioids within 7 days of their postoperative appointment. Of the 147 patients who were employed, 111 (75.5%) reported missing ≤3 work days, 57 of whom (51.4%) missed no work at all. Patients who were employed were more likely to take opioid analgesics postoperatively (P = .049). Patients who took no opioid analgesics experienced less maximum (P require any opioid analgesics, and nearly all of those who thought that they did need opioids used reserved.

Antioxidant, antimicrobial, cytotoxic and analgesic activities of ethanolic extract of Mentha arvensis L.

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Nripendra Nath Biswas

2014-10-01

Conclusions: These results suggest that the ethanolic extract of Mentha arvensis L. has potential antioxidant, antibacterial, cytotoxic and analgesic activities that support the ethnopharmacological uses of this plant.

Analgesic effect of breast milk versus sucrose for analgesia during heel lance in late preterm infants.

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Simonse, Eva; Mulder, Paul G H; van Beek, Ron H T

2012-04-01

The purpose of this trial was to investigate whether breast milk (either breastfed or bottle-fed) has a better analgesic effect than sucrose in newborns born at a postmenstrual age between 32 and 37 weeks. We conducted a randomized controlled trial at a secondary care neonatal unit in the Netherlands on 71 preterm neonates (postmenstrual age at birth 32-37 weeks), undergoing heel lance with an automated piercing device. Newborns were randomly assigned to breast milk (either breastfed or bottle-fed) administered during heel lance or oral sucrose administered before heel lance. We assessed the Premature Infant Pain Profile (PIPP) score (range, 0-21) to investigate whether there was a difference in pain score between neonates receiving breast milk and those receiving sucrose solution. There was no significant difference in mean PIPP score between neonates receiving breast milk (6.1) and those receiving sucrose (5.5), with a mean difference of 0.6 (95% confidence interval -1.6 to 2.8; P = .58). From this study, it cannot be concluded that breast milk has a better analgesic effect than sucrose in late preterm infants. From the results, it follows with 95% confidence that the analgesic effect of breast milk is not >1.6 points better and not > 2.8 points worse on the PIPP scale (SD 3.7) than the analgesic effect of sucrose in late preterm infants.

LEAVES EXTRACT OF MURRAYA KOENIGII LINN FOR ANTIINFLAMMATORY AND ANALGESIC ACTIVITY IN ANIMAL MODELS

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Ganesh N. Sharma

2010-03-01

Full Text Available This work has been done for the investigation of the anti-inflammatory andanalgesic activity of methanol extract of dried leaves of Murraya koenigii Linn by oraladministration at dose of 100, 200 and 400 mg/kg body weight, to healthy animals.Extract was studied for its anti-inflammatory activity by using carrageenan-induced hindpaw edema in albino rats and the mean increase in paw volume and % inhibition in pawvolume were measured plethysmometrically at different time intervals after carrageenan(1% w/v injection. Extract was also evaluated for analgesic activity using Eddy’s hotplate method and formalin induced paw licking method in albino rats. The methanolextract showed significant (P < 0.001 reduction in the carrageenan-induced paw edemaand analgesic activity evidenced by increase in the reaction time by eddy’s hot platemethod and percentage increase in pain in formalin test. The methanol extract showedanti-inflammatory and analgesic effect in dose dependent manner when compared withthe control and standard drug, diclofenac sodium (10mg/kg, p.o. These inhibitions werestatistically significant (P < 0.05. Thus our investigation suggests a potential benefit ofMurraya koenigii in treating conditions associated with inflammatory pain.

Post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy

International Nuclear Information System (INIS)

Khan, A.W.; Maqsood, R.; Saleem, M.M.

2017-01-01

To compare the mean post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of General Surgery Combined Military Hospital Quetta, from 1st August 2014 to 30th April 2015. Material and Methods: A total of 60 patients were included in this study and were divided into two groups of 30 each. Patients in group A underwent open appendectomy with closure of peritoneum while patients in group B had non-closure of peritoneum during the same procedure. Post-operatively, pain severity was assessed on visual analogue scale (VAS) numeric pain distress scale. On presence of VAS numeric pain distress scale between 5 to 7, intramuscular (IM) diclofenac sodium was given and on score >7, intravascular (IV) tramadol was given. The final outcome was measured at day 0 and day 1. Results: Pain score and analgesic requirements were significantly less in non-closure group than closure group on day 0 and day 1, showing statistically significant difference between the two groups. Conclusion: Mean post-operative analgesic requirement is significantly less in non-closure group as compared to closure group during open appendectomy. (author)

Long-term effects of octreotide on pituitary gigantism: its analgesic action on cluster headache.

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Otsuka, Fumio; Mizobuchi, Satoshi; Ogura, Toshio; Sato, Kenji; Yokoyama, Masataka; Makino, Hirofumi

2004-10-01

We report the case of 19-year-old man with pituitary gigantism due to growth hormone-producing pituitary macroadenoma. The patient complained of recurrent headache and excessive growth spurt since age 15. Octreotide administration was initiated following transsphenoidal pituitary adenomectomy. Octreotide injection for 4 years efficaciously reduced the size of remnant adenoma as well as serum growth hormone levels. Notably, octreotide exhibited a potent analgesic effect on his intractable cluster headache that has continued even after reduction of the adenoma volume. The analgesic effect lasted 2 to 6 hours after each injection and no tachyphylaxis to octreotide appeared during 4-year treatment. To characterize the headache and the pain intensity, analgesic drugs including octreotide, lidocaine, morphine and thiopental were tested using a visual analogue scale (VAS) evaluation, with the result that octreotide exhibited a prompt and complete disappearance of the headache. Headache relief was in part reproduced by morphine injection (56% reduction) but not by lidocaine or thiopental. The present case suggests that the intractable headache associated with pituitary gigantism is possibly related to the endogenous opioid system. Thus, the headache control by octreotide is clinically helpful for continuation of the self-injection regimen.

Access to Strong Opioid Analgesics in the Context of Legal and Regulatory Barriers in Eleven Central and Eastern European Countries.

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Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M

2018-04-06

In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.

In vivo analgesic activities and safety assessment of Vitis vinifera L ...

African Journals Online (AJOL)

analgesic drug. Results: In acetic acid writhe test, pre-treatment with both extracts significantly decreased (p < 0.0001) .... maceration for 24 h with 500 ml of methanol: water (70:30 v:v) ... per os distilled water and serial doses (0.5, 2.5,. 5.0 and ...

Effect of ondansetron on the analgesic efficacy of tramadol used for ...

African Journals Online (AJOL)

However, its use has been associated with a higher .... Patients with a PONV score of 3 were treated with metoclopramide ... receptors.11 It also exerts analgesic effect by inhibiting serotonin and norepinephrine reuptake thereby blocking the nociceptive ... higher incidence of PONV.12 Ondansetron is a highly selective.

Breaking barriers to novel analgesic drug development.

Science.gov (United States)

Yekkirala, Ajay S; Roberson, David P; Bean, Bruce P; Woolf, Clifford J

2017-08-01

Acute and chronic pain complaints, although common, are generally poorly served by existing therapies. This unmet clinical need reflects a failure to develop novel classes of analgesics with superior efficacy, diminished adverse effects and a lower abuse liability than those currently available. Reasons for this include the heterogeneity of clinical pain conditions, the complexity and diversity of underlying pathophysiological mechanisms, and the unreliability of some preclinical pain models. However, recent advances in our understanding of the neurobiology of pain are beginning to offer opportunities for developing novel therapeutic strategies and revisiting existing targets, including modulating ion channels, enzymes and G-protein-coupled receptors.

AN EXPERIMENTAL COMPARATIVE STUDY OF ANALGESIC ACTIVITY OF CURCUMA: AMADA (MANGO - GINGER WITH CONVENTIONAL NSAID ASPIRIN IN MALE ALBINO WISTAR RATS

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Shanmukananda

2015-09-01

Full Text Available BACKGROUND: Mango ginger ( Curcuma amada Roxb. belongs to Zingiberaceae family has biological activities include antioxidant, antibacterial, antifungal, anti - inflammatory, antiallergic, CNS depressant and analgesic activity. The major chemical components include starch, phenolic acids, volatile oils, curcuminoids and terpenoids like difurocumenonol, amadannulen and amadaldehyde. Pain is often the first indication of disease or injury and a major symptom in many clinical conditions and can significantly interferes with a person’s quality of life and general functioning. The standard and test drugs suppress the inflammatory mediators associated with pain. This article brings out the analgesic activity of C. Amada in comparison with aspirin. Therefore aqueous extract of C. amada was evaluated for analgesic activity in animal models of pain. OBJECTIVES: 1. To evaluate rhizomes of Curcuma Amada for analgesic activity in male albino wistar rats and to compare the analgesic activity with aspirin . 2. To Evaluate if combination of Curcuma Amada with aspirin is synergistic . MATERIALS AND METHODS: Albino rats are the proven models for analgesic studies. They were obtained from the animal house of DR.B. R. Ambedkar Medical College. Animals were maintained as per CPCSEA guidelines .The aqueous extract of Curcuma Amada was used. Aspirin (100mg/kg was used as the standard analgesic drug. 4x4 groups of 6 Rats were used to ensure that results obtained were statistically significant using ANOVA test. Analgesic activity will be assessed with the help of following screening methods Acetic Acid Writhing Method using Acetic Acid, Tail Flick Method using the Analgesiometer, Tail Immersion Method using Hot Water (55 0 C , Hot Plate method using Hot Plate . RESULTS : Aqueous extract of Curcuma Amada significantly suppressed the 1% acetic acid induced writhing response in rats when compared to standard drug aspirin. In the Tail flick and Hot plate test Curcuma

Tolerance to non-opioid analgesics is opioid-sensitive in nucleus raphe magnus

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Merab G Tsagareli

2011-07-01

Full Text Available Repeated injection of opioid analgesics can lead to a progressive loss of its effect. This phenomenon is known as tolerance. Several lines of investigations have shown that systemic, intraperitoneal administration or the microinjection of non-opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs in the midbrain periaqueductal gray matter induces antinociception with some effects of tolerance. Our recent study has revealed that microinjection of three drugs analgin, ketorolac and xefocam into the central nucleus of amygdala produce tolerance to them and cross-tolerance to morphine. Here we report that repeated administrations of these NSAIDs into the nucleus raphe magnus (NRM in the following four days result in progressively less antinociception, i.e. produce the development of tolerance to these drugs in mail rats. Special control experiments showed that post-treatment with μ-opioid antagonist naloxone in NRM significantly decreased antinociceptive effects of NSAIDs at the first day in behavioral tail flick reflex (TF and hot plate (HP latencies. At the second day, naloxone generally had trend effects in both TF and HP tests impeded the development of tolerance to the antinociceptive effect of non-opioid analgesics. These findings strongly support the suggestion on endogenous opioid involvement in NSAIDs antinociception and tolerance in the descending pain control system. Moreover, repeated injections of NSAIDs progressively lead to tolerance to them, cross-tolerance to morphine and the risk of a withdrawal syndrome. Therefore, these results are important for human medicine too.

Post-operative analgesic effects of paracetamol, NSAIDs, glucocorticoids, gabapentinoids and their combinations

DEFF Research Database (Denmark)

Dahl, Jørgen Berg; Nielsen, Rasmus; Wetterslev, Jørn

2014-01-01

, and no well-documented 'gold standards' exist. The aim of the present topical, narrative review is to provide an update of the evidence for post-operative analgesic efficacy with the most commonly used, systemic non-opioid drugs, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs)/COX-2 antagonists......, glucocorticoids, gabapentinoids, and combinations of these. The review is based on data from previous systematic reviews with meta-analyses, investigating effects of non-opioid analgesics on pain, opioid-requirements, and opioid-related adverse effects. Paracetamol, NSAIDs, COX-2 antagonists, and gabapentin....... Trials of pregabalin > 300 mg/day indicated a morphine-sparing effect of 13.4 (4, 22.8) mg morphine/24 h. Notably, though, the available evidence for additive or synergistic effects of most combination regimens was sparse or lacking. Paracetamol, NSAIDs, selective COX-2 antagonists, and gabapentin all...

Effects of Analgesic Use on Inflammation and Hematology in a Murine Model of Venous Thrombosis

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Hish, Gerald A; Diaz, Jose A; Hawley, Angela E; Myers, Daniel D; Lester, Patrick A

2014-01-01

Venous thrombosis (VT) is a significant cause of morbidity and mortality in humans. Surgical animal models are crucial in studies investigating the pathogenesis of this disease and evaluating VT therapies. Because inflammation is critical to both the development and resolution of VT, analgesic medications have the potential to adversely affect multiple parameters of interest in VT research. The objective of this study was to determine how several common analgesics affect key variables in a murine ligation model of deep vein thrombosis. Male C57BL/6 mice were randomly assigned to receive either local (bupivacaine) or systemic parenteral analgesia (buprenorphine, tramadol, or carprofen) or 0.9% NaCl (control). All mice underwent laparotomy and ligation of the inferior vena cava, and treatment was continued until euthanasia at 6 or 48 h after surgery. Analysis of harvested tissues and blood included: hematology, thrombus weight, serum and vein-wall cytokines (IL1β, IL6, IL10, TNFα), soluble P-selectin, and vein-wall leukocyte infiltration. Compared with 0.9% NaCl, all of the analgesics affected multiple parameters important to VT research. Carprofen and tramadol affected the most parameters and should not be used in murine models of VT. Although they affected fewer parameters, a single dose of bupivacaine increased thrombus weight at 6 h, and buprenorphine was associated with reduced vein wall macrophages at 48 h. Although we cannot recommend the use of any of the evaluated analgesic dosages in this mouse model of VT, buprenorphine merits additional investigation to ensure the highest level of laboratory animal care and welfare. PMID:25255071

Correlation of ADRB1 rs1801253 Polymorphism with Analgesic Effect of Fentanyl After Cancer Surgeries

Science.gov (United States)

Wei, Wei; Tian, Yanli; Zhao, Chunlei; Sui, Zhifu; Liu, Chang; Wang, Congmin; Yang, Rongya

2015-01-01

Background Our study aimed to explore the association between β1-adrenoceptor (ADRB1) rs1801253 polymorphism and analgesic effect of fentanyl after cancer surgeries in Chinese Han populations. Material/Methods Postoperative fentanyl consumption of 120 patients for analgesia was recorded. Genotype distributions were detected by allele specific amplification-polymerase chain reaction (ASA-PCR) method. Postoperative pain was measured by visual analogue scale (VAS) method. Differences in postoperative VAS score and postoperative fentanyl consumption for analgesia in different genotype groups were compared by analysis of variance (ANOVA). Preoperative cold pressor-induced pain test was also performed to test the analgesic effect of fentanyl. Results Frequencies of Gly/Gly, Gly/Arg, Arg/Arg genotypes were 45.0%, 38.3%, and 16.7%, respectively, and passed the Hardy-Weinberg Equilibrium (HWE) test. The mean arterial pressure (MAP) and the heart rate (HR) had no significant differences at different times. After surgery, the VAS score and fentanyl consumption in Arg/Arg group were significantly higher than in other groups at the postoperative 2nd hour, but the differences were not obvious at the 4th hour, 24th hour, and the 48th hour. The results suggest that the Arg/Arg homozygote increased susceptibility to postoperative pain. The preoperative cold pressor-induced pain test suggested that individuals with Arg/Arg genotype showed worse analgesic effect of fentanyl compared to other genotypes. Conclusions In Chinese Han populations, ADRB1 rs1801253 polymorphism might be associated with the analgesic effect of fentanyl after cancer surgery. PMID:26694722

Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy

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Luis Antônio Borges

2017-05-01

Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included. The local group (LG received local infiltration (0.75% ropivacaine under general anesthesia; the spinal group (SG received subarachnoid block (2 ml of 0.5% bupivacaine. Analgesic supplementation consisted of fentanyl for LG and lidocaine for SG. Postoperative pain intensity, sphincter relaxation, lower-limb strength, time to discharge, analgesic dose over one week and adverse effects were assessed. RESULTS: Eleven LG patients (52.4% required supplementation, but no SG patients. Pain intensity was higher for LG up to 120 min, but there were no differences at 150 or 180 min. There were no differences in the need for paracetamol or tramadol. Times to first analgesic supplementation and hospital discharge were longer for SG. The adverse effects were nausea, dizziness and urinary retention. CONCLUSIONS: Pain intensity was higher in LG than in SG over the first 2 h, but without differences after 150 and 180 min. Time to first supplementation was shorter in LG. There were no differences in doses of paracetamol and tramadol, or in adverse effects. REGISTRATION: ClinicalTrials.gov NCT02839538.

Comparison Relation to Analgesics Between Nurses and Patients Perception in Pain in Patients who had Undergone Coronary Bypass Graft

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A. Karamporian

2003-04-01

Full Text Available Pain is the most important and current nursing diagnosis at I.C.U of heart surgery. So it must be relive for its acute complication. The purpose of this study was to compare nurses and patients perception of pain and its relation to analgesics in patients undergone coronary bypass surgery in one of the selected hospital in Iran medical university in 2000 and to give some suggestions according to results of this study. This research was a descriptive study. In this study 30 patients with30 nurses caring of them in cardiac surgery I.C.U in one of the hospital of Iran medical university were participated .The materials in this study included question forms, scale of intensity of pain and analgesic dose check list. The first part included questions related to personal specifications of nurses and patients participating in study. The second part included 25 sentences about patients and nurses understanding of pain. For evaluating the degree of pain and severity of its perception in patients the statistical method was used. According to its"10" scores column the "o" was for no pain perception and "10" was for the most possible sense pain. The result of this study was summarized in 6 figures. The " T " statistical analysis showed that the patients average of pain perception was more than pain perception of nurses (P=0.001. The "pair t-test" detected significant differences between degree of perception of pain in patients before and after injection of analgesics and also perception of patients pain in their nurses (P=0.001. In addition according to "t-test" there was significant differences between the degree of pain in patients and degree of perception of this pain in nurses before and after the injection of analgesics (P=0.001. But, there was no relation between dose of analgesics with the patients’ and nurses’ perception of pain, and also the degree of patients pain before and after the injection of analgesics and degree of nurses perception of

Analgesic and Anti-Inflammatory Activities of Methanol Extract of Cissus repens in Mice

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Ching-Wen Chang

2012-01-01

Full Text Available The aim of this study was to investigate possible analgesic and anti-inflammatory mechanisms of the CRMeOH. Analgesic effect was evaluated in two models including acetic acid-induced writhing response and formalin-induced paw licking. The anti-inflammatory effect was evaluated by λ-carrageenan-induced mouse paw edema and histopathologic analyses. The results showed that CRMeOH (500 mg/kg decreased writhing response in the acetic acid assay and licking time in the formalin test. CRMeOH (100 and 500 mg/kg significantly decreased edema paw volume at 4th to 5th hours after λ-carrageenan had been injected. Histopathologically, CRMeOH abated the level of tissue destruction and swelling of the edema paws. These results were indicated that anti-inflammatory mechanism of CRMeOH may be due to declined levels of NO and MDA in the edema paw through increasing the activities of SOD, GPx, and GRd in the liver. Additionally, CRMeOH also decreased IL-1β, IL-6, NFκB, TNF-α, COX-2, and iNOS levels. The contents of two active ingredients, ursolic acid and lupeol, were quantitatively determined. This paper demonstrated possible mechanisms for the analgesic and anti-inflammatory effects of CRMeOH and provided evidence for the classical treatment of Cissus repens in inflammatory diseases.

Analgesic techniques in minor painful procedures in neonatal units: a survey in northern Italy.

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Codipietro, Luigi; Bailo, Elena; Nangeroni, Marco; Ponzone, Alberto; Grazia, Giuseppe

2011-01-01

The aim of this survey was to evaluate the current practice regarding pain assessment and pain management strategies adopted in commonly performed minor painful procedures in Northern Italian Neonatal Intensive Care Units (NICUs). A multicenter survey was conducted between 2008 and 2009 in 35 NICUs. The first part of the survey form covered pain assessment tools, the timing of analgesics, and the availability of written guidelines. A second section evaluated the analgesic strategies adopted in commonly performed painful procedures. The listed analgesic procedures were as follows: oral sweet solutions alone, non-nutritive sucking (NNS) alone, a combination of sweet solutions and NNS, breast-feeding where available, and topical anesthetics. Completed questionnaires were returned from 30 neonatal units (85.7% response rate). Ten of the 30 NICUs reported using pain assessment tools for minor invasive procedures. Neonatal Infant Pain Scale was the most frequently used pain scale (60%). Twenty neonatal units had written guidelines directing pain management practices. The most frequently used procedures were pacifiers alone (69%), followed by sweet-tasting solutions (58%). A 5% glucose solution was the most frequently utilized sweet-tasting solution (76.7%). A minority of NICUs (16.7%) administered 12% sucrose solutions for analgesia and the application of topical anesthetics was found in 27% of NICUs while breast-feeding was performed in 7% of NICUs. This study found a low adherence to national and international guidelines for analgesia in minor procedures: the underuse of neonatal pain scales (33%), sucrose solution administration before heel lance (23.3%), topical anesthetics before venipuncture, or other analgesic techniques. The presence of written pain control guidelines in these regions of Northern Italy increased in recent years (from 25% to 66%). © 2010 World Institute of Pain.

Language competence and communication skills in 3-year-old children after prenatal exposure to analgesic opioids.

Science.gov (United States)

Skovlund, Eva; Handal, Marte; Selmer, Randi; Brandlistuen, Ragnhild Eek; Skurtveit, Svetlana

2017-06-01

An increasing consumption of opioids in the general population has been reported in several countries also among pregnant women. Limited information is available regarding the effect of prenatal exposure to analgesic opioids on long-term neurocognitive function in children. The primary aim of the study was to determine the association between prenatal exposure to analgesic opioids and language competence and communication skills at 3 years of age. The Norwegian Mother and Child Cohort Study (MoBa) prospectively included pregnant women during the period from 1999 to 2008. Participants reported medication use at pregnancy weeks 17-18 and 30, and 6 months after birth. Children's language competence and communication skills were reported by mothers on validated scales. A total of 45 211 women with 51 679 singleton pregnancies were included. The use of analgesic opioids was reported in 892 pregnancies (1.7%). In adjusted analyses, no association between opioid use and reduced language competence or communication skills was found, OR = 1.04 (95%CI: 0.89-1.22) and OR = 1.10 (95%CI: 0.95-1.27), respectively. Both pain and use of paracetamol were associated with a small reduction in communication skills. No such association was found for language competence. The use of analgesic opioids in pregnant women does not seem to affect language development or communication skills in children at 3 years of age. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Effect of paracetamol injection on the analgesic effect of tramadol in ...

African Journals Online (AJOL)

Five dogs each were randomly treated with 30mg/kg paracetamol (treatment KXDTA) intravenously or equal volume of normal saline (treatment KXDTS) to evaluate if paracetamol potentiate the analgesic effects of tramadol during the intra-operative period. Thirty minutes later, both groups were treated with 3mg/kg tramadol ...

The analgesic effect of clonidine as an adjuvant in dorsal penile ...

African Journals Online (AJOL)

Introduction: Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block. Methods: It was a prospective randomized double-blind clinical trial including ...

Intrauterine exposure to mild analgesics during pregnancy and the occurrence of cryptorchidism and hypospadia in the offspring: the Generation R Study

DEFF Research Database (Denmark)

Snijder, Claudia A.; Kortenkamp, Andreas; Steegers, Eric A.P.

2012-01-01

BACKGROUND: Recently, over-the-counter mild analgesic use during pregnancy has been suggested to influence the risk of reproductive disorders in the offspring. We examined the influence of maternal exposure to mild analgesics during pregnancy on the occurrence of cryptorchidism and hypospadia in ...

Antioxidant, analgesic and anti-inflammatory activities of the methanolic extract of Piper betle leaves

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Badrul Alam

2013-05-01

Full Text Available Objective:The present study was designed to evaluate the antioxidant, analgesic, and anti-inflammatory activities ofthe methanolic extract of Piper betle leaves (MPBL. Materials and Methods: MPBL was evaluated for anti-inflammatory activity using carrageenan-induced hind paw edema model. Analgesic activity of MPBL was evaluated by hot plate, writhing, and formalin tests. Total phenolic and flavonoids content, total antioxidant activity, scavenging of 1,1-diphenyl-2-picrylhydrazyl (DPPH radical, peroxynitrate (ONOO- as well as  inhibition of total ROS generation, and assessment of reducing power were used to evaluate antioxidant potential of MPBL. Results: The extract of MPBL, at the dose of 100 and 200 mg/kg, produced a significant (p

Risks associated with borrowing and sharing of prescription analgesics among patients observed by pain management physicians in Croatia: a qualitative study

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Markotic F

2016-11-01

Full Text Available Filipa Markotic,1 Livia Puljak2 1Centre for Clinical Pharmacology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina; 2Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Background: Understanding and improving patient safety is a key issue in medicine. One of the potential threats to patient safety is the sharing of medication among patients, which is a form of self-medication. This study analyzed experiences and attitudes of pain management physicians (PMPs about sharing prescription analgesics among patients.Methods: This qualitative study was conducted by semi-structured interviews among PMPs employed in Croatian pain clinics. The study involved two researchers and 15 PMPs.Results: Among PMPs, 80% have seen patients who share their prescription analgesics with other patients for whom prescription is not intended. Most PMPs consider prescription analgesics sharing a risky and negative behavior. Some of them, however, found certain positive aspects associated to it, such as being a benevolent behavior, helping patients to get medications when they need them, and helping them cope with pain.Conclusion: The majority of physicians specialized in pain management encountered patients sharing prescription analgesics. Most of them considered this as risky behavior with a number of potential consequences. It has been noted that this problem is neglected and that physicians should inquire about medication sharing. Direct-to-consumers advertising was perceived as a factor contributing to such behavior. Patient education and more involvement of physicians in identifying this behavior were cited as potential remedies for preventing sharing of prescription analgesics. Keywords: analgesics, sharing, lending, borrowing, risks

Phytochemical screening and studies of analgesic potential of Moringa oleifera Lam. stem bark extract on experimental animal model

OpenAIRE

Shumaia Parvin; Md. Abu Shuaib Rafshanjani; Md. Abdul Kader; Most. Afia Akhtar; Tahmida Sharmin

2014-01-01

The work has been done for the phytochemical investigation and study of analgesic activity of Moringa oleifera Lam. ethanolic stem bark extract using Acetic Acid Induced Writhing method. The effect of extract was tested for qualitative chemical analysis which reveals the presence of alkaloid, glycosides, flavonoids, tannins, saponin, carbohydrate etc. For peripheral analgesic effect acetic acid induced writhing test was used and for this stem bark extract was administered intraperitoneally at...

Analgesic effectiveness of prophylactic therapy and continued therapy with naproxen sodium post simple extraction.

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Angel Asmat-Abanto

2015-02-01

Full Text Available To compare the analgesic effectiveness of the prophylactic therapy and continued therapy with naproxen sodium after a simple dental extraction. Material and methods: This prospective randomized, parallel, single-blind clinical trial was developed in the Dental Clinic of the Universidad Alas Peruanas in Trujillo (Peru. The patients, who required simple extraction due to dental caries, were randomly distributed into three groups: 30 of them took 550mg naproxen sodium in the preoperative period and then every 12 hours, other 30 took 550mg naproxen sodium in the postoperative period and then every 12 hours, and 30(control group, received 400mg ibuprofen in the postoperative period and then every 8 hours, depending on the established criteria. The procedure was standardized, analgesic effectiveness was assessed by visual analog scale and the presence of adverse drug reactions was evaluated as well. Data were analyzed using ANOVA and Duncan’s test using IBM SPSS 22 with a significance level of 5%. Results: Continued therapy with naproxen sodium showed greater analgesic effectiveness after a simple extraction at 1, 8 and 24 hours (p<0.005. Conclusion: Continued therapy with naproxen sodium presented greater effectiveness than prophylactic therapy with naproxen sodium after a simple extraction.

Analgesic efficacy of lysine clonixinate plus tramadol versus tramadol in multiple doses following impacted third molar surgery.

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Perez-Urizar, J; Martínez-Rider, R; Torres-Roque, I; Garrocho-Rangel, A; Pozos-Guillen, A

2014-03-01

This study compared the analgesic and anti-inflammatory efficacy, trismus control, and tolerability of the combination of lysine clonixinate and tramadol (LCT) versus tramadol (T) alone after surgical removal of impacted mandibular third molars. This study was a double-blind, randomized clinical trial, including two study groups of 20 patients each, who exhibited acute pain subsequent to surgical extraction of two mandibular third molars. Pain intensity was quantified over a 96-h period using a visual analogue scale and a 5-point verbal rating scale. Secondary indicators of analgesic and anti-inflammatory efficacy, trismus control, and tolerability were determined. Patients administered LCT exhibited better therapeutic effects that those administered T. Fifty percent of patients in the LCT group rated this therapy as 'excellent analgesia' compared with only 10% in the T group. The onset of the analgesic effect of LCT was significantly faster, without any therapeutic failures. There were no significant differences between the groups with regard to anti-inflammatory effect or trismus. The results of this study suggest that the postsurgical analgesic efficacy of LCT in combination (LC 125 mg + T 25 mg) is superior to that obtained with T alone, administered at the standard dose of 50 mg, for up to 96 h after the extraction of both impacted mandibular third molars. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Analgesic Effect of Intra-Articular Injection of Temperature-Responsive Hydrogel Containing Bupivacaine on Osteoarthritic Pain in Rats

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Kim, Taemin; Seol, Dong Rim; Hahm, Suk-Chan; Ko, Cheolwoong; Kim, Eun-Hye; Chun, Keyoungjin; Kim, Junesun; Lim, Tae-Hong

2015-01-01

The present study examined the analgesic effects of slow-releasing bupivacaine from hydrogel on chronic arthritic pain in rats. Osteoarthritis (OA) was induced by monosodium iodoacetate (MIA) injection into the right knee joint. Hydrogel (HG: 20, 30, and 50 μL) and temperature-sensitive hydrogel containing bupivacaine (T-gel: 20, 30, and 50 μL) were injected intra-articularly 14 days after MIA injection. Behavioral tests were conducted. The rats showed a significant decrease in weight load and paw withdrawal threshold (PWT). Intra-articular 0.5% bupivacaine (10 and 20 μL) significantly reversed MIA-induced decreased PWT, with no effect on weight load. In normal rats, hydrogel did not produce significant changes in PWT but at 30 and 50 μL slightly decreased weight bearing; T-gel did not cause any changes in both the weight load and PWT. In OA rats, T-gel at 20 μL had a significant analgesic effect for 2 days, even though T-gel at 50 μL further reduced the weight load, demonstrating that intra-articular T-gel (20 μL) has long-lasting analgesic effects in OA rats. Thus, T-gel designed to deliver analgesics into the joint cavity could be an effective therapeutic tool in the clinical setting. PMID:26881207

Chronic Pain: How Challenging Are DDIs in the Analgesic Treatment of Inpatients with Multiple Chronic Conditions?

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Siebenhuener, Klarissa; Eschmann, Emmanuel; Kienast, Alexander; Schneider, Dominik; Minder, Christoph E.; Saller, Reinhard; Zimmerli, Lukas; Blaser, Jürg; Battegay, Edouard

2017-01-01

Background Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. Methods and Findings We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients). Data were extracted from the electronic health records and reviewed. We identified 433 hospitalizations of patients with chronic pain and analyzed their combinations of chronic conditions (multimorbidity). We then classified all analgesic prescriptions according to the World Health Organization (WHO) analgesic ladder. Furthermore, we used a Swiss drug-drug interactions knowledge base to identify potential interactions between opioids and other drug classes, in particular coanalgesics and other concomitant drugs. Chronic pain was present in 38% of patients with multimorbidity. On average, patients with chronic pain were aged 65.7 years and had a mean number of 6.6 diagnoses. Hypertension was the most common chronic condition. Chronic back pain was the most common painful condition. Almost 90% of patients were exposed to polypharmacotherapy. Of the chronic pain patients, 71.1% received opioids for moderate to severe pain, 43.4% received coanalgesics. We identified 3,186 potential drug-drug interactions, with 17% classified between analgesics (without coanalgesics). Conclusions Analgesic drugs-related DDIs, in particular opioids, in multimorbid patients are often complex and difficult to assess by using DDI knowledge bases alone. Drug-multimorbidity interactions are not sufficiently investigated and understood. Today, the scientific literature is scarce for chronic pain in combination with multiple coexisting medical conditions and medication

Analgesic Effect of Methanol Leaf Extract of Alstonia Boonei De Wild ...

African Journals Online (AJOL)

pain and other conditions. Methods: Alstonia boonei leaves were extracted with methanol. Rodent models were employed in screening the analgesic effect of the extract. Pain indices evaluated in hot plate and tail flick tests, formalin pain test and mouse writhing assay were mean reaction time to latent heat, time spent in ...

Preclinical Science Regarding Cannabinoids as Analgesics: An Overview

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ME Lynch

2005-01-01

Full Text Available Modern pharmacology of cannabinoids began in 1964 with the isolation and partial synthesis of delta-9-tetrahydrocannabinol, the main psychoactive agent in herbal cannabis. Since then, potent antinociceptive and antihyperalgesic effects of cannabinoid agonists in animal models of acute and chronic pain; the presence of cannabinoid receptors in pain-processing areas of the brain, spinal cord and periphery; and evidence supporting endogenous modulation of pain systems by cannabinoids has provided support that cannabinoids exhibit significant potential as analgesics. The present article presents an overview of the preclinical science.

Use of and barriers to access to opioid analgesics: a worldwide, regional, and national study.

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Berterame, Stefano; Erthal, Juliana; Thomas, Johny; Fellner, Sarah; Vosse, Benjamin; Clare, Philip; Hao, Wei; Johnson, David T; Mohar, Alejandro; Pavadia, Jagjit; Samak, Ahmed Kamal Eldin; Sipp, Werner; Sumyai, Viroj; Suryawati, Sri; Toufiq, Jallal; Yans, Raymond; Mattick, Richard P

2016-04-16

Despite opioid analgesics being essential for pain relief, use has been inadequate in many countries. We aim to provide up-to-date worldwide, regional, and national data for changes in opioid analgesic use, and to analyse the relation of impediments to use of these medicines. We calculated defined daily doses for statistical purposes (S-DDD) per million inhabitants per day of opioid analgesics worldwide and for regions and countries from 2001 to 2013, and we used generalised estimating equation analysis to assess longitudinal change in use. We compared use data against the prevalence of some health disorders needing opioid use. We surveyed 214 countries or territories about impediments to availability of these medicines, and used regression analyses to establish the strength of associations between impediments and use. The S-DDD of opioid analgesic use more than doubled worldwide between 2001-03 and 2011-13, from 1417 S-DDD (95% CI -732 to 3565; totalling about 3.01 billion defined daily doses per annum) to 3027 S-DDD (-1162 to 7215; totalling about 7.35 billion defined daily doses per annum). Substantial increases occurred in North America (16,046 S-DDD [95% CI 4032-28,061] to 31,453 S-DDD [8121-54,785]), western and central Europe (3079 S-DDD [1274-4883] to 9320 S-DDD [3969-14,672]), and Oceania (2275 S-DDD [763-3787] to 9136 S-DDD [2508-15,765]). Countries in other regions have shown no substantial increase in use. Impediments to use included an absence of training and awareness in medical professionals, fear of dependence, restricted financial resources, issues in sourcing, cultural attitudes, fear of diversion, international trade controls, and onerous regulation. Higher number of impediments reported was significantly associated with lower use (unadjusted incidence rate ratio 0.39 [95% CI 0.29-0.52]; p<0.0001), but not when adjusted for gross domestic product and human development index (0.91 [0.73-1.14]; p=0.4271). Use of opioid analgesics has increased, but

Comparison of rocuronium and succinylcholine on postintubation sedative and analgesic dosing in the emergency department.

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Korinek, Justin D; Thomas, Rachel M; Goddard, Luke A; St John, Alexander E; Sakles, John C; Patanwala, Asad E

2014-06-01

Rocuronium and succinylcholine are both commonly used neuromuscular blockers for rapid sequence intubation in the emergency department (ED). The objective of this study was to determine if patients who receive rocuronium are more likely to receive lower doses of postintubation sedatives and analgesics compared with patients who receive succinylcholine. This was a retrospective cohort study carried out in a tertiary, academic ED. Consecutive adult patients, who were intubated using etomidate for induction of sedation, were included. Patients were categorized on the basis of whether they received (a) rocuronium or (b) succinylcholine for paralysis. The dosing of postintubation sedative and analgesic infusions were compared 30 min after initiation between the two groups. A total of 254 patients were included in the final analysis (rocuronium=127 and succinylcholine=127). In the overall cohort, 90.2% (n=229) of patients were administered a sedative postintubation in the ED. Most of these patients were initiated on propofol infusions. The mean propofol infusion rate at 30 min was 30±23 mcg/kg/min in the rocuronium group and 42±24 mcg/kg/min in the succinylcholine group (P=0.002). A total of 42.5% of patients (n=108) received an analgesic infusion (all patients received fentanyl). The mean fentanyl infusion rate at 30 min was 0.65±0.55 and 0.86±0.49 mcg/kg/h in the rocuronium and succinylcholine groups, respectively (P=0.041). Patients who receive rocuronium are more likely to receive lower doses of sedative and analgesic infusions after intubation. This may place them at risk of being awake under paralysis.

Evaluation of the analgesic activity of the methanolic stem bark extract of dialium guineense (wild).

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Ezeja, Mi; Omeh, Ys; Ezeigbo, Ii; Ekechukwu, A

2011-01-01

Dialium guineense is a medicinal plant used by some communities of Enugu-Ezike in Enugu State, Nigeria for treatment of fever, headache and other diverse ailments. The present study evaluated the analgesic activity of the methanolic stem bark extract of the plant. Acetic acid-induced abdominal constriction or writhing, tail immersion and hot plate analgesic models in albino Wistar mice were used for the study. Three test doses (250, 500, 1000 mg/kg body weight) of the extract were administered orally by gastric gavage. The activity was compared with a standard reference drug, acetylsalicylic acid (aspirin) (400 mg/kg) and negative control. The results were analysed by SPSS version 17 using ANOVA and Post Hoc Duncan. In the acetic acid-induced writhing reflex model, D. guineense extract and the reference drug significantly (P =0.014 - 0.002) decreased the mean total number of abdominal constriction in the mice in a dose dependent fashion. The percentage inhibition of the abdominal constriction reflex was increased dose dependently from 0% in the negative control group to 71% at the highest dose of the extract (1000mg/kg). In the tail immersion model the extract at the dose of 1000 mg/kg significantly (P = 0. 048) increased the pain reaction time (PRT) while in hot plate model the extract and drug also significantly (P = 0.048 - 0.05) increased the mean PRT at the doses of 500 and 1000 mg/kg. The dose of 250 mg/kg showed no analgesic activity in tail immersion and hot plate models. Dialium guineense demonstrated significant analgesic activity that may be mediated through peripheral pain mechanism.

Investigation on the anti- inflammatory and analgesic effects of Olea europaea L. metanolic extract on male NMRI mouse

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Elaheh Tekye

2012-04-01

Full Text Available Background: Different mediators are involved in pain and edema induction during different stages of inflammation. Then, treatment of them encounters some difficulties. Medicinal plants are an important source of substances which are claimed to induce anti-inflammatory effects. This study was aimed to investigate anti-inflammatory and analgesic effects of Olea europaea L.methanolic extract on male NMRI mouse. Methods: Methanolic extraction was done for leaf of Olea europaea L. and different doses (200, 300 and 400 mg/kg were intraperitoneally (i.p. adminstered to male NMRI mice. Analgesic and anti-inflammatory effects of extract was measured during both phases of Formalin test, Acetic acid induced visceral pain and xylene inflammation tests. A standard analgesic and anti-inflammatory drug such as indomethacin, dexamethasone and morphine were administered in positive control groups where appropriates. Results: Results indicated significant dose-dependent analgesic and anti-inflammatory effects of methanolic extract of Olea europaea L. leaf on pain which induced by formalin (both phase and acetic acid, and inflammation caused by xylene. Conclusion: Our findings Showed that administration of methanolic extract of Olea europaea L.leaf can suppress pain and inflammation dose dependently which, may mediate via different components of extract. However, more investigations need to be done.

A comparison Comparison between analgesic effects of aqueous ethanolic extract of mentha longifolia and morphine in male rats

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Ezatollah Paknia

2013-08-01

Full Text Available Background and Aim: Long-term consumption of many drugs followed by reduction of their effectiveness has necessitated performing research on new analgesics .Thus, the present study was conducted to evaluate the analgesic effects of mentha longifolia and morphine in mice using writhing and hot plate tests. Materials and Methods: In this experimental study, 70 male rats were divided into 7 equal groups. The groups included the control, three experimental groups receiving 400, 800, or 1600 mg/kg of mentha extract and three experimental groups which received 2, 4, or 8 mg/kg of morphine .In order to measure pain, the two acceptable tests, writhing and hot plate tests, were applied. Pain scores were measured at 0, 15, 30, 45 or 60 min after administration of algogenic stimulus. Results: It was found that in hot plate test, only the dose of 1600mg/kg of Mentha extract after 60 minutes was significantly able to exert an analgesic effect (P<0.05. In wrighting test, mentha extract at different doses significantly reduced the number and time of wrightes in the rats, comparable to morphine (P<0.05. Conclusion: It seems that all doses of mentha extract in wrighting test have analgesic effects which indicate chronic pain inhibition of mentha hydroalcholic extract.

Treatment with analgesics after mouse sciatic nerve injury does not alter expression of wound healing-associated genes

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Matt C Danzi

2016-01-01

Full Text Available Animal models of sciatic nerve injury are commonly used to study neuropathic pain as well as axon regeneration. Administration of post-surgical analgesics is an important consideration for animal welfare, but the actions of the analgesic must not interfere with the scientific goals of the experiment. In this study, we show that treatment with either buprenorphine or acetaminophen following a bilateral sciatic nerve crush surgery does not alter the expression in dorsal root ganglion (DRG sensory neurons of a panel of genes associated with wound healing. These findings indicate that the post-operative use of buprenorphine or acetaminophen at doses commonly suggested by Institutional Animal Care and Use Committees does not change the intrinsic gene expression response of DRG neurons to a sciatic nerve crush injury, for many wound healing-associated genes. Therefore, administration of post-operative analgesics may not confound the results of transcriptomic studies employing this injury model.

Adherence to Analgesics for Cancer Pain: A Comparative Study of African Americans and Whites Using an Electronic Monitoring Device.

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Meghani, Salimah H; Thompson, Aleda M L; Chittams, Jesse; Bruner, Deborah W; Riegel, Barbara

2015-09-01

Despite well-documented disparities in cancer pain outcomes among African Americans, surprisingly little research exists on adherence to analgesia for cancer pain in this group. We compared analgesic adherence for cancer-related pain over a 3-month period between African Americans and whites using the Medication Event Monitoring System (MEMS). Patients (N = 207) were recruited from outpatient medical oncology clinics of an academic medical center in Philadelphia (≥18 years of age, diagnosed with solid tumors or multiple myeloma, with cancer-related pain, and at least 1 prescription of oral around-the-clock analgesic). African Americans reported significantly greater cancer pain (P < .001), were less likely than whites to have a prescription of long-acting opioids (P < .001), and were more likely to have a negative Pain Management Index (P < .001). There were considerable differences between African Americans and whites in the overall MEMS dose adherence, ie, percentage of the total number of prescribed doses that were taken (53% vs 74%, P < .001). On subanalysis, analgesic adherence rates for African Americans ranged from 34% (for weak opioids) to 63% (for long-acting opioids). Unique predictors of analgesic adherence varied by race; income levels, analgesic side effects, and fear of distracting providers predicted analgesic adherence for African Americans but not for whites. Perspective: Despite evidence of disparities in cancer pain outcomes among African Americans, surprisingly little research exists on African Americans' adherence to analgesia for cancer pain. This prospective study uses objective measures to compare adherence to prescribed pain medications between African American and white patients with cancer pain. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

Potential of the strain Raoultella sp KDF8 for removal of analgesics

Czech Academy of Sciences Publication Activity Database

Palyzová, Andrea; Zahradník, Jiří; Marešová, Helena; Sokolová, Lucie; Kyslíková, Eva; Grulich, Michal; Štěpánek, Václav; Řezanka, Tomáš; Kyslík, Pavel

2018-01-01

Roč. 63, č. 3 (2018), s. 273-282 ISSN 0015-5632 R&D Projects: GA TA ČR TH02030337 Institutional support: RVO:61388971 ; RVO:86652036 Keywords : Microbial degradation * Raoultella sp. * Analgesics Subject RIV: EE - Microbiology, Virology OBOR OECD: Microbiology Impact factor: 1.521, year: 2016

High Performance Liquid Chromatography of Some Analgesic Compounds: An Instrumental Analysis Experiment.

Science.gov (United States)

Haddad, Paul; And Others

1983-01-01

Background information, procedures, and results are provided for an experiment demonstrating techniques of solvent selection, gradient elution, pH control, and ion-pairing in the analysis of an analgesic mixture using reversed-phase liquid chromatography on an octadecylsilane column. Although developed using sophisticated/expensive equipment, less…

Tolerance to Non-Opioid Analgesics is Opioid Sensitive in the Nucleus Raphe Magnus.

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Tsagareli, Merab G; Nozadze, Ivliane; Tsiklauri, Nana; Gurtskaia, Gulnaz

2011-01-01

Repeated injection of opioid analgesics can lead to a progressive loss of effect. This phenomenon is known as tolerance. Several lines of investigations have shown that systemic, intraperitoneal administration or the microinjection of non-opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) into the midbrain periaqueductal gray matter induces antinociception with some effects of tolerance. Our recent study has revealed that microinjection of three drugs analgin, ketorolac, and xefocam into the central nucleus of amygdala produce tolerance to them and cross-tolerance to morphine. Here we report that repeated administrations of these NSAIDs into the nucleus raphe magnus (NRM) in the following 4 days result in progressively less antinociception compare to the saline control, i.e., tolerance develops to these drugs in male rats. Special control experiments showed that post-treatment with the μ-opioid antagonist naloxone into the NRM significantly decreased antinociceptive effects of NSAIDs on the first day of testing in the tail-flick (TF) reflex and hot plate (HP) latency tests. On the second day, naloxone generally had trend effects in both TF and HP tests and impeded the development of tolerance to the antinociceptive effect of non-opioid analgesics. These findings strongly support the suggestion of endogenous opioid involvement in NSAIDs antinociception and tolerance in the descending pain-control system. Moreover, repeated injections of NSAIDs progressively lead to tolerance to them, cross-tolerance to morphine, and the risk of a withdrawal syndrome. Therefore, these results are important for human medicine too.

Synthesis of Silver Nanoparticles Using Buchu Plant Extracts and Their Analgesic Properties

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Herbert Chiguvare

2016-06-01

Full Text Available We herein report for the first time the synthesis and analgesic properties of silver nanoparticles (Ag-NPs using buchu plant extract. The as-synthesised Ag-NPs at different temperatures were characterised by UV-Vis spectroscopy, Fourier transform infra-red spectroscopy (FTIR and transmission transform microscopy (TEM to confirm the formation of silver nanoparticles. Phytochemical screening of the ethanolic extract revealed the presence of glycosides, proteins, tannins, alkaloids, flavonoids and saponins. The absorption spectra showed that the synthesis is temperature and time dependent. The TEM analysis showed that the as-synthesised Ag-NPs are polydispersed and spherical in shape with average particle diameter of 19.95 ± 7.76 nm while the FTIR results confirmed the reduction and capping of the as-synthesised Ag-NPs by the phytochemicals present in the ethanolic extract. The analgesic study indicated that the combined effect of the plant extract and Ag-NPs is more effective in pain management than both the aspirin drug and the extract alone.

Does the use of a brief cryotherapy intervention with analgesic administration improve pain management after total knee arthroplasty?

Science.gov (United States)

Wittig-Wells, Deborah; Johnson, Ifeya; Samms-McPherson, Jacqueline; Thankachan, Soosan; Titus, Bobina; Jacob, Ani; Higgins, Melinda

2015-01-01

Prior studies have evaluated only the prolonged use of cryotherapy as a nonpharmacologic pain intervention. The purpose of this study was to determine whether a 30-minute application of cryotherapy at the time pain medication was given after a total knee arthroplasty (TKA) provided better pain relief than analgesic drugs alone. A pretest, posttest, randomized controlled trial study design with crossover was used to evaluate the effects of cryotherapy on postoperative pain and satisfaction with pain management. A convenience sample of postoperative knee replacement patients constituted participants in the study. Two sequential episodes of pain requiring analgesic administration were studied in each patient, one with a 30-minute cryotherapy application and the other without cryotherapy. Dependent variables were changes in pain (posttest minus pretest) and level of satisfaction with pain management. Data were analyzed with repeated-measures analysis of variance, with p cryotherapy administration for the other pain episode. No significant difference between the two treatments was found for changes in pain scores after the treatments or patient satisfaction with pain management (p > .05). The order in which the treatments were provided was found to be significant (p = .02) for scores on patient satisfaction with pain management, with cryotherapy as the treatment for the second pain episode having higher scores than when delivered for the first pain episode. Sixty minutes after analgesic administration with or without cryotherapy, average pain scores remained greater than 7. In TKA patients, the short-term application of cryotherapy with analgesic medication administration did not significantly decrease pain or improve patient satisfaction with pain management compared with analgesic medication administration only. Further study is necessary to determine whether short-term cryotherapy shortly after TKA is of benefit to pain relief and patient satisfaction.

Parents' preferences strongly influence their decisions to withhold prescribed opioids when faced with analgesic trade-off dilemmas for children: a prospective observational study.

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Voepel-Lewis, Terri; Zikmund-Fisher, Brian J; Smith, Ellen Lavoie; Zyzanski, Sarah; Tait, Alan R

2015-08-01

Despite parents' stated desire to treat pain in their children, recent studies have critiqued their underuse of prescribed analgesics to treat pain in their children after painful procedures. Parents' analgesic preferences, including their perceived importance of providing pain relief or avoiding adverse drug effects may have important implications for their analgesic decisions, yet no studies have evaluated the influence of preferences on decisions to withhold prescribed opioids for children. We prospectively explored how parents' preferences influenced decisions to withhold prescribed opioids when faced with hypothetical dilemmas and after hospital discharge. Prospective Observational Study Design: Phase 1 included hypothetical analgesic decisions and Phase 2, real analgesic decisions after hospital discharge. Large tertiary care pediatric hospital in the Midwest of the United States. Five-hundred seven parents whose children underwent a painful surgical procedure requiring an opioid prescription were included. At baseline, parents completed surveys assessing their pain relief preference (i.e., their rated importance of pain relief relative to adverse drug event avoidance), preferred treatment thresholds (i.e., pain level at which they would give an opioid), adverse drug event understanding, and hypothetical trade-off decisions (i.e., scenarios presenting variable pain and adverse drug event symptoms in a child). After discharge, parents recorded all analgesics they gave their child as well as pain scores at the time of administration. Higher preference to provide pain relief (over avoid analgesic risk) lessened the likelihood that parents would withhold the prescribed opioid when adverse drug event symptoms were present together with high pain scores in the hypothetical scenarios. Additionally, higher preferred treatment thresholds increased the likelihood of parents withholding opioids during their hypothetical decision-making as well as at home. The strong

Evaluation of in vivo anti-inflmmatory and analgesic activity of Dillenia indica f. elongata (Miq. Miq. and Shorea robusta stem bark extracts

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Preet Amol Singh

2016-01-01

Full Text Available Objective: To evaluate the in vivo anti-inflammatory and analgesic potential of stem bark extract of Dillenia indica f. elongata (Miq. Miq. (D. indica f. elongata and its comparison with Shorea robusta Gaertn. (S. robusta and respective standard drugs in experimental animals. Methods: Analgesic models (hot plate, tail flick and formalin induced paw licking along with acute (carrageenan-induced and chronic (formalin-induced models of inflammation were evaluated for analgesic and anti-inflammatory potential of the plant extracts. Results: The results of the study showed that the ethyl acetate extracts of D. indica f. elongata (100 and 300 mg/kg and S. robusta (100 and 300 mg/kg possessed good central as well as peripheral analgesic activity as compared with pentazocine and indomethacin (10 mg/kg respectively. The extracts showed significant (P < 0.01 activity in carrageenan- and formalininduced chronic inflammation models by using indomethacin (8 mg/kg and diclofenac (13.5 mg/kg as standard drugs respectively. Conclusions: It can be concluded that the presence of major constituents like flavonoids, tannins and phenols in the ethyl acetate extracts of stem bark of D. indica f. elongata (100 and 300 mg/kg and S. robusta (100 and 300 mg/kg may be responsible for its analgesic and antiinflammatory activity.

Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy

DEFF Research Database (Denmark)

Røjskjaer, Jesper O; Gade, Erik; Kiel, Louise B

2015-01-01

OBJECTIVE: To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen. DESIGN: A randomized, double-blind, placebo-controlled trial following the CONSORT criteria. SETTING: Hvidovre Univers...

A prospective study to assess the palatability of analgesic medicines in children.

Science.gov (United States)

Smith, Coral June; Sammons, Helen M; Fakis, Apostolos; Conroy, Sharon

2013-03-01

This study examined children's opinions on the taste of three analgesic medicines: paracetamol, ibuprofen and codeine. Many medicines for children are unpleasant and unacceptable. Research has shown that children's taste preferences differ to adults, in whom palatability is often tested. Little British research exists on children's opinions on the palatability of medicines. This study aimed to address this gap in knowledge. Prospective observational study. Between May-September 2008, hospital inpatients aged 5-16 years rated the taste of required analgesics on a 100-mm visual analogue scale. This incorporated a 5-point facial hedonic scale. They were also asked their favourite flavour and colour for a medicine. A total of 159 children took part. Eighty-five males (53·5%) and 74 females (46·5%). The median age was 8 years (Inter-quartile range 6-11). The taste of ibuprofen was significantly preferred to paracetamol or codeine. Significant differences were observed depending if the medicine rated was taken first or second (for example pre-medication with paracetamol and ibuprofen). Younger children (5-8 years) were more likely to choose the extremes of the scale when grading than older children were. Preferred flavours on questioning were strawberry 44% and banana 17%. Favourite colours were pink 25·8% and red 20·8%, with girls more likely to choose pink and boys blue. Ibuprofen was the most palatable analgesic medicine tested. Children reported they preferred fruit flavours and colour was sex dependent. Nurses when administering two medicines together should consider giving the least palatable first, for example paracetamol before ibuprofen for pre-medication. © 2012 Blackwell Publishing Ltd.

Analgesic consumption trajectories in 8975 patients 1 year after fast-track total hip or knee arthroplasty

DEFF Research Database (Denmark)

Jørgensen, C C; Petersen, M; Kehlet, H

2018-01-01

, opioids, anticonvulsants and antidepressants 1 month preoperatively and 1 year postoperatively. Patients were stratified according to preoperative opioid use. Postoperative analgesic consumption trajectories were stratified as increased, decreased or no use compared to the preoperative period. RESULTS.......6 (TKA) and 10.2% (THA) compared to 9.9 and 6.3% in opioid-naive TKA and THA patients, respectively. Increased NSAID and paracetamol use was seen in 11.5 and 12.4% of all patients. Preoperative analgesic use (any), TKA, psychiatric disorder, tobacco abuse, cardiac disease and use of walking aids were...

Comparison of Analgesic and Hypoglycemic Effect of Hexanic and Alcohlic Extract of Fenugreek Seed in Male Diabetic Rats

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Sima Nasri

2013-04-01

Full Text Available Background & Objectives: Diabetes mellitus is recognized with severe metabolic complications. Many herbal medicines have been recommended for treatment of diabetes. In this study, the antidiabetic and analgesic effect of hexanic and alcohlic extract Trigonella-foenum graecum was investigated in normal and streptozotocin-induced diabetic rats.  Methods: Present study was carried out in 2011 at Guilan University of Medical Sciences, 48 male Sprague Dawley rats (230-300 gr were divided into six groups: control, type 1 diabetic, and 4 treat ed groups that received intraperitonealy hexanic and alcoholic extract of fenugreek (100, 200 mg/kg body weight for 28 days. Two experimental models were used (acetic acid, and hot-plate tests in order to characterize the analgesic effect. Blood glucose was measured with glucometer. Data analyzed with spss software 16 and one way ANOVA and Tukey tests. P<0.05 was statistically significant.  Results: Compared to control rats, both of the aqueous - alcoholic and Hexan ic extract significantly reduced blood glucose level in all diabetics groups. This effect was stronger in groups that received Hexanic extract (p<0.05 . All groups received the aqueous - alcoholic and Hexan ic extract showed analgesic effect but this effect was more clear in the Hexanic 200 mg/kg group (p<0.05.  Conclusion: Fenugreek extract possesses hypoglycemic , and analgesic effects .

Antioxidant, Anti-inflammatory, Analgesic Properties, and Phytochemical Characterization of Stem Bark Extract and Fractions of Anthocleista nobilis.

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Ngwoke, Kenneth Gerald; Akwagbulam, Amaka Godsaveus; Erhirhie, Ernest Oghenesuvwe; Ajaghaku, Daniel Lotanna; Okoye, Festus Basden Chiedu; Esimone, Charles Okechukwu

2018-01-01

Anthocleista nobilis ( Loganiaceae ) is used by Mbano people of Imo State, Nigeria, for the treatment of various ailments. The aim of this study is to evaluate the antioxidant, anti-inflammatory, and analgesic properties of the methanol extract, fractions, and subfractions of A. nobilis . The powdered stem bark was extracted with methanol and sequentially fractionated into n-hexane, ethyl acetate, and butanol fractions. The constituents of the fractions were analyzed using high-pressure liquid chromatography (HPLC), and the components were identified by dereplication. Antioxidant potential of the extracts and fractions was investigated using 2,2-diphenyl-1-picrylhydrazyl free-radical scavenging method. Anti-inflammatory and analgesic activities of the extract and fractions were also investigated using xylene-induced inflammation and acetic acid-induced writhing models, respectively. A total of five compounds isovitexin ( R t = 18.77 min), isovitexin-2''-O-xyl ( R t = 19.68 min), p-Hydroxybenzoic acid ( R t = 11.88 min), Sarasinoside L ( R t = 19.64 min), isovitexin ( R t = 18.77), and apigenin monoglycoside ( R t = 19.64 min) were identified by HPLC analysis and dereplication. The ethyl acetate fraction and subfraction elicited the best anti-inflammatory activity. The ethyl acetate subfraction also inhibited acetic acid-induced pain by 79% and 85.0% at the doses of 100 mg/kg and 200 mg/kg, respectively, which was better than 71.1% and 81.3% observed for diclofenac at similar doses. A. nobilis could be a potential source of anti-inflammatory and analgesic lead compounds. The extract, fractions and subfractions of Anthocleista nobilis were screened or antioxidant, anti-inflammatory and Analgesic properties in vitro and in mice models. Some of the components were identified by dereplication after HPLC analysis. The results demonstrated potent anti-inflammatory and analgesic property of the extracts and fractions. The dereplication analysis also identified vitexin and

Antioxidant, Anti-inflammatory, Analgesic Properties, and Phytochemical Characterization of Stem Bark Extract and Fractions of Anthocleista nobilis

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Ngwoke, Kenneth Gerald; Akwagbulam, Amaka Godsaveus; Erhirhie, Ernest Oghenesuvwe; Ajaghaku, Daniel Lotanna; Okoye, Festus Basden Chiedu; Esimone, Charles Okechukwu

2018-01-01

Background: Anthocleista nobilis (Loganiaceae) is used by Mbano people of Imo State, Nigeria, for the treatment of various ailments Objective: The aim of this study is to evaluate the antioxidant, anti-inflammatory, and analgesic properties of the methanol extract, fractions, and subfractions of A. nobilis. Materials and Methods: The powdered stem bark was extracted with methanol and sequentially fractionated into n-hexane, ethyl acetate, and butanol fractions. The constituents of the fractions were analyzed using high-pressure liquid chromatography (HPLC), and the components were identified by dereplication. Antioxidant potential of the extracts and fractions was investigated using 2,2-diphenyl-1-picrylhydrazyl free-radical scavenging method. Anti-inflammatory and analgesic activities of the extract and fractions were also investigated using xylene-induced inflammation and acetic acid-induced writhing models, respectively. Results: A total of five compounds isovitexin (Rt = 18.77 min), isovitexin-2''-O-xyl (Rt = 19.68 min), p-Hydroxybenzoic acid (Rt = 11.88 min), Sarasinoside L (Rt = 19.64 min), isovitexin (Rt = 18.77), and apigenin monoglycoside (Rt = 19.64 min) were identified by HPLC analysis and dereplication. The ethyl acetate fraction and subfraction elicited the best anti-inflammatory activity. The ethyl acetate subfraction also inhibited acetic acid-induced pain by 79% and 85.0% at the doses of 100 mg/kg and 200 mg/kg, respectively, which was better than 71.1% and 81.3% observed for diclofenac at similar doses. Conclusion: A. nobilis could be a potential source of anti-inflammatory and analgesic lead compounds. SUMMARY The extract, fractions and subfractions of Anthocleista nobilis were screened or antioxidant, anti-inflammatory and Analgesic properties in vitro and in mice models. Some of the components were identified by dereplication after HPLC analysis. The results demonstrated potent anti-inflammatory and analgesic property of the extracts and

Immigration within European Union – Does health immigration make a difference in analgesic use?

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Airaksinen M.

2006-12-01

Full Text Available European integration has facilitated the emigration inside Europe and it has been predicted that the amount of immigrants in Southern European countries will increase in the future. As these people age and their morbidity increases, they will demand more services from local health care than immigrants do at the moment. The aim of this study is to determine the amount of Finnish people who have moved to Spain for health reasons (health immigrants and whether their health service and analgesic usage patterns differed from those of non-health immigrants. Methods: This study was carried out among Finnish people living in Costa del Sol area, southern Spain. The data were collected by questionnaire during 2002 by using a convenience sample of 1,000 Finns living permanently in the area (response rate 53%, n=530. Statistical analyses were conducted using statistical software SPSS 11.5.Results: Two-thirds of the respondents were categorised as health immigrants. Health immigrants were more often suffering from chronic morbidity, their perceived health status was poorer and they used public health services more often than the non-health immigrants. Half (50% of the all respondents had used some analgesics during the two weeks before the survey. There were more analgesic users among the health immigrant group (54 % vs. 43 %, p = 0.034 and they also used analgesics more frequently than the non-health immigrants (27 % vs. 9 %, p= 0.020. Conclusions: Our study indicates, that high amount of Finnish immigrants suffer from some degree of health problems and the health state factors have a large influence on the emigration into Spain. As this kind of trend might also exist among immigrants from other EU-nations, immigrants might burden the local Spanish health care services in the future. Therefore the Providers of health care services in immigrant areas should consider these trends in planning health care in the future.

Xiaozhi decoction reduced posthemorrhoidectomy pain and analgesic medication consumption: a prospective study

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Shen JB

2017-01-01

Full Text Available Jianbin Shen,1,* Xiagang Luo,2,* Xiao Zhou,3 Chengwu Tang,1 Huanyu Ju,2 Yongqiang Xu,1 Lianjin Qin1 1Department of General Surgery, First People’s Hospital Affiliated to Huzhou Normal College, Huzhou, Zhejiang, 2Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 3Department of Orthopedics, People’s Hospital of Zhangqiu, Jinan, Shandong, People’s Republic of China *These authors contributed equally to this work Objective: The aim of this study was to investigate the effect of Xiaozhi decoction (XZD on posthemorrhoidectomy pain and analgesic medication consumption.Methods: From May 2013 to March 2015, 315 patients who underwent open hemorrhoidectomy in our hospital were enrolled in this study, of whom, 160 patients were randomly assigned to accept sitz bath with warm water after hemorrhoidectomy (control group and 155 patients were randomly assigned to accept sitz bath with XZD (XZD group after hemorrhoidectomy. Postoperative pain at 12 hours after surgery and on postoperative days (PODs 1, 2, 7, 14 and 28 was evaluated by Visual Analog Scale (VAS. Pain on defecation on PODs 1, 2, 7, 14 and 28 was also recorded using the VAS. The consumption of analgesics was also analyzed.Results: No significant difference was found in baseline characteristics between the two groups. Postoperative pain score of the XZD group was significantly lower on POD 2 (6.04±1.11 vs 6.33±1.14, P=0.0229, POD 7 (3.35±0.75 vs 4.22±0.87, P=0.0000 and POD 14 (2.87±0.64 vs 3.64±0.77, P=0.0000 than that of the control group. Similarly, patients in the XZD group experienced significantly less pain on defecation on POD 2 (5.02±1.34 vs 5.43±1.56, P=0.0130, POD 7 (3.08±1.17 vs 3.52±1.29, P=0.0017 and POD 14 (2.31±0.85 vs 2.68±0.99, P=0.0004. Patients in the XZD group consumed significantly less analgesic medication on POD 2 (P=0.0136, POD 7 (P=0.0074 and POD 14 (P=0.0046 than the control group. Conclusion

Massage therapy plus topical analgesic is more effective than massage alone for hand arthritis pain.

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Field, Tiffany; Diego, Miguel; Solien-Wolfe, Lynda

2014-07-01

20 adults were randomly assigned to a massage therapy or a massage therapy plus a topical analgesic application group. Both groups received a weekly massage from a therapist and were taught self-massage (same procedure) to be done by each participant once daily over a four-week period. The massage plus topical analgesic group as compared to the massage group had greater improvement in hand function as measured by a digital hand exerciser following the first session and across the four-week period. That group also had a greater increase in perceived grip strength and a greater decrease in hand pain, depressed mood and sleep disturbances over the four-week period. Massage therapy has been effective for several pain syndromes including migraine headaches (Lawle and Cameron, 2006)), lower back pain (Hsieh et al., 2004), fibromyalgia (Kalichman, 2010), neck and shoulder pain (Kong et al., 2013), carpal tunnel syndrome (Elliott and Burkett, 2013), and pain related to upper limb arthritis (Field et al., 2013). The purpose of the current study was to determine whether applying a topical analgesic following massage might be more effective than massage alone in treating pain associated with hand arthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Paracetamol as a prophylactic analgesic for hysterosalpingography: A double blind randomized controlled trial

International Nuclear Information System (INIS)

Elson, E.M.; Ridley, N.T.F.

2000-01-01

AIM: To evaluate the effectiveness of paracetamol as a prophylactic analgesic for hysterosalpingography (HSG). DESIGN: A prospective double blind randomized controlled trial comparing one 1 g of paracetamol (SmithKline Beecham, Brentford, U.K.) to placebo taken 30 min before HSG. One hundred consecutive out-patients were studied prospectively. The analgesic effectiveness during the procedure and at 24 h and 1 week post procedure was analysed by a postal pain score questionnaire. Additional data on the ethnicity of the patient, sex and level of experience of the radiologist performing the hysterosalpingogram, the parity of the patient, the ease of the procedure, and whether pathology was identified were also recorded. RESULTS: Eighty-eight patients (88%) replied, 39 (44%) received paracetamol and 49 placebo (56%). During the procedure 3/39 (7%) of women in the paracetamol group were pain-free compared to 9/49 (18%) in the placebo group, which was not significant (P = 0.11). At 24 h, 15/39 (38%) of women in the paracetamol group were pain-free compared to 20/49 (41%) in the placebo group, which was not significant (P = 0.82). At 1 week, 27/39 (69%) of women in the paracetamol group were pain-free compared to 29/49 (59%) in the placebo group, which was not significant (P = 0.33). No significant difference in mean pain scores was determined during the procedure (P 0.91), or at 24 h post procedure (P = 0.94). Similarly, no difference in mean pain scores was identified with regard to the ethnicity of the patient, the sex of the radiologist performing the procedure, the level of experience of the radiologist performing the procedure, or whether pathology was present or not. Difficult cannulations were associated with higher mean pain scores, however, there was no difference in mean pain scores between the paracetamol or placebo groups for both easy and difficult cannulations. CONCLUSION: Paracetamol is not effective as a prophylactic analgesic for HSG. If a prophylactic

Paracetamol as a prophylactic analgesic for hysterosalpingography: A double blind randomized controlled trial

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Elson, E.M.; Ridley, N.T.F

2000-09-01

AIM: To evaluate the effectiveness of paracetamol as a prophylactic analgesic for hysterosalpingography (HSG). DESIGN: A prospective double blind randomized controlled trial comparing one 1 g of paracetamol (SmithKline Beecham, Brentford, U.K.) to placebo taken 30 min before HSG. One hundred consecutive out-patients were studied prospectively. The analgesic effectiveness during the procedure and at 24 h and 1 week post procedure was analysed by a postal pain score questionnaire. Additional data on the ethnicity of the patient, sex and level of experience of the radiologist performing the hysterosalpingogram, the parity of the patient, the ease of the procedure, and whether pathology was identified were also recorded. RESULTS: Eighty-eight patients (88%) replied, 39 (44%) received paracetamol and 49 placebo (56%). During the procedure 3/39 (7%) of women in the paracetamol group were pain-free compared to 9/49 (18%) in the placebo group, which was not significant (P = 0.11). At 24 h, 15/39 (38%) of women in the paracetamol group were pain-free compared to 20/49 (41%) in the placebo group, which was not significant (P = 0.82). At 1 week, 27/39 (69%) of women in the paracetamol group were pain-free compared to 29/49 (59%) in the placebo group, which was not significant (P = 0.33). No significant difference in mean pain scores was determined during the procedure (P 0.91), or at 24 h post procedure (P = 0.94). Similarly, no difference in mean pain scores was identified with regard to the ethnicity of the patient, the sex of the radiologist performing the procedure, the level of experience of the radiologist performing the procedure, or whether pathology was present or not. Difficult cannulations were associated with higher mean pain scores, however, there was no difference in mean pain scores between the paracetamol or placebo groups for both easy and difficult cannulations. CONCLUSION: Paracetamol is not effective as a prophylactic analgesic for HSG. If a prophylactic

Analgesic and anti-inflammatory controlled-released injectable microemulsion: Pseudo-ternary phase diagrams, in vitro, ex vivo and in vivo evaluation.

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Pineros, Isabel; Slowing, Karla; Serrano, Dolores R; de Pablo, Esther; Ballesteros, Maria Paloma

2017-04-01

Development of analgesic and anti-inflammatory controlled-released injectable microemulsions utilising lysine clonixinate (LC) as model drug and generally regarded as safe (GRAS) excipients. Different microemulsions were optimised through pseudo-ternary phase diagrams and characterised measuring droplet size, viscosity, ex vivo haemolytic activity and in vitro drug release. The anti-inflammatory and analgesic activity was tested in mice (Hot plate test) and rats (Carrageenan-induced paw edema test) respectively and their activity was compared to an aqueous solution of LC salt. The aqueous solution showed a faster and shorter response whereas the optimised microemulsion increased significantly (p<0.01) the potency and duration of the analgesic and anti-inflammatory activity after deep intramuscular injection. The droplet size and the viscosity were key factors to control the drug release from the systems and enhance the effect of the formulations. The microemulsion consisting of Labrafil®/Lauroglycol®/Polysorbate 80/water with LC (56.25/18.75/15/10, w/w) could be a promising formulation after buccal surgery due to its ability to control the drug release and significantly achieve greater analgesic and anti-inflammatory effect over 24h. Copyright © 2016. Published by Elsevier B.V.

Influence of serotonin on the analgesic effect of granisetron on temporomandibular joint arthritis

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Ülle Voog

2004-01-01

Full Text Available THE influence of circulating serotonin (5-HT on the effects of intra-articular administration of granisetron on temporomandibular joint (TMJ pain was investigated in 11 patients with chronic polyarthritides. An analgesic effect superior to placebo has been shown previously.

The analgesic effect of different antidepressants combined with aspirin on thermally induced pain in Albino mice

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Abdalla S. Elhwuegi

2012-04-01

Full Text Available Background:Combination analgesics provide more effective pain relief for a broader spectrum of pain. This research examines the possible potentiation of the analgesic effect of different classes of antidepressants when combined with aspirin in thermal model of pain using Albino mice.Methods:Different groups of six animals each were injected intraperitoneally by different doses of aspirin (50, 100, or 200 mg/kg, imipramine (2.5, 7.5, 15 or 30 mg/kg, fluoxetine (1.25, 2.5, 5 or 7.5 mg/kg, mirtazapine (1.25, 2.5, or 5 mg/kg and a combination of a fixed dose of aspirin (100 mg/kg with the different doses of the three antidepressants. One hour later the analgesic effect of these treatments were evaluated against thermally induced pain. All data were subjected to statistical analysis using unpaired Student's t-test.Results:Aspirin had no analgesic effect in thermally induced pain. The three selected antidepressants produced dose dependent analgesia. The addition of a fixed dose of aspirin to imipramine significantly increased the reaction time (RT of the lowest dose (by 23% and the highest dose (by 20%. The addition of the fixed dose of aspirin to fluoxetine significantly increased RT by 13% of the dose 2.5 mg/Kg. Finally, the addition of the fixed dose of aspirin significantly potentiated the antinociceptive effect of the different doses of mirtazapine (RT was increased by 24, 54 and 38% respectively.Conclusion:Combination of aspirin with an antidepressant might produce better analgesia, increasing the efficacy of pain management and reduces side effects by using smaller doses of each drug.

Evaluation of the analgesic activity and safety of ketorolac in whole body fractionated gamma irradiated animals

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Sara Aly

2015-06-01

Full Text Available This study was performed to evaluate the analgesic activity and the toxicity of ketorolac in normal and fractionated (1.5 Gy/day/4 days γ-irradiated animals. Determination of brain serotonin content and serum prostaglandin level were also undertaken. The analgesic activity was tested using formalin test, at three dose levels (15, 30 and 60 mg/kg after 1 and 7 days post radiation exposure. LD50 determinations and assessment of liver and kidney function tests were performed. Our results indicated marked analgesic effects on the early and late phases of nociception. Double treatment with ketorolac and irradiation increased brain serotonin content. The acute LD50 of ketorolac was decreased in irradiated animals as compared to the LD50 of normal animals. Double treatment with ketorolac and irradiation induced an elevation of gastric mucin content, urea and BUN levels on the 1st day post irradiation, whereas, albumin level was lowered and globulin level was elevated after 7 days post irradiation. Depending on this study the dose of ketorolac used for treating cancer patients addressed to radiotherapy should be reduced, however, this requires further clinical confirmation.

The cumulative analgesic effect of repeated electroacupuncture involves synaptic remodeling in the hippocampal CA3 region☆

Science.gov (United States)

Xu, Qiuling; Liu, Tao; Chen, Shuping; Gao, Yonghui; Wang, Junying; Qiao, Lina; Liu, Junling

2012-01-01

In the present study, we examined the analgesic effect of repeated electroacupuncture at bilateral Zusanli (ST36) and Yanglingquan (GB34) once a day for 14 consecutive days in a rat model of chronic sciatic nerve constriction injury-induced neuropathic pain. In addition, concomitant changes in calcium/calmodulin-dependent protein kinase II expression and synaptic ultrastructure of neurons in the hippocampal CA3 region were examined. The thermal pain threshold (paw withdrawal latency) was increased significantly in both groups at 2 weeks after electroacupuncture intervention compared with 2 days of electroacupuncture. In ovariectomized rats with chronic constriction injury, the analgesic effect was significantly reduced. Electroacupuncture for 2 weeks significantly diminished the injury-induced increase in synaptic cleft width and thinning of the postsynaptic density, and it significantly suppressed the down-regulation of intracellular calcium/calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. Repeated electroacupuncture intervention had a cumulative analgesic effect on injury-induced neuropathic pain reactions, and it led to synaptic remodeling of hippocampal neurons and upregulated calcium/calmodulin-dependent protein kinase II expression in the hippocampal CA3 region. PMID:25657670

The analgesic effect of tramadol in animal models of neuropathic pain and fibromyalgia.

Science.gov (United States)

Kaneko, Kumi; Umehara, Masato; Homan, Takashi; Okamoto, Ken; Oka, Michiko; Oyama, Tatsuya

2014-03-06

(±)-Tramadol hydrochloride (tramadol) is a widely used analgesic for the treatment of cancer pain and chronic pain. Although many animal studies have shown antinociceptive effects of tramadol in both acute and chronic pain, little is known about the effect of tramadol in putative animal models of fibromyalgia. In this study, we compared the antiallodynic effects of oral administration of tramadol in two kinds of rat chronic pain models, neuropathic pain induced by partial sciatic nerve ligation (PSL) and reserpine-induced myalgia (RIM). In PSL rats, the threshold for responses induced by tactile stimulation with von Frey filaments was significantly decreased seven days after the operation, suggesting that the operation induced tactile allodynia. Orally administered tramadol showed a potent and dose-dependent antiallodynic effect on PSL-induced allodynia. In RIM rats, the threshold was significantly decreased five days after reserpine treatment. Orally administered tramadol also attenuated reserpine-induced tactile allodynia. To explore the mechanism of the antiallodynic effect of tramadol in RIM rats, we investigated the effect of the opioid antagonist naloxone on the tramadol-induced analgesic effect in these rats. The effect of tramadol was partially antagonized by naloxone, suggesting that the opioid receptor is involved at least in part in the antiallodynic effect of tramadol in RIM rats. These data indicate that orally administered tramadol produced improvement in both PSL rats and RIM rats at similar doses and provide evidence that the opioid system is partly involved in the analgesic effect of tramadol in RIM rats. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Analgesic and anti-inflammatory activity of root bark of Grewia asiatica Linn. in rodents

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Udaybhan Singh Paviaya

2013-01-01

Conclusions: The present study indicates that root bark of G. asiatica exhibits peripheral and central analgesic effect and anti-inflammatory activity, which may be attributed to the various phytochemicals present in root bark of G. asiatica.

[Pharmacist perception of the use of analgesics and their practice on mild-moderate pain. DOLOR-OFF survey].

Science.gov (United States)

Arrebola, Cristobal; García-Delgado, Pilar; Labrador Barba, Elena; Orera Peña, Maria Luisa; Martínez-Martínez, Fernando

2016-01-01

To examine the use of analgesics, from the perspective of the pharmacist community, and pharmaceutical practice in mild-moderate pain. A cross-sectional, observational study was performed between April and September 2013. 696 community pharmacies in 20 Spanish provinces. Community pharmacists with a minimum professional experience of one year. Characterisation of the demand for analgesics, analgesic users, and pharmaceutical intervention for mild-moderate pain from the perspective of the pharmaceutical community. The main reason why a patient with mild-moderate pain visits a pharmacy is to receive a drug with prescription (45.5%), and the most common condition is headache (35.2%). Ibuprofen and paracetamol are the most commonly used drugs for mild-moderate pain. More than one-third (38.9%) of pharmacists follow a protocol for counselling. A correlation was found between the pharmacist's professional experience and the application of counselling process (Fisher P<.05). Some 87.8% of pharmacists checked two indicators from the dispensing service, and only 1.3% did not check any. Referral to a physician was made by 14.8% of pharmacists, with the main reason being the detection of alarm indicators. Protocols need to be designed and adapted to the characteristics of the 3 profiles identified, in order to increase the efficiency of pharmaceutical services in mild-moderate pain relief. Practical and specific training in pain are required to implement services to ensure the correct and systemic use of analgesics and positive clinical outcomes. Copyright © 2016. Publicado por Elsevier España, S.L.U.

The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review

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Andrew D. Vigotsky

2015-01-01

Full Text Available Manual therapy has long been a component of physical rehabilitation programs, especially to treat those in pain. The mechanisms of manual therapy, however, are not fully understood, and it has been suggested that its pain modulatory effects are of neurophysiological origin and may be mediated by the descending modulatory circuit. Therefore, the purpose of this review is to examine the neurophysiological response to different types of manual therapy, in order to better understand the neurophysiological mechanisms behind each therapy’s analgesic effects. It is concluded that different forms of manual therapy elicit analgesic effects via different mechanisms, and nearly all therapies appear to be at least partially mediated by descending modulation. Additionally, future avenues of mechanistic research pertaining to manual therapy are discussed.

Coffee drinking enhances the analgesic effect of cigarette smoking

DEFF Research Database (Denmark)

Nastase, Anca; Ioan, Silvia; Braga, Radu I

2007-01-01

Nicotine (from cigarette smoke) and caffeine (from coffee) have analgesic effects in humans and experimental animals. We investigated the combined effects of coffee drinking and cigarette smoking on pain experience in a group of moderate nicotine-dependent, coffee drinking, young smokers. Pain...... threshold and pain tolerance were measured during cold pressor test following the habitual nocturnal deprivation of smoking and coffee drinking. Smoking increased pain threshold and pain tolerance in both men and women. Coffee drinking, at a dose that had no independent effect, doubled the increase in pain...

SEDATIVE AND ANALGESIC EFFECTS OF DETOMIDINE HYDROCHLORIDE IN GOATS

OpenAIRE

A. N. Tunio., A. B. Kalhoro and I.H. Kathio1

2003-01-01

The sedative and analgesic effects of three dose rates of detomidine (40, 50 and 60µg/kg body weight) were studied in six goats. Moderate to deep sedation occurred after administration of 40µg/kg of detomidine as compared to deep sedation produced by 50 and 60µg/kg of detomidine. The degree, onset and duration of sedation and onset and duration of maximum sedation were all dose dependent. Skin analgesia and recumbency were produced in all animals with higher doses (50 and 60µg/kg) and in thre...

Antioxidant, analgesic and anti-inflammatory activities of the methanolic extract of Piper betle leaves.

Science.gov (United States)

Alam, Badrul; Akter, Fahima; Parvin, Nahida; Sharmin Pia, Rashna; Akter, Sharmin; Chowdhury, Jesmin; Sifath-E-Jahan, Kazi; Haque, Ekramul

2013-01-01

The present study was designed to evaluate the antioxidant, analgesic, and anti-inflammatory activities of the methanolic extract of Piper betle leaves (MPBL). MPBL was evaluated for anti-inflammatory activity using carrageenan-induced hind paw edema model. Analgesic activity of MPBL was evaluated by hot plate, writhing, and formalin tests. Total phenolic and flavonoids content, total antioxidant activity, scavenging of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical, peroxynitrate (ONOO) as well as inhibition of total ROS generation, and assessment of reducing power were used to evaluate antioxidant potential of MPBL. The extract of MPBL, at the dose of 100 and 200 mg/kg, produced a significant (p<0.05) increase in pain threshold in hot plate method whereas significantly (p<0.05) reduced the writhing caused by acetic acid and the number of licks induced by formalin in a dose-dependent manner. The same ranges of doses of MPBL caused significant (p<0.05) inhibition of carrageenan-induced paw edema after 4 h in a dose-dependent manner. In DPPH, ONOO(-), and total ROS scavenging method, MPBL showed good antioxidant potentiality with the IC50 value of 16.33±1.02, 25.16±0.61 , and 41.72±0.48 µg/ml, respectively with a significant (p<0.05) good reducing power. The findings of the study suggested that MPBL has strong analgesic, anti-inflammatory, and antioxidant effects, conforming the traditional use of this plant for inflammatory pain alleviation to its antioxidant potentiality.

Prolonged analgesic effect of PLGA-encapsulated bee venom on formalin-induced pain in rats.

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Jeong, Injae; Kim, Beom-Soo; Lee, Hyejung; Lee, Kang-Min; Shim, Insop; Kang, Sung-Keel; Yin, Chang-Shick; Hahm, Dae-Hyun

2009-10-01

To enhance the medicinal activity of bee venom (BV) acupuncture, bee venom was loaded into biodegradable poly(D,L-lactide-co-glycolide) nanoparticles (BV-PLGA-NPs) by a water-in-oil-in-water-emulsion/solvent-evaporation technique. Rat formalin tests were performed after subcutaneous injection of BV-PLGA-NPs to the Zusanli acupuncture point (ST36) at 0.5, 1, 2, 6, 12, 24, and 48 h before plantar injection of 2% formalin. BV-PLGA-NPs treatment showed comparable analgesic activity to typical BV acupuncture during the late phase, compared with saline-treated controls, and the analgesic effect lasted for 12h. PLGA-encapsulation was also effective in alleviating the edema induced by allergens in bee venom. These results indicate that PLGA-encapsulation provided a more prolonged effect of BV acupuncture treatment, while maintaining a comparable therapeutic effect.

Prescription Pattern of Analgesic Drugs for Patients Receiving Palliative Care in a Teaching Hospital in India.

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Menezes, Vishma Hydie; Nair, Shoba N; Soumya, M S; Tarey, S D

2016-01-01

Drugs used in the palliative care unit for managing symptoms are major contributors toward the expenditure occurring in palliative care. This study was conducted to understand the prescription pattern of analgesic drugs in the patients who are receiving palliative care in a teaching hospital in India by a retrospective study of case records. Case record based, retrospective, descriptive study was conducted at the Pain and Palliative Care Department of St. John's Medical College Hospital, Bengaluru. Case record files of all patients referred to Pain and Palliative Care Department for the treatment of pain in the year of 2012 were studied. Patients' age, gender, diagnoses, numerical pain rating scale (0-10), drugs prescribed, dosage, frequency, route of administration were recorded. The difference in drug utilization between the genders was done using Chi-square test. Data were collected from 502 patients of which 280 (56%) were males and 222 (44%) were females. Twelve percent of patients had mild pain (1-3), 34% had moderate pain (4-6), and 54% had severe pain (7-10). The most commonly used analgesic drugs were opioids (47%), followed by nonsteroidal anti-inflammatory drugs (36%). The opioids used were tramadol (56%), and morphine (38%). Ninety percent of patients with numerical pain scale more than 6 received morphine. There was no difference in analgesic drug utilization with regards to gender. Prescription pattern differed depending on the severity of pain. Opioids were the most commonly used drugs for pain management. The study shows that prescription pattern in palliative care unit of this hospital was in accordance with WHO pain management guidelines. The study showed the current trend in prescription of analgesic drugs in the teaching hospital where the study was conducted.

Correlation between synergistic action of Radix Angelica dahurica extracts on analgesic effects of Corydalis alkaloid and plasma concentration of dl-THP.

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Liao, Zheng-Gen; Liang, Xin-Li; Zhu, Jing-Yun; Zhao, Guo-Wei; Yang, Ming; Wang, Guang-Fa; Jiang, Qie-Ying; Chen, Xu-Long

2010-05-04

Yuanhu Zhitong prescription that consists of Corydalis yanhusuo and Radix Angelicae dahuricae has been used for the treatment of gastralgia, costalgia, headache and dysmenorrhea in Traditional Chinese Medicine. Our previous studies demonstrated that Corydalis alkaloid (CA, derived from the root of Corydalis yanhusu) had potent analgesic properties, and the total coumarins of Angelica dahurica (Cou) and volatile oil (VO) that derived from the root of Radix Angelicae dahuricae all could increase the analgesic effect of CA. The major objective of this paper was to investigate the mechanism that leading the analgesia of CA increased by Cou and (or) VO. The relationship between analgesic effect of CA and the plasma concentration of Dl-tetrahydropalmatine (dl-THP, active component of CA) was assayed in mice writhing test. The CA (34, 68 and 134 mg/kg) reduced the nociception by acetic acid intraperitoneal injection in a dose-dependent manner, and there was a significant linear relationship between the analgesic effect of CA and the plasma concentration of dl-THP. Then the plasma concentration of dl-THP at different time intervals in rats after oral administration of CA, CA-Cou, CA-VO and CA-Cou-VO were examined by using HPLC. The results indicated that Cou and (or) VO raised the plasma concentration of dl-THP prominently. In conclusion, the reason that Radix Angelica dahurica extracts reinforced the analgesic effects of Corydalis alkaloid was related to the improvement of the plasma concentration of dl-THP. (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Evaluation of the Analgesic Efficacy of Dexketoprofen Added to Paracetamol.

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Ceyhan, Dilek; Bilir, Ayten; Güleç, Mehmet Sacit

2016-12-01

Multimodal analgesic methods are preferred for the treatment of postoperative pain; as a result, the additive effects of analgesics are provided while probable side effects are avoided. The current study aimed to compare the effects of the combination of dexketoprofen and paracetamol with regard to postoperative pain therapy. Ninety-six patients who underwent non-malignant gynaecological laparotomy operations were included in this study. Patients were randomized into 3 groups. Group D received 50 mg intravenous dexketoprofen 15 minutes before the end of the operation and 8 and 16 hours after the operation. Group P received 1 g intravenous paracetamol and Group DP received the combination of 500 mg paracetamol and 25 mg dexketoprofen at the same time intervals. All patients received morphine infusion after operation. Total morphine consumption at 24 hours, visual analog scale, patient satisfaction and side effects were investigated. Comparison of the visual analog scale scores revealed that the Group DP presented lower scores at 24th hours compared to the other groups; and the difference between Group DP and Group D was statistically significant. Total morphine consumption was not significantly different between the three groups. The minimum number of side effects was observed in the Group DP. Co-administration of paracetamol, dexketoprofen and morphine provided good analgesia and fewer side effects in gynaecological abdominal surgery.

The analgesic effect of dexketoprofen when added to lidocaine for intravenous regional anaesthesia: a prospective, randomized, placebo-controlled study.

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Yurtlu, S; Hanci, V; Kargi, E; Erdoğan, G; Köksal, B G; Gül, Ş; Okyay, R D; Ayoğlu, H; Turan, I Ö

2011-01-01

This prospective, randomized, placebo-controlled study evaluated the effects of dexketoprofen as an adjunct to lidocaine in intravenous regional anaesthesia (IVRA) or as a supplemental intravenous (i.v.) analgesic. Patients scheduled for elective hand or forearm soft-tissue surgery were randomly divided into three groups. All 45 patients received 0.5% lidocaine as IVRA. Dexketoprofen was given either i.v. or added into the IVRA solution and the control group received an equal volume of saline both i.v. and as part of the IVRA. The times of sensory and motor block onset, recovery time and postoperative analgesic consumption were recorded. Compared with controls, the addition of dexketoprofen to the IVRA solution resulted in more rapid onset of sensory and motor block, longer recovery time, decreased intra- and postoperative pain scores and decreased paracetamol use. It is concluded that coadministration of dexketoprofen with lidocaine in IVRA improves anaesthetic block and decreases postoperative analgesic requirements.

The analgesic effect of orexin-A in a murine model of chemotherapy-induced neuropathic pain.

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Toyama, Satoshi; Shimoyama, Naohito; Shimoyama, Megumi

2017-02-01

Orexins are neuropeptides that are localized to neurons in the lateral and dorsal hypothalamus but its receptors are distributed to many different regions of the central nervous system. Orexins are implicated in a variety of physiological functions including sleep regulation, energy homeostats, and stress reactions. Furthermore, orexins administered exogenously have been shown to have analgesic effects in animal models. A type of intractable pain in patients is pain due to chemotherapy-induced peripheral neuropathy (CIPN). Several chemotherapeutic agents used for the treatment of malignant diseases induce dose-limiting neuropathic pain that compromises patients' quality of life. Here, we examined the analgesic effect of orexin-A in a murine model of CIPN, and compared it with the effect of duloxetine, the only drug recommended for the treatment of CIPN pain in patients. CIPN was induced in male BALB/c mice by repeated intraperitoneal injection of oxaliplatin, a platinum chemotherapeutic agent used for the treatment of advanced colorectal cancer. Neuropathic mechanical allodynia was assessed by the von Frey test, and the effect on acute thermal pain was assessed by the tail flick test. Intracerebroventricularly administered orexin-A dose-dependently attenuated oxaliplatin-induced mechanical allodynia and increased tail flick latencies. Oxaliplatin-induced mechanical allodynia was completely reversed by orexin-A at a low dose that did not increase tail flick latency. Duloxetine only partially reversed mechanical allodynia and had no effect on tail flick latency. The analgesic effect of orexin-A on oxaliplatin-induced mechanical allodynia was completely antagonized by prior intraperitoneal injection of SB-408124 (orexin type-1 receptor antagonist), but not by prior intraperitoneal injection of TCS-OX2-29 (orexin type-2 receptor antagonist). Our findings suggest that orexin-A is more potent than duloxetine in relieving pain CIPN pain and its analgesic effect is

Greater number of narcotic analgesic prescriptions for osteoarthritis is associated with falls and fractures in elderly adults.

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Rolita, Lydia; Spegman, Adele; Tang, Xiaoqin; Cronstein, Bruce N

2013-03-01

To evaluate the changes in types of medications prescribed for pain before and after withdrawal of certain selective cyclooxygenase 2 (COX-2) inhibitors in 2004 and to determine whether there was an association with fall events in elderly adults with a diagnosis of osteoarthritis (OA). A nested case-control design using electronic medical records compiled between 2001 and 2009. Electronic medical records for care provided in an integrated health system in rural Pennsylvania over a 9-year period (2001-09), the midpoint of which rofecoxib and valdecoxib were pulled from the market. Thirteen thousand three hundred fifty-four individuals aged 65 to 89 with a diagnosis of OA. The incidence of falls and fractures was examined in relation to analgesics prescribed: narcotics, COX-2 inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). The comparison sample of individuals who did not fall was matched 3:1 with those who fell according to age, sex, and comorbidity. Narcotic analgesic prescriptions were associated with a significantly greater risk of falls and fractures. The likelihood of experiencing a fall/fracture was higher in participants prescribed narcotic analgesics than those prescribed a COX-2 inhibitor (odds ratio (OR) = 3.3, 95% confidence interval (CI) = 2.5-4.3) or NSAID (OR = 4.1, 95% CI = 3.7-4.5). Use of narcotic analgesics is associated with risk of falls and fractures in elderly adults with OA, an observation that suggests that the current guidelines for the treatment of pain, which include first-line prescription of narcotics, should be reevaluated. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Standards of analgesic treatment versus hospital practice

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Anna Lewandowska

2017-07-01

Full Text Available Introduction: Pain remedying is a fundamental patient law. Modern medicine is acknowledging the mechanism and the warp of pain, commanding more efficient therapeutic means allowing to control the pain.  Multidirectional pain therapy uses variable techniques and medicines which enables to maximize the analgesic effect during the reduction of side effects of each method. Objective: Evaluation of applying standards of analgesic treatment in hospital practice. Material and methods: There were 100 people with severe pain who underwent surgical and orthopedic treatment, as well as, the ones with chronic pain, staying in neurological ward who took part in the examination. Choice of examined patients was random and embraced hospitals patients in the Podkarpackie voivodeship with “Szpital bez Bólu” (eng.: Hospital without pain certificate.  Examined group comprised of : 57% of women and 44% of men, living in rural (56% and urban (44% area. Research methods used in the examinations, were diagnostic opinion poll, records analysis and pain measurements. Results: 42 % of patients can feel the pain intermittently, 37% is not able to estimate how often do pain ailments occur, however, 21% of people suffer from chronic pain ailments. Patients have estimated their pain as follows: severe (26%, difficult to determine (20%, shooting (16%, burning (15%, radiating (10%, dull (8%, stinging (3% and the one which appears when touched (2%. Having estimated the pain intensity, 53% of respondents claimed that they feel medium pain intensity and 33% claimed to have felt great pain. Nurses in the post-op (54% and anesthesiologist (26% are the one, to inform patient about possibilities and eventual methods of post-operative pain management. Conclusions: Pain limits physical functioning of patient. Five-stage scales included in the examination, were VAS and VRS which are sufficient in prophylaxis and pain alleviation but not entirely readable and understandable for all

Microbial and physicochemical assays of paracetamol in different brands of analgesic syrups sold in Sana’a City-Yemen

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Ali G. Al−Kaf

2015-02-01

Full Text Available Context: Contamination of pharmaceuticals with microorganisms irrespective whether they are harmful or nonpathogenic can bring about changes in physicochemical characteristics of the drugs. Aims: To assay the microbial and physicochemical characteristics of paracetamol of two hundreds samples of different brands of analgesic syrups sold in Sana’a City, Yemen. Methods: Total viable aerobic count, type of isolated microorganisms, physical properties, and content of active ingredients were identified and evaluated by standard methods and techniques. The SPSS program was used to statistical analysis of variance for results obtained. Results: The total bacterial count of <10 CFU/mL and <100 CFU/mL in 179 (89.5% and 21 (10.5% samples, respectively was recorded, while the total fungal count was ≤10 CFU/mL in all analyzed syrup samples. The isolated bacteria were Bacillus subtilis, Micrococcus fulvum, and Staphylococcus epidermidis while isolated fungi were Aspergillus niger, Aspergillus fumigatus, and Penicillium notatum. Bacillus subtilis and Aspergillus niger were the predominant bacteria and fungi isolated. The color results had a light red liquid with a sweet taste in the analyzed analgesic syrups. The pH values were ranged from 4.44–5.88. However, the density fluctuated from 1.149–1.184 g/mL. The paracetamol concentration as an active ingredient in the analgesic syrup was recorded from 98.19% – 106.53%. Conclusions: This finding showed that all analgesic syrups sold in Sana’a City followed Pharmacopeia specifications on microbial and physicochemical qualities.

Analgesic synergy between opioid and α2 -adrenoceptors.

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Chabot-Doré, A-J; Schuster, D J; Stone, L S; Wilcox, G L

2015-01-01

Opioid and α2 -adrenoceptor agonists are potent analgesic drugs and their analgesic effects can synergize when co-administered. These supra-additive interactions are potentially beneficial clinically; by increasing efficacy and/or reducing the total drug required to produce sufficient pain relief, undesired side effects can be minimized. However, combination therapies of opioids and α2 -adrenoceptor agonists remain underutilized clinically, in spite of a large body of preclinical evidence describing their synergistic interaction. One possible obstacle to the translation of preclinical findings to clinical applications is a lack of understanding of the mechanisms underlying the synergistic interactions between these two drug classes. In this review, we provide a detailed overview of the interactions between different opioid and α2 -adrenoceptor agonist combinations in preclinical studies. These studies have identified the spinal cord as an important site of action of synergistic interactions, provided insights into which receptors mediate these interactions and explored downstream signalling events enabling synergy. It is now well documented that the activation of both μ and δ opioid receptors can produce synergy with α2 -adrenoceptor agonists and that α2 -adrenoceptor agonists can mediate synergy through either the α2A or the α2C adrenoceptor subtypes. Current hypotheses surrounding the cellular mechanisms mediating opioid-adrenoceptor synergy, including PKC signalling and receptor oligomerization, and the evidence supporting them are presented. Finally, the implications of these findings for clinical applications and drug discovery are discussed. This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2. © 2014 The British Pharmacological Society.

Intravenous flurbiprofen axetil can increase analgesic effect in refractory cancer pain

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Hao Jiqing

2009-03-01

Full Text Available Abstract Background The aim of this study was to investigate the analgesic effects of intravenous flurbiprofen axetil for the refractory pain in cancer patients. Methods 2109 patients were screened from the department of medical oncology, the first affiliated hospital of Anhui medical university in China between October of 2007 and October of 2008. Thirty-seven cases of cancer patients who had bad effect from anaesthetic drugs were received administration of intravenous flurbiprofen axetil with dose of 50 mg/5 ml/day. The pain score was evaluated for pre- and post- treatment by Pain Faces Scale criteria, and the side effects were also observed. Results Intravenous flurbiprofen axetil increased the analgesic effects. The total effective rate was 92%. The side effects, such as abdominal pain, alimentary tract bleeding which were found in using NSAIDs or constipation, nausea, vomit, sleepiness which were found in using opioid drugs did not be found. Conclusion Intravenous flurbiprofen axetil could provide better analgesia effects and few side effects to patients with refractory cancer pain. It could also increase analgesia effects when combining with anesthetic drugs in treatment of moderate or severe pain, especially breakthrough pain, and suit to patients who can not take oral drugs for the reason of constipation and psychosomatic symptoms.

Intravenous flurbiprofen axetil can increase analgesic effect in refractory cancer pain

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Wu, Hongyang; Chen, Zhendong; Sun, Guoping; Gu, Kangsheng; Pan, Yueyin; Hao, Jiqing; Du, Yingying; Ning, Jie

2009-01-01

Background The aim of this study was to investigate the analgesic effects of intravenous flurbiprofen axetil for the refractory pain in cancer patients. Methods 2109 patients were screened from the department of medical oncology, the first affiliated hospital of Anhui medical university in China between October of 2007 and October of 2008. Thirty-seven cases of cancer patients who had bad effect from anaesthetic drugs were received administration of intravenous flurbiprofen axetil with dose of 50 mg/5 ml/day. The pain score was evaluated for pre- and post- treatment by Pain Faces Scale criteria, and the side effects were also observed. Results Intravenous flurbiprofen axetil increased the analgesic effects. The total effective rate was 92%. The side effects, such as abdominal pain, alimentary tract bleeding which were found in using NSAIDs or constipation, nausea, vomit, sleepiness which were found in using opioid drugs did not be found. Conclusion Intravenous flurbiprofen axetil could provide better analgesia effects and few side effects to patients with refractory cancer pain. It could also increase analgesia effects when combining with anesthetic drugs in treatment of moderate or severe pain, especially breakthrough pain, and suit to patients who can not take oral drugs for the reason of constipation and psychosomatic symptoms. PMID:19267934

Maternal use of mild analgesics during pregnancy associated with reduced anogenital distance in sons: a cohort study of 1027 mother-child pairs.

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Lind, Dorte Vesterholm; Main, Katharina M; Kyhl, Henriette Boye; Kristensen, David Møbjerg; Toppari, Jorma; Andersen, Helle Raun; Andersen, Marianne Skovsager; Skakkebæk, Niels E; Jensen, Tina Kold

2017-01-01

Is maternal use of mild analgesics in pregnancy associated with anogenital distance (AGD)-the distance from the anus to the genitals-in the offspring? Maternal use of mild analgesics [especially simultaneous use of paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs)] during pregnancy was associated with a shorter AGD in boys whereas no effect was found in girls. Mild analgesics including paracetamol (acetaminophen) and NSAIDs (e.g. ibuprofen and acetyl salicylic acid) have endocrine disrupting properties and in utero exposure reduces AGD in male rats. In humans, maternal exposure has been associated with cryptorchidism and hypospadias in male offspring but no studies have examined AGD. A prospective birth cohort study. Between 2010 and 2012, 2500 pregnant women were recruited from the Odense Child Cohort. Children were examined 3 months after the expected date of birth. Pregnant women were asked about use of medication including mild analgesics (paracetamol and NSAID) during pregnancy at recruitment (gestational age (GA) week 10-27) and at GA week 28. AGD and penile width were measured 3 months after expected date of birth by trained personnel. A total of 1027 women answered both questionnaires and their children were examined. Associations between prenatal exposure to mild analgesics and AGD and penile width were estimated using multivariable linear regression adjusting for age and weight-for-age SD score. A total of 40% of the women reported use of paracetamol and/or NSAIDs (4.4%) during the first 28 weeks of pregnancy. Exposure to analgesics during pregnancy was associated with a reduced AGD in boys, although statistically significant only for NSAIDs. The association was significant among 20 boys exposed to both paracetamol and NSAIDs (AGD -4.1 mm; CI 95%: -6.4; -1.7). Maternal intake of analgesics did not show any clear association with AGD in female offspring. No effect on penile width was found. Only 27 boys and 18 girls were exposed to NSAIDs and

Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis.

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Peek, Jesse; Smeeing, Diederik P J; Hietbrink, Falco; Houwert, Roderick M; Marsman, Marije; de Jong, Mirjam B

2018-02-06

Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks. PubMed, EMBASE and CENTRAL databases were searched to identify comparative studies investigating epidural, intravenous, paravertebral and intercostal interventions for traumatic rib fractures, without restriction for study type. The search strategy included keywords and MeSH or Emtree terms relating blunt chest trauma (including rib fractures), analgesic interventions, pain management and complications. A total of 19 papers met our inclusion criteria and were finally included in this systematic review. Significant differences were found in favor of epidural analgesia for the reduction of pain. No significant differences were observed between epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks, for the secondary outcomes. Results of this study show that epidural analgesia provides better pain relief than the other modalities. No differences were observed for secondary endpoints like length of ICU stay, length of mechanical ventilation or pulmonary complications. However, the quality of the available evidence is low, and therefore, preclude strong recommendations.

Ginger (Zingiber officinale) as an Analgesic and Ergogenic Aid in Sport: A Systemic Review.

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Wilson, Patrick B

2015-10-01

Ginger is a popular spice used to treat a variety of maladies, including pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used by athletes to manage and prevent pain; unfortunately, NSAIDs contribute to substantial adverse effects, including gastrointestinal (GI) dysfunction, exercise-induced bronchoconstriction, hyponatremia, impairment of connective tissue remodeling, endurance competition withdrawal, and cardiovascular disease. Ginger, however, may act as a promoter of GI integrity and as a bronchodilator. Given these potentially positive effects of ginger, a systematic review of randomized trials was performed to assess the evidence for ginger as an analgesic and ergogenic aid for exercise training and sport. Among 7 studies examining ginger as an analgesic, the evidence indicates that roughly 2 g·d(-1) of ginger may modestly reduce muscle pain stemming from eccentric resistance exercise and prolonged running, particularly if taken for a minimum of 5 days. Among 9 studies examining ginger as an ergogenic aid, no discernable effects on body composition, metabolic rate, oxygen consumption, isometric force generation, or perceived exertion were observed. Limited data suggest that ginger may accelerate recovery of maximal strength after eccentric resistance exercise and reduce the inflammatory response to cardiorespiratory exercise. Major limitations to the research include the use of untrained individuals, insufficient reporting on adverse events, and no direct comparisons with NSAID ingestion. While ginger taken over 1-2 weeks may reduce pain from eccentric resistance exercise and prolonged running, more research is needed to evaluate its safety and efficacy as an analgesic for a wide range of athletic endeavors.

Does transcutaneous electrical nerve stimulation (TENS have a clinically relevant analgesic effect on different pain conditions? A literature review

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Asami Naka

2013-07-01

Full Text Available Transcutaneous electric nerve stimulation (TENS is a standard therapy used in different painful conditions such as low back pain, diabetic polyneuropathy or arthrosis. However, literature reviews focusing on the effects and the clinical implication of this method in various painful conditions are yet scarce. The purpose of this literature research was to determine, whether TENS provides an analgesic effect on common painful conditions in clinical practice. Literature research was performed using three data bases (Pubmed, Embase, Cochrane Database, focusing on papers published in the space of time from 2007 to 2012. Papers were evaluated from two reviewers independently concerning the clinical outcome, taking account for the level of external evidence according to the German Cochrane levels of evidence (Ia – IV. 133 papers of varying methodological quality dealing with different painful conditions were selected in total. A clinically relevant analgesic effect was described in 90 painful conditions (67%. In 30 painful states (22%, the outcome was inconclusive due to the study design. No significant analgesic effect of TENS was observed in 15 painful conditions (11%. The vast majority of the papers were classified as Cochrane evidence level Ib (n = 64; 48%, followed by level Ia (n = 23; 17%, level III (n = 18; 14%, level IV (n = 15; 11%, level IIb (n = 10; 8% and level IIa (n = 3; 2%. Most of the studies revealed an analgesic effect in various painful conditions, confirming the usefulness of TENS in clinical practice.

Novel polymeric bioerodable microparticles for prolonged-release intrathecal delivery of analgesic agents for relief of intractable cancer-related pain.

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Han, Felicity Y; Thurecht, Kristofer J; Lam, Ai-Leen; Whittaker, Andrew K; Smith, Maree T

2015-07-01

Intractable cancer-related pain complicated by a neuropathic component due to nerve impingement is poorly alleviated even by escalating doses of a strong opioid analgesic. To address this unmet medical need, we developed sustained-release, bioerodable, hydromorphone (potent strong opioid)- and ketamine (analgesic adjuvant)-loaded microparticles for intrathecal (i.t.) coadministration. Drug-loaded poly(lactic-co-glycolic acid) (PLGA) microparticles were prepared using a water-in-oil-in-water method with evaporation. Encapsulation efficiency of hydromorphone and ketamine in PLGA (50:50) microparticles was 26% and 56%, respectively. Microparticles had the desired size range (20-60 μm) and in vitro release was prolonged at ≥28 days. Microparticles were stable for ≥6 months when stored refrigerated protected from light in a desiccator. Desirably, i.t. injected fluorescent dye-labeled PLGA microparticles in rats remained in the lumbar region for ≥7 days. In a rat model of neuropathic pain, i.t. coinjection of hydromorphone- and ketamine-loaded microparticles (each 1 mg) produced analgesia for 8 h only. Possible explanations include inadequate release of ketamine and/or hydromorphone into the spinal fluid, and/or insufficient ketamine loading to prevent development of analgesic tolerance to the released hydromorphone. As sub-analgesic doses of i.t. ketamine at 24-48 h intervals restored analgesia on each occasion, insufficient ketamine loading appears problematic. We will investigate these issues in future work. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

Maternal use of mild analgesics during pregnancy associated with reduced anogenital distance in sons

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Lind, Dorte Vesterholm; Main, Katharina Maria; Kyhl, Henriette Boye

2017-01-01

(NSAIDs)] during pregnancy was associated with a shorter AGD in boys whereas no effect was found in girls. WHAT IS KNOWN ALREADY: Mild analgesics including paracetamol (acetaminophen) and NSAIDs (e.g. ibuprofen and acetyl salicylic acid) have endocrine disrupting properties and in utero exposure reduces...

Strain-specific response to anaesthetics and analgesics in rat and rabbit : A pharmacogenetic approach

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Avsaroglu, H.

2008-01-01

The response of (laboratory) animals to anaesthetics and analgesics is known to show intraspecies variability. Apart from environmental influences, this may also be caused by genetic factors. In this thesis, rabbit and rat inbred strains were used to identify differences in response to anaesthetics

Screening of analgesic and anti-inflammatory active component in Fructus Alpiniae zerumbet based on spectrum-effect relationship and GC-MS.

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Xiao, Rui-Yao; Wu, Ling-Jing; Hong, Xiao-Xiao; Tao, Ling; Luo, Peng; Shen, Xiang-Chun

2018-03-01

Fructus Alpiniae zerumbet is widely used in Guizhou province as a miao folk herb with anti-inflammatory, analgesic, protection against cardiovascular diseases, antihypertension and antioxidant activities. To further investigate the chemical material basis, the spectrum-effect relationship was established using gray relational analysis between the chromatographic fingerprint and its bioactivities. Herein, the fingerprints of essential oils from Fructus Alpiniae zerumbet (EOFAZ) from various sources were determined by gas chromatography mass spectrometry, and the analgesic and anti-inflammatory bioactivities were investigated using the mouse model of acetic acid-induced writhing test and dimethylbenzene-induced mouse ear edema test. Finally, 17 common peaks were identified from nine batches of A. zerumbet, by comparison with the standard mass spectra in Nist2005, Wiley275 library. Meanwhile, the results showed significant analgesic and anti-inflammatory effects in all of the different sources of EOFAZ. In particularly, peak 1 (α-pipene), peak 3 (β-pinene), peak 9 (camphor) and peak 16 (α-cadinol) might be the main bioactive ingredients for analgesic and anti-inflammatory activities. The model of the spectrum-effect relationships of EOFAZ was successfully discovered, which provided a novel platform for finding the bioactive components, a theoretical foundation for its further study and helping to establish quality control of Fructus A. zerumbet. Copyright © 2017 John Wiley & Sons, Ltd.

Regioselective synthesis of isoxazole-mercaptobenzimidazole hybrids and their in vivo analgesic and anti-inflammatory activity studies

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Kankala, Shravankumar; Kankala, Ranjith Kumar; Gundepaka, Prasad

2013-01-01

Regioselective synthesis of isoxazole-mercaptobenzimidazole hybrids and their efficiency in in vivo analgesic and anti-inflammatory activity was described. A comparison of structure-activity relationship for there compounds was also emphasized....

Analgesic effect of the neuropeptide cortistatin in murine models of arthritic inflammatory pain.

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Morell, Maria; Souza-Moreira, Luciana; Caro, Marta; O'Valle, Francisco; Forte-Lago, Irene; de Lecea, Luis; Gonzalez-Rey, Elena; Delgado, Mario

2013-05-01

To investigate the role of the antiinflammatory neuropeptide cortistatin in chronic pain evoked by joint inflammation. Thermal and mechanical hyperalgesia was evoked in mouse knee joints by intraplantar injection of tumor necrosis factor α and intraarticular infusion of Freund's complete adjuvant, and the analgesic effects of cortistatin, administered centrally, peripherally, and systemically, were assessed. In addition, the effects of cortistatin on the production of nociceptive peptides and the activation of pain signaling were assayed in dorsal root ganglion cultures and in inflammatory pain models. The role of endogenous cortistatin in pain sensitization and perpetuation of chronic inflammatory states was evaluated in cortistatin-deficient mice. Finally, the effect of noxious/inflammatory stimuli in the production of cortistatin by the peripheral nociceptive system was assayed in vitro and in vivo. Expression of cortistatin was observed in peptidergic nociceptors of the peripheral nociceptive system, and endogenous cortistatin was found to participate in the tuning of pain sensitization, especially in pathologic inflammatory conditions. Results showed that cortistatin acted both peripherally and centrally to reduce the tactile allodynia and heat hyperalgesia evoked by arthritis and peripheral tissue inflammation in mice, via mechanisms that were independent of its antiinflammatory action. These mechanisms involved direct action on nociceptive neurons and regulation of central sensitization. The analgesic effects of cortistatin in murine arthritic pain were linked to binding of the neuropeptide to somatostatin and ghrelin receptors, activation of the G protein subunit Gαi , impairment of ERK signaling, and decreased production of calcitonin gene-related peptide in primary nociceptors. These findings indicate that cortistatin is an antiinflammatory factor with potent analgesic effects that may offer a new approach to pain therapy in pathologic inflammatory

Analgesic properties of oleoylethanolamide (OEA) in visceral and inflammatory pain.

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Suardíaz, Margarita; Estivill-Torrús, Guillermo; Goicoechea, Carlos; Bilbao, Ainhoa; Rodríguez de Fonseca, Fernando

2007-12-15

Oleoylethanolamide (OEA) is a natural fatty acid amide that mainly modulates feeding and energy homeostasis by binding to peroxisome proliferator-activated receptor-alpha (PPAR-alpha) [Rodríguez de Fonseca F, Navarro M, Gómez R, Escuredo L, Navas F, Fu J, et al. An anorexic lipid mediator regulated by feeding. Nature 2001;414:209-12; Fu J, Gaetani S, Oveisi F, Lo Verme J, Serrano A, Rodríguez de Fonseca F, et al. Oleoylethanolamide regulates feeding and body weight through activation of the nuclear receptor PPAR-alpha. Nature 2003;425:90-3]. Additionally, it has been proposed that OEA could act via other receptors, including the vanilloid receptor (TRPV1) [Wang X, Miyares RL, Ahern GP. Oleoylethanolamide excites vagal sensory neurones, induces visceral pain and reduces short-term food intake in mice via capsaicin receptor TRPV1. J Physiol 2005;564:541-7.] or the GPR119 receptor [Overton HA, Babbs AJ, Doel SM, Fyfe MC, Gardner LS, Griffin G, et al. Deorphanization of a G protein-coupled receptor for oleoylethanolamide and its use in the discovery of small-molecule hypophagic agents. Cell Metab 2006;3:167-175], suggesting that OEA might subserve other physiological roles, including pain perception. We have evaluated the effect of OEA in two types of nociceptive responses evoked by visceral and inflammatory pain in rodents. Our results suggest that OEA has analgesic properties reducing the nociceptive responses produced by administration of acetic acid and formalin in two experimental animal models. Additional research was performed to investigate the mechanisms underlying this analgesic effect. To this end, we evaluated the actions of OEA in mice null for the PPAR-alpha receptor gene and compared its actions with those of PPAR-alpha receptor wild-type animal. We also compared the effect of MK-801 in order to evaluate the role of NMDA receptor in this analgesia. Our data showed that OEA reduced visceral and inflammatory responses through a PPAR

Fatty acid composition, anti-inflammatory and analgesic activities of Hibiscus sabdariffa Linn. seeds

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Sumaia Awad Elkariem Ali

2014-06-01

Full Text Available Hibiscus (H. sabdariffa (commonly known as “Karkadeh” in Arabic is widely used in various pharmacological applications in Sudan. The present study was carried out to investigate the anti-inflammatory and analgesic activities of H. sabdariffa seed extracts using rat models. In acute anti-inflammatory models, oral administration of petroleum ether extract of H. sabdariffa seeds inhibited the hind paw edema (p<0.01 which was induced by carrageenan. The petroleum ether extract exhibited significant (p<0.01 inhibition of vascular permeability in rats induced by intraperitoneal injection of acetic acid (0.6%. In cotton pellet granuloma method, the petroleum ether extract of H. sabdariffa seed showed significant inhibition of granuloma. The extract reduced (p<0.001 abdominal constrictions which was induced by injection of acetic acid (0.7%. Analysis of seed oil of H. sabdariffa using Gas Chromatography revealed the presence of three fatty acids; these were linolelaidic acid, arachidic acid, and palmitic acid. In conclusion, H. sabdariffa seeds possess anti-inflammatory and analgesic activities in rat model.

The analgesic effect of clonixine is not mediated by 5-HT3 subtype receptors.

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Paeile, C; Bustamante, S E; Sierralta, F; Bustamante, D; Miranda, H F

1995-10-01

1. The analgesic effect of clonixinate of L-lysine (Clx) in the nociceptive C-fiber reflex in rat and in the writhing test in mice is reported. 2. Clx was administered by three routes, i.v., i.t. and i.c.v., inducing a dose-dependent antinociception. 3. The antinociceptive effect of Clx was 40-45% with respect to the control integration values in the nociceptive C-fiber reflex method. 4. The writhing test yielded ED50 values (mg/kg) of 12.0 +/- 1.3 (i.p.), 1.8 +/- 0.2 (i.t.) and 0.9 +/- 0.1 (i.c.v.) for Clx administration. 5. Ondansetron was not able to antagonize the antinociception response of Clx in the algesiometric tests used. 6. Chlorophenilbiguanide did not produce any significative change in the analgesic effect of Clx in the nociceptive C-fiber reflex method. 7. It is suggested that the mechanism of action of the central analgesia of Clx is not mediated by 5-HT3 subtype receptors.

Analgesic Effect of Tramadol and Buprenorphin in Continuous Propofol Anaesthesia

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Capík I.

2016-03-01

Full Text Available The objective of this study was to compare in clinical patients the analgesic effect of the centrally acting analgesics tramadol and buprenorphine in continuous intravenous anaesthesia (TIVA with propofol. Twenty dogs undergoing prophylactic dental treatment, aged 2−7 years, weighing 6−27 kg, were included in ASA I. and II. groups. Two groups of dogs received intravenous (IV administration of tramadol hydrochloride (2 mg.kg−1 or buprenorphine hydrochloride (0.2 mg.kg−1 30 minutes prior to sedation, provided by midazolam hydrochloride (0.3 mg.kg−1 and xylazine hydrochloride (0.5 mg.kg-1 IV. General anaesthesia was induced by propofol (2 mg.kg−1 and maintained by a 120 minutes propofol infusion (0.2 mg.kg−1min−1. Oscilometric arterial blood pressure (ABP measured in mm Hg, heart rate (HR, respiratory rate (RR, SAT, body temperature (BT and pain reaction elicited by haemostat forceps pressure at the digit were recorded in ten minute intervals. The tramadol group of dogs showed significantly better parameters of blood pressure (P < 0.001, lower tendency to bradycardia (P < 0.05, and better respiratory rate (P < 0.001 without negative influence to oxygen saturation. Statistically better analgesia was achieved in the tramadol group (P < 0.001. Tramadol, in comparison with buprenorphine provided significantly better results with respect to the degree of analgesia, as well as the tendency of complications arising during anaesthesia.

Studies on analgesic, anti-inflammatory activities of stem and roots of Inula cuspidata C.B Clarke

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Sarvesh Kumar Paliwal

2017-10-01

Stem and roots were extracted with chloroform (ICSCE, ICRCE and methanol (ICSME, ICRME. Acute oral toxicity of all extracts was determined by OECD guidelines 425. Analgesic activity was investigated by using hot plate and acetic acid induced writhing models. Anti-inflammatory activity (acute of all extracts was evaluated by carrageenan induced paw edema model. In addition, root and stem powder was screened for heavy metals (As, Pb, Cd, Hg estimation using atomic absorption spectroscopy. In acute toxicity study no mortality was observed when each extract was orally administered with 2.0 g/kg. At the doses (100 and 200 mg/kg ICRME followed by ICSME showed significant and dose dependent analgesic and anti-inflammatory effects compared with chloroform extracts. The heavy metals concentration in stem and root powders was found to be within the permissible limits as recommended by WHO for herbal raw materials. The findings of the present study validated the folkloric use of Inula cuspidata as analgesic and anti-inflammatory. In addition, the results intimate that heavy metals present in raw material were found to be within the defined limits, and it exhibits that the therapeutic efficacy of plant may not be effected, which can be otherwise possibly effected if the plant sequester high concentration of heavy metals from the polluted environment as well as from the soil rich in pesticides and sewage sludge etc.

Adult emergency department patients with sickle cell pain crisis: results from a quality improvement learning collaborative model to improve analgesic management.

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Tanabe, Paula; Hafner, John W; Martinovich, Zoran; Artz, Nicole

2012-04-01

The aims of this study were to 1) estimate differences in pain management process and patient-reported outcomes, pre- and postimplementation of analgesic protocols for adults with sickle cell disease (SCD), and 2) examine the effects of site and visit frequency on changes in pain scores and time to analgesic. A multicenter, prospective, longitudinal study enrolled patients from three academic medical centers between October 2007 and September 2009. All ED patients 18 years or older with a chief complaint of a sickle cell pain episode were enrolled. Sites formed a SCD quality improvement (QI) team and implemented standard nurse-initiated emergency department (ED) analgesic protocols; outcomes were compared between study periods defined as pre- and postimplementation of protocols. Medical record review was conducted to measure time to administration of initial analgesic, opioids used, route of opioid administration, the change in pain scores from arrival to discharge (negative numbers reflect a decrease in pain scores), and the number of ED visits per individual patient during the study period at each site. On day 7 after the ED visit, a follow-up phone interview was conducted. Patients were queried about their ED pain management using a scale from 1 to 10 (1 = outstanding, 10 = worst). Descriptive statistics are used to report the results. Ordinary least-squares regression models were constructed to measure the effect of time period, site, and number of visits per patient on change in pain score. During the study period, 342 unique patients (57% female, mean ± SD age = 32 ± 11 years) were enrolled and had a total of 2,934 visits. There was no difference in time to administration of the initial analgesic between study periods. Overall, there was a significant decrease in pain scores from arrival to discharge between the pre- and postintervention study periods: the average difference in arrival to discharge pain scores (cm) was greater during the postimplementation

Analgesic effect of GT-0198, a structurally novel glycine transporter 2 inhibitor, in a mouse model of neuropathic pain

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Yu Omori

2015-03-01

Full Text Available This study was conducted to identify the characteristic pharmacological features of GT-0198 that is phenoxymethylbenzamide derivatives. GT-0198 inhibited the function of glycine transporter 2 (GlyT2 in human GlyT2-expressing HEK293 cells and did not bind various major transporters or receptors of neurotransmitters in a competitive manner. Thus, GT-0198 is considered to be a comparatively selective GlyT2 inhibitor. Intravenous, oral, and intrathecal injections of GT-0198 decreased the pain-related response in a model of neuropathic pain with partial sciatic nerve ligation. This result suggests that GT-0198 has an analgesic effect. The analgesic effect of GT-0198 was abolished by the intrathecal injection of strychnine, a glycine receptor antagonist. Therefore, GT-0198 is considered to exhibit its analgesic effect via the activation of a glycine receptor by glycine following presynaptic GlyT2 inhibition in the spinal cord. In summary, GT-0198 is a structurally novel GlyT2 inhibitor bearing a phenoxymethylbenzamide moiety with in vivo efficacy in behavioral models of neuropathic pain.

Analgesic Effects of Diluted Bee Venom Acupuncture Mediated by δ-Opioid and α2-Adrenergic Receptors in Osteoarthritic Rats.

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Huh, Jeong-Eun; Seo, Byung-Kwan; Lee, Jung-Woo; Kim, Chanyoung; Park, Yeon-Cheol; Lee, Jae-Dong; Baek, Yong-Hyeon

2017-06-23

Context • Pain from osteoarthritis is associated with peripheral nociception and central pain processing. Given the unmet need for innovative, effective, and well-tolerated therapies, many patients, after looking for more satisfactory alternatives, decide to use complementary and alternative modalities. The analgesic mechanism of subcutaneous injections of diluted bee venom into an acupoint is thought to be part of an anti-inflammatory effect and the central modulation of pain processing. Objectives • Using the rat model of collagenase-induced osteoarthritis (CIOA), the study intended to investigate the analgesic effects of bee venom acupuncture (BVA) as they are related to the acupuncture points and dosage used and to determine whether the analgesic mechanisms of BVA for pain were mediated by opioid or adrenergic receptors. Design • Male Sprague-Dawley rats were randomly assigned to one of 19 groups, with n = 10 for each group. Setting • The study was conducted at the East-West Bone and Joint Research Institute at Kyung Hee University (Seoul, South Korea). Intervention • All rats were intra-articularly injected with collagenase solution in the left knee, followed by a booster injection performed 4 d after the first injection. For the groups receiving BVA treatments, the treatment was administered into the ST-36 acupoint, except for 1 group that received the treatment into a nonacupoint. Three BVA intervention groups received no pretreatment with agonists or antagonists; 1 of them received a dose of 1 mg/kg of bee venom into acupoint ST-36, 1 received a dose of 2 mg/kg into acupoint ST-36, and 1 received a dose of 1 mg/kg into a nonacupoint location. For the intervention groups receiving pretreatments, the opioid-receptor or adrenergic-receptor agonists or antagonists were injected 20 min before the 1-mg/kg BVA treatments. Outcome Measures • Changes in the rats' pain thresholds were assessed by evaluation of pain-related behavior, using a tail flick

Physician-related barriers to cancer pain management with opioid analgesics

DEFF Research Database (Denmark)

Jacobsen, Ramune; Sjøgren, Per; Møldrup, Claus

2007-01-01

OBJECTIVE: The purpose of this review is to summarize the results of studies on physician-related barriers to cancer pain management with opioid analgesics. METHODS: A literature search was conducted in PUBMED, using a combined text word and MeSH heading search strategy. Those articles whose full...... texts were not available in PUBMED were retrieved from the electronic databases of specific journals. RESULTS: Sixty-five relevant articles, published in the period from 1986 to 2006, were identified. Physicians' barriers to cancer pain management were studied in questionnaire surveys and in the reviews...

Analgesic efficacy of continuous femoral nerve block commenced prior to operative fixation of fractured neck of femur

LENUS (Irish Health Repository)

Szucs, Szilard

2012-06-27

AbstractBackgroundPeripheral nerve blocks are effective in treating acute pain, thereby minimizing the requirement for opiate analgesics. Fractured neck of femur (FNF) is a common, painful injury. The provision of effective analgesia to this cohort is challenging but an important determinant of their functional outcome. We investigated the analgesic efficacy of continuous femoral nerve block (CFNB) in patients with FNF.MethodsFollowing institutional ethical approval and with informed consent, patients awaiting FNF surgery were randomly allocated to receive either standard opiate-based analgesia (Group 1) or a femoral perineural catheter (Group 2). Patients in Group 1 received parenteral morphine as required. Those in Group 2 received a CFNB comprising a bolus of local anaesthetic followed by a continuous infusion of 0.25% bupivacaine. For both Groups, rescue analgesia consisted of intramuscular morphine as required and all patients received paracetamol regularly. Pain was assessed using a visual analogue scale at rest and during passive movement (dynamic pain score) at 30 min following first analgesic intervention and six hourly thereafter for 72 hours. Patient satisfaction with the analgesic regimen received was recorded using verbal rating scores (0-10). The primary outcome measured was dynamic pain score from initial analgesic intervention to 72 hours later.ResultsOf 27 recruited, 24 patients successfully completed the study protocol and underwent per protocol analysis. The intervals from recruitment to the study until surgery were similar in both groups [31.4(17.7) vs 27.5(14.2) h, P = 0.57]. The groups were similar in terms of baseline clinical characteristics. For patients in Group 2, pain scores at rest were less than those reported by patients in Group 1 [9.5(9.4) vs 31(28), P = 0.031]. Dynamic pain scores reported by patients in Group 2 were less at each time point from 30 min up to 54 hours [e.g at 6 h 30.7(23.4) vs 67.0(32.0), P = 0

The use of different analgesics in orthodontic tooth movements.

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Hammad, Shaza M; El-Hawary, Yousry M; El-Hawary, Amira K

2012-09-01

To provide a semi-quantitative assessment of the effect of different analgesics (celecoxib, ketorolac, and paracetamol) on tooth movement and bone resorption using immunohistochemical staining of matrix metalloproteinase-13 (MMP-13). Forty white male rats (12-weeks old; body weight: 230-250 g) were divided into four groups (10 rats each) and were given the treatment once a day for 2 consecutive months. Group A (control group) rats were given the reverse osmosis water; group B rats were given 10 mg/kg celecoxib; group C rats were given 3 mg/kg ketorolac; and group D rats were given 150 mg/kg paracetamol. A precalibrated closed Sentalloy coil spring was placed inside each rat mouth to deliver a constant force of 50 cN. The magnitude of tooth movement was measured intraorally. After 2 months, the rats were sacrificed, and the sections were mounted on L-polylysine-coated glass slides. Slides from each specimen were stained with hematoxylin and eosin, and others were stained with MMP-13. Data were analyzed with the one-way analysis of variance (ANOVA). Celecoxib, ketorolac, and paracetamol groups showed tooth movement of 1.81 ± 0.43 mm, 1.13 ± 0.28 mm, and 1.08 ± 0.27 mm, respectively. The mean number of MMP-13-positive osteoclasts was highest in celecoxib-treated group followed by the control group and was decreased in the ketorolac and paracetamol groups. Comparing all groups to the control revealed significant differences (P < .05). Administration of celecoxib did not reduce bone resorption or interfere with tooth movement in rats compared to other analgesics tested (ketorolac and paracetamol).

Analgesic, anti-inflammatory, antipyretic and haematological effects of aethiopinone, an o-naphthoquinone diterpenoid from Salvia aethiopis roots and two hemisynthetic derivatives.

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Hernández-Pérez, M; Rabanal, R M; de la Torre, M C; Rodríguez, B

1995-12-01

Aethiopinone (1), an o-naphthoquinone diterpene from Salvia aethiopis L. roots and two hemisynthetic derivatives 2 and 3 have been evaluated for toxicity, anti-inflammatory, analgesic, antipyretic, and haemostatic activities. The compounds tested showed low toxicity and a pharmacological profile similar to other NSAI substances on reducing the edema induced by carrageenan and contractions induced by phenyl-p-quinone; the most active compounds were 1 and 2. In the same way and as expected with these types of substances, the bleeding time increased. In the TPA-induced ear inflammation model, the three compounds showed a moderate reduction of edema, and 1 produced a significant increase in the reaction time against thermal painful stimuli in the tail immersion test. The results demonstrated strong anti-inflammatory, peripheral and central analgesic properties for 1, as well as antiedematose topical action and peripheral analgesic properties for 2 and 3.

Auricular point acupressure as an adjunct analgesic treatment for cancer patients: a feasibility study.

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Yeh, Chao Hsing; Chien, Lung-Chang; Chiang, Yi Chien; Ren, Dianxu; Suen, Lorna Kwai-Ping

2015-06-01

This study aimed (1) to examine the feasibility of an auricular point acupressure (APA) research protocol in terms of recruitment and for the assessment and management of pain and (2) to examine the potential APA analgesic effects for cancer patients. This study was a repeated-measures one-group design. Participants were recruited from the cancer center follow-up clinic affiliated with a large university hospital in the northeastern United States. Participants included 50 patients aged 55-87 years with a diagnosis of cancer. Participants received 7 days of APA treatment for their pain. After appropriate acupoints were identified, vaccaria seeds were carefully taped onto each selected auricular point on each ear. The study recruitment and retention rates were 92% and 91%, respectively. Importantly, the study found preliminary evidence for the analgesic effects of APA for cancer pain management. For example, by the end of the 7-day study, APA reduced pain intensity more than 55% for "worst pain" and about 57% for "average pain" and "pain intensity." Moreover, the use of pain medication was reduced during the APA treatment (e.g., 78% of patients [n = 39] took less pain medication than before the treatment). APA appears to be highly acceptable to patients with cancer-related pain. However, without a placebo control, we cannot draw conclusive evidence for the analgesic effect of APA for cancer patients. A sham group must be added to future studies to differentiate the true effects of APA from the possible psychological effects of the APA treatment. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Analgesic and Anti-Inflammatory Effects of 80% Methanol Extract of Leonotis ocymifolia (Burm.f. Iwarsson Leaves in Rodent Models

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Asnakech Alemu

2018-01-01

Full Text Available Background. Pain and inflammation are the major health problems commonly treated with traditional remedies mainly using medicinal plants. Leonotis ocymifolia is one of such medicinal plants used in folkloric medicine of Ethiopia. However, the plant has not been scientifically evaluated. The aim of this study was to evaluate analgesic and anti-inflammatory effects of the 80% methanol leaves extract of Leonotis ocymifolia using rodent models. Method. The central and peripheral analgesic effect of the extract at 100, 200, and 400 mg/kg dose levels was evaluated using hot plate and acetic acid induced writhing rodent models, whereas carrageenan induced paw edema and cotton pellet granuloma methods were used to screen anti-inflammatory effect of the extract at the same dose levels. Acute toxicity test was also done. Data were analyzed using one-way ANOVA followed by Tukey’s post hoc test and p<0.05 was considered significant. Results. The extract did not produce mortality up to 2000 mg/kg. All tested doses of the extract showed significant analgesic effect with maximum latency response of 62.8% and inhibition of acetic acid induced writhing. Maximum anti-inflammatory effect was recorded at 6 h after induction, with 75.88% reduction in carrageenan induced paw edema. Moreover, all tested doses of extract significantly inhibited the formation of inflammatory exudates and granuloma formation (p<0.001. Conclusion. The study indicated that the extract was safe in mice and it has both analgesic and anti-inflammatory effect in rodent models.

Gram Scale Syntheses of (-)-Incarvillateine and Its Analogs. Discovery of Potent Analgesics for Neuropathic Pain.

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Huang, Bin; Zhang, Fengying; Yu, Gang; Song, Yan; Wang, Xintong; Wang, Meiliang; Gong, Zehui; Su, Ruibin; Jia, Yanxing

2016-04-28

(-)-Incarvillateine (INCA) is the major antinociceptive component of Incarvillea sinensis, which has been used to treat rheumatism and relieve pain in traditional Chinese medicine. We have developed a concise and general synthetic approach for INCA, which enabled gram-scale asymmetric syntheses of (-)-INCA, (-)-incarvilline, (-)-isoincarvilline, and six other INCA analogues. The synthesis of isoincarvilline was reported for the first time. Three structurally simplified analogues of INCA were also synthesized. In vivo screening found that INCA and two structurally optimized analogues were efficacious in preventing the acetic acid-induced writhing response. Moreover, their analgesic efficacy was demonstrated in formalin induced pain model. More importantly, administration of 20 or 40 mg/kg INCA and two structurally optimized analogues showed strong analgesic effects in spared nerve injury (SNI) model, and their effective doses were lower than the current gold standard, gabapentin (100 mg/kg in this model).

Perception of the risk of adverse reactions to analgesics: differences between medical students and residents

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Sandra Castillo-Guzman

2016-07-01

Full Text Available Background. Medications are not exempt from adverse drug reactions (ADR and how the physician perceives the risk of prescription drugs could influence their availability to report ADR and their prescription behavior. Methods. We assess the perception of risk and the perception of ADR associated with COX2-Inbitors, paracetamol, NSAIDs, and morphine in medical students and residents of northeast of Mexico. Results. The analgesic with the highest risk perception in both group of students was morphine, while the drug with the least risk perceived was paracetamol. Addiction and gastrointestinal bleeding were the ADR with the highest score for morphine and NSAIDs respectively. Discussion. Our findings show that medical students give higher risk scores than residents toward risk due to analgesics. Continuing training and informing physicians about ADRs is necessary since the lack of training is known to induce inadequate use of drugs.

Analgesic effect of expressed breast milk in neonates during venipuncture in comparison with formula and 50% dextrose

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fariba Tarhani

2013-02-01

Conclusion : Expressed breast milk effectively reduces pain of venipuncture in term neonates and it could be natural, noninvasive and available analgesic particularly when mother can not be present to breastfeeding.

Perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted gastric sleeve resection

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Anita Joselyn

2015-01-01

Full Text Available Purpose: One of the major advantages for patients undergoing minimally invasive surgery as compared to an open surgical procedure is the improved recovery profile and decreased opioid requirements in the perioperative period. There are no definitive studies comparing the analgesic requirements in patients undergoing two different types of minimally invasive procedure. This study retrospectively compares the perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted, laparoscopic gastric sleeve resection. Materials and Methods: With Institutional Review Board approval, the medication administration records of all severely obese patients who underwent gastric sleeve resection were retrospectively reviewed. Intra-operative analgesic and adjuvant medications administered, postoperative analgesic requirements, and visual analog pain scores were compared between those undergoing a laparoscopic procedure versus a robotic-assisted procedure. Results: This study cohort included a total of 28 patients who underwent gastric sleeve resection surgery with 14 patients in the laparoscopic group and 14 patients in the robotic-assisted group. Intra-operative adjuvant administration of both intravenous acetaminophen and ketorolac was similar in both groups. Patients in the robotic-assisted group required significantly less opioid during the intra-operative period as compared to patients in the laparoscopic group (0.15 ± 0.08 mg/kg vs. 0.19 ± 0.06 mg/kg morphine, P = 0.024. Cumulative opioid requirements for the first 72 postoperative h were similar in both the groups (0.64 ± 0.25 vs. 0.68 ± 0.27 mg/kg morphine, P = NS. No difference was noted in the postoperative pain scores. Conclusion: Although intraoperative opioid administration was lower in the robotic-assisted group, the postoperative opioid requirements, and the postoperative pain scores were similar in both groups.

Efficacy of Acute Pain Control Protocol in Triage Department on Analgesics Administration Time and Patients' Satisfaction

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Seyedhossein Seyyedhoseini Davaraani

2014-07-01

Full Text Available Objective: Current study was conducted to develop a pain control protocol by Morphine Sulfate (MS Suppository in triage ward with the main primary outcomes of first analgesic administration time, patients' satisfaction and also the changes in pain intensity. Methods: In this randomized clinical trial, 318 consecutive patients attending to an academic tertiary health care center in Tehran, Iran in 2011 and 2012 were enrolled. The patients were randomly assigned to receive either routine pain control by emergency medicine residents in emergency department (n=132 or pain control protocol in triage level by nurses (n=186. Those with pain in control group were treated with conventional pain control program and those in intervention group with pain intensities higher than four were treated with suppository stat 10 mg dose of MS administered by nurses in triage ward. Results: The mean change in pain intensity was significantly (P<0.0001 higher in intervention group (4.2 versus 0.2 and the first analgesic administration time was significantly different between groups (P<0.05 being less in the intervention group (43.1 versus 4.6. Also the patients' satisfaction was significantly higher in the intervention group (P<0.0001. No drug adverse effects were seen. Conclusions: Totally, according to the obtained results, it may be concluded that acute pain control protocol in triage department by suppository of MS would result in reduced analgesics administration time and higher patients' satisfaction.   Keywords: Analgesia; Emergency Department; Pain Control

Preoperative analgesics for additional pain relief in children and adolescents having dental treatment.

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Ashley, Paul F; Parekh, Susan; Moles, David R; Anand, Prabhleen; MacDonald, Laura C I

2016-08-08

Fear of dental pain is a major barrier to treatment for children who need dental care. The use of preoperative analgesics has the potential to reduce postoperative discomfort and intraoperative pain. We reviewed the available evidence to determine whether further research is warranted and to inform the development of prescribing guidelines. This is an update of a Cochrane review published in 2012. To assess the effects of preoperative analgesics for intraoperative or postoperative pain relief (or both) in children and adolescents undergoing dental treatment without general anaesthesia or sedation. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 5 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2015, Issue 12), MEDLINE via OVID (1946 to 5 January 2016), EMBASE via OVID (1980 to 5 January 2016), LILACS via BIREME (1982 to 5 January 2016) and the ISI Web of Science (1945 to 5 January 2016). We searched ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials to 5 January 2016. There were no restrictions regarding language or date of publication in the searches of the electronic databases. We handsearched several specialist journals dating from 2000 to 2011.We checked the reference lists of all eligible trials for additional studies. We contacted specialists in the field for any unpublished data. Randomised controlled clinical trials of analgesics given before dental treatment versus placebo or no analgesics in children and adolescents up to 17 years of age. We excluded children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia. Two review authors assessed titles and abstracts of the articles obtained from the searches for eligibility, undertook data extraction and assessed the risk of bias in the included studies. We assessed the quality of the

Analgesic and anti-inflammatory drug use and risk of bladder cancer: a population based case control study

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Heaney John

2007-08-01

Full Text Available Abstract Background Use of phenacetin and other analgesic and non-steroidal anti-inflammatory drugs (NSAIDs potentially influences bladder cancer incidence, but epidemiologic evidence is limited. Methods We analyzed data from 376 incident bladder cancer cases and 463 controls from a population-based case-control study in New Hampshire on whom regular use of analgesic drugs and NSAIDs was obtained. Odds ratios and 95% confidence intervals were computed using logistic regression with adjustment for potentially confounding factors. Separate models by tumor stage, grade and TP53 status were conducted. Results We found an elevated odds ratio (OR associated with reported use of phenacetin-containing medications, especially with longer duration of use (OR >8 years = 3.00, 95% confidence interval (CI = 1.4–6.5. In contrast, use of paracetamol did not relate overall to risk of bladder cancer. We also found that regular use of any NSAID was associated with a statistically significant decrease in bladder cancer risk (OR = 0.6, 95% CI = 0.4–0.9, and specifically use of aspirin. Further, the association with NSAID use was largely among invasive, high grade and TP53 positive tumors. Conclusion While these agents have been investigated in several studies, a number of questions remain regarding the effects of analgesic and NSAID use on risk of bladder cancer.

PHYTOCHEMICAL SCREENING, ANTI-INFLAMMATORY AND ANALGESIC PROPERTIES OF PENTANISIA PRUNELLOIDES FROM THE EASTERN CAPE PROVINCE, SOUTH AFRICA.

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Mathews, Miya Gugulethu; Ajayi, Oyemitan Idris; Opeoluwa, Oyedeji Oyehan; Oluwatobi, Oluwafemi Samuel; Benedicta N, Nkeh-Chungag; Phindile, Songca Sandile; Oyedeji; Omowumi, Adebola

2016-01-01

Pentanisia prunelloides is a medicinal plant widely used to remedy various ailments including infections, fever and rheumatism in Eastern Cape Province of South Africa. There is scanty report on the phytochemical and biological properties of the plant; hence various solvent extracts of the dried plant materials were phytochemically screened, and its aqueous extract evaluated for acute toxicity effect, analgesic and antiinflammatory properties in rodents. Different extracts of both leaf and rhizome were obtained separately with ethanol, methanol and water. Portions of the filtrate were used for qualitative screening of secondary metabolites and remaining portions were concentrated and dried. Dried grounded leaf and rhizome of the plant were also used for quantitative screening for some major components. The aqueous extract of the leaf and rhizome were used for acute toxicity (LD 50 ) test, antiinflammatory and analgesic activities in rodents. The qualitative phytochemical screening showed the presence of several phytoconstituents with saponins, flavonoids and alkaloids constituting highest constituents in the leaf and rhizome. The LD50: of the aqueous extracts (from leaf or rhizome) was found to be ≥5000 mg/kg orally. The leaf and rhizome aqueous extract (250-500 mg/kg) significantly (pphytochemicals which could be associated with their medicinal uses. The aqueous leaf and rhizome extracts are similarly non-toxic orally, showed antiinflammatory and analgesic potentials thus rationalizing its use in folkloric medicine.

Synthesis and Analgesic Effects of μ-TRTX-Hhn1b on Models of Inflammatory and Neuropathic Pain

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Yu Liu

2014-08-01

Full Text Available μ-TRTX-Hhn1b (HNTX-IV is a 35-amino acid peptide isolated from the venom of the spider, Ornithoctonus hainana. It inhibits voltage-gated sodium channel Nav1.7, which has been considered as a therapeutic target for pain. The goal of the present study is to elucidate the analgesic effects of synthetic μ-TRTX-Hhn1b on animal models of pain. The peptide was first synthesized and then successfully refolded/oxidized. The synthetic peptide had the same inhibitory effect on human Nav1.7 current transiently expressed in HEK 293 cells as the native toxin. Furthermore, the analgesic potentials of the synthetic peptide were examined on models of inflammatory pain and neuropathic pain. μ-TRTX-Hhn1b produced an efficient reversal of acute nociceptive pain in the abdominal constriction model, and significantly reduced the pain scores over the 40-min period in the formalin model. The efficiency of μ-TRTX-Hhn1b on both models was equivalent to that of morphine. In the spinal nerve model, the reversal effect of μ-TRTX-Hhn1b on allodynia was longer and higher than mexiletine. These results demonstrated that μ-TRTX-Hhn1b efficiently alleviated acute inflammatory pain and chronic neuropathic pain in animals and provided an attractive template for further clinical analgesic drug design.

Accounting for the sedative and analgesic effects of medication changes during patient participation in clinical research studies: measurement development and application to a sample of institutionalized geriatric patients.

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Sloane, Philip; Ivey, Jena; Roth, Mary; Roederer, Mary; Williams, Christianna S

2008-03-01

To date, no system has been published that allows investigators to adjust for the overall sedative and/or analgesic effects of medications, or changes in medications, in clinical trial participants for whom medication use cannot be controlled. This is common in clinical trials of behavioral and complementary/alternative therapies, and in research involving elderly or chronically ill patients for whom ongoing medical care continues during the trial. This paper describes the development, and illustrates the use, of a method we developed to address this issue, in which we generate single continuous variables to represent the daily sedative and analgesic loads of multiple medications. Medications for 90 study participants in a clinical trial of a nonpharmacological intervention were abstracted from medication administration records across multiple treatment periods. An expert panel of three academic clinical pharmacists and a geriatrician met to develop a system by which each study medication could be assigned a sedative and analgesic effect rating. The two measures, when applied to data on 90 institutionalized persons with Alzheimer's disease, resulted in variables with moderately skewed distributions that are consistent with the clinical profile of analgesia and sedation use in long-term care populations. The average study participant received 1.89 analgesic medications per day and had a daily analgesic load of 2.96; the corresponding figures for sedation were 2.07 daily medications and an average daily load of 11.41. A system of classifying the sedative and analgesic effects of non-study medications was created that divides drugs into categories based on the strength of their effects and assigns a rating to express overall sedative and analgesic effects. These variables may be useful in comparing patients and populations, and to control for drug effects in future studies.

Analgesic effects of tramadol, carprofen or multimodal analgesia in rats undergoing ventral laparotomy.

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Zegre Cannon, Coralie; Kissling, Grace E; Goulding, David R; King-Herbert, Angela P; Blankenship-Paris, Terry

2011-03-01

In this study, the authors evaluated the analgesic efficacy of tramadol (an opioid-like analgesic), carprofen (a nonsteroidal anti-inflammatory drug) and a combination of both drugs (multimodal therapy) in a rat laparotomy model. The authors randomly assigned rats to undergo either surgery (abdominal laparotomy with visceral manipulation and anesthesia) or anesthesia only. Rats in each group were treated with tramadol (12.5 mg per kg body weight), carprofen (5 mg per kg body weight), a combination of tramadol and carprofen (12.5 mg per kg body weight and 5 mg per kg body weight, respectively) or saline (anesthesia control group only; 5 mg per kg body weight). The authors administered analgesia 10 min before anesthesia, 4 h after surgery or (for the rats that received anesthesia only) anesthesia and 24 h after surgery or anesthesia. They measured locomotor activity, running wheel activity, feed and water consumption, body weight and fecal corticosterone concentration of each animal before and after surgery. Clinical observations were made after surgery or anesthesia to evaluate signs of pain and distress. The authors found that carprofen, tramadol and a combination of carprofen and tramadol were all acceptable analgesia regimens for a rat laparotomy model.

Bioactivity-guided fractionation for anti-inflammatory and analgesic properties and constituents of Xanthium strumarium L.

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Han, T; Li, H-L; Zhang, Q-Y; Han, P; Zheng, H-C; Rahman, K; Qin, L-P

2007-12-01

The aim of this study was to fractionate an extract of Xanthium strumarium L. (EXS) and to investigate the anti-inflammatory and analgesic properties of the extract and its fractions. The ethanol extract of X. strumarium (EXS) was fractionated on the basis of polarity. Among the different fractions, the n-butanol fraction showed the highest anti-inflammatory activity in the croton-oil-induced ear edema test and furthermore reduced the number of writhings induced by acetic acid in mice in a dose-dependent manner. This indicates that the n-butanol fraction of X. strumarium possesses potent analgesic effects which are likely to be mediated by its anti-inflammatory activity. Bioassay-guided fractionation of EXS led to the isolation and identification of ten caffeoylquinic acids and three heterocyclics by HPLC-DAD-MS(n) from the active n-butanol fraction, implying that the active compounds are polar in nature. The isolated caffeoylquinic acids could partially explain the antinociceptive effect of X. strumarium polar extract.

Analgesic properties of the aqueous and ethanol extracts of the leaves of Kalanchoe crenata (Crassulaceae).

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Nguelefack, T B; Fotio, A L; Watcho, P; Wansi, S L; Dimo, T; Kamanyi, A

2004-05-01

The aqueous and ethanol extracts of the dry leaves of Kalanchoe crenata (300 and 600 mg/kg) were evaluated for their analgesic properties on the pain induced by acetic acid, formalin and heat in mice and by pressure on rats. The ethanol extract of K. crenata at a dose of 600 mg/kg produced an inhibition of 61.13% on pain induced by acetic acid and 50.13% for that induced by formalin. An inhibition of 67.18% was observed on pain induced by heat 45 min after the administration of the extract. The aqueous extract administered at a dose of 600 mg/kg produced a maximum effect of 25% on pain induced by pressure. These activities were similar to those produced by a paracetamol-codeine association, while indomethacin exhibited a protective effect only against the writhing test. Our results suggest that the leaves of K. crenata could be a source of analgesic compounds. Copyright 2004 John Wiley & Sons, Ltd.

Comparing Early Postoperative Period Analgesic Effect of Dexketoprofene Trometamol and Lornoxicam in Mediastinoscopy Cases

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Sagiroglu, Gonul

2011-01-01

Objective: In this study, we aimed comparing early postoperative period analgesic effectiveness and the effects on opioid consumption of intravenous dexketoprofen and lornoxicam that are given preemptively. Materials and Methods: Forty patients, planned elective mediastinoscopy, were included in this prospective randomized study. These patients were classified in two groups, group D for dexketoprofene trometamol and group L for lornoxicam, randomly. 20 minutes before the operation 50 mg dexketoprofene trometamol and 8 mg lornoxicam were injected intravenously for group D and group L respectively. In postoperative intensive care unit, pain scores, mean arterial pressures, heart rates and peripheric O2 saturations of patients were recorded at 0, 10, 20, 60, 90 and 120th minutes. Results: When we evaluate the VAS score of the groups, there was a significant decrease in group D in all measured timesstatistically compairing to group L (p0.05). Conclusion: Since intravenous dexketoprofen, applied preemptively, has more potent analgesic effect and causing less opioid consumption in early postoperative period, is better than intravenous lornoxicam. PMID:25610155

Determination of two capsaicinoids in analgesic transdermal patches using RP-HPLC and UV spectroscopy

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F. Kobarfard

2017-11-01

Full Text Available Background and objectives: At the present time, a considerable frontier in the administration of therapeutic medications is transdermal drug delivery. Methods: In this study, a rapid, precise, sensitive and selective reversed-phasehigh performance liquid chromatography (RP-HPLC method has been evaluated, developed and validated to separate and quantitate capsaicin and dihydrocapsaicin (main active agents in analgesic dermal patches produced in Iran. Results: After isolation from laminated adhesive patches, capsaicinoids were analyzed on Lichrospher C18 analytical columns with reversed phase, using a mobile phase composition of methanol and distilled water (70:30 v/v and without any buffer (pH=6.5. The flow rate was 1 mL/min and the UV detector was operating at 281 nm. The assay was found to be linear over the range of 0.1-1.0 mg/mL. All validation parameters were within the acceptable range. Conclusion: It seems that the developed method was fairly sensitive and reliable in measuring capsaicinoids in commercially available analgesic transdermal patches in Iran.

Choosing the right analgesic. A guide to selection.

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Bushnell, Timothy G; Justins, Douglas M

1993-09-01

Pain is an unpleasant sensory and emotional experience, unique to each individual patient. In the dynamic processes of nociceptive stimulation, signal transmission, central decoding and interpretation there are many potential sites for pharmacological intervention, and there are many drugs which will produce analgesia. An analgesic 'ladder' has been proposed for rational pain relief in cancer and a similar concept should be used in all forms of acute and chronic pain. Continuing research and drug development undoubtedly extends our understanding, but consistent improvement in our clinical ability to relieve pain depends more on our willingness to consider the need of each patient individually, to tailor the drug, route and mode of administration to that patient's requirements, and then to monitor on the basis of the response of the patient to the treatment.

A CLINICAL COMPARATIVE STUDY OF ANALGESIC EFFECT OF TRAMADOL AND PENTAZOCINE IN POST - OPERATIVE PATIENTS FOLLOWING UPPER ABDOMINAL SURGERY

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Jamuna

2015-06-01

Full Text Available The post - operative pain can be treated by various approaches. Aim of this randomised prospective study was to compare two drugs (Tramadol and Pentazocine . 100 adult patients of both sexes of ASA status 1 & 2 posted for elective upper abdominal surgery were randomly assigned into two groups of 50 each, where Group 1 received Tramadol intravenously and Group 2 received Pentazocine intravenously as post - opera tive pain management. The efficacy of the analgesic effect of intravenous Tramadol & Pentazocine was compared during post - operative pain management. It was observed that Tramadol has got more potent analgesic action compared to equianalgesic dose of Pentaz ocine.

Evaluation of analgesic, anti-inflammatory, antipyretic and antiulcer effect of aqueous and methanol extracts of leaves of Polygonum minus Huds. (Polygonaceae in rodents

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Parayil Varghese Christapher

2015-01-01

Full Text Available Background: Polygonum minus (Kesum is an annual plant that grows throughout South East Asian countries. The Leaf of P. minus is commonly used as diet ingredient in Malaysia. Traditionally the decoction of leaves of this plant is used to treat stomach ache and digestive problems. The plant has known antioxidant activity, and its pharmacological properties are remaining unclear. Hence the study is planned to evaluate the analgesic, anti-inflammatory, antiulcer and antipyretic activity of kesum. Materials and methods: P. minus leaves was extracted with methanol and distilled water by simple maceration. The dried extract was used for further phytochemical and pharmacological analysis. The analgesic effect of methanol and aqueous extract of P. minus was studied using acetic acid, tail immersion and formalin induced pain in rats. The anti-inflammatory effect of both extracts was studied using carrageenan induced paw edema in rats. The pyloric ligation model was used to study the antiulcer effect. The antipyretic effect was studied using Brewer′s yeast induced pyrexia. Results: The percentage yield of aqueous and methanol extract of P. minus leaves were 1.15 and 2.57% w/w respectively. Both the extract showed significant analgesic effect against acetic acid writing, tail immersion and formalin induced pain methods, but the effect was not equivalent to that of standard. Aqueous extract showed significant anti-inflammatory action and methanol extract showed significant anti-ulcer effect. Conclusion: The aqueous extract of the P. minus has significant analgesic and anti-inflammatory action, whereas methanolic extract showed presence of analgesic and anti-ulcer activity. Both aqueous and methanolic extract did not show any significant antipyretic activity.

Genome-wide association study identifies polymorphisms associated with the analgesic effect of fentanyl in the preoperative cold pressor-induced pain test

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Kaori Takahashi

2018-03-01

Full Text Available Opioid analgesics are widely used for the treatment of moderate to severe pain. The analgesic effects of opioids are well known to vary among individuals. The present study focused on the genetic factors that are associated with interindividual differences in pain and opioid sensitivity. We conducted a multistage genome-wide association study in subjects who were scheduled to undergo mandibular sagittal split ramus osteotomy and were not medicated until they received fentanyl for the induction of anesthesia. We preoperatively conducted the cold pressor-induced pain test before and after fentanyl administration. The rs13093031 and rs12633508 single-nucleotide polymorphisms (SNPs near the LOC728432 gene region and rs6961071 SNP in the tcag7.1213 gene region were significantly associated with the analgesic effect of fentanyl, based on differences in pain perception latency before and after fentanyl administration. The associations of these three SNPs that were identified in our exploratory study have not been previously reported. The two polymorphic loci (rs13093031 and rs12633508 were shown to be in strong linkage disequilibrium. Subjects with the G/G genotype of the rs13093031 and rs6961071 SNPs presented lower fentanyl-induced analgesia. Our findings provide a basis for investigating genetics-based analgesic sensitivity and personalized pain control. Keywords: Opioid sensitivity, Analgesia, Fentanyl, Polymorphism, GWAS

Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles.

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Vorobeichik, L; Brull, R; Bowry, R; Laffey, J G; Abdallah, F W

2018-04-01

Major shoulder surgery is associated with moderate-to-severe pain, but consensus on the optimal analgesic approach is lacking. Continuous catheter-based interscalene block (CISB) prolongs the analgesic benefits of its single-injection counterpart (SISB), but concerns over CISB complications and difficulties in interpreting comparative evidence examining major and minor shoulder procedures simultaneously, despite their differences in postoperative pain, have limited CISB popularity. This meta-analysis evaluates the CISB analgesic role and complications compared with SISB for major shoulder surgery. We retrieved randomised controlled trials (RCTs) comparing the effects of CISB to SISB on analgesic outcomes and side-effects after major shoulder surgery. Postoperative opioid consumption at 24 h was designated as the primary outcome. Secondary outcomes included 24-48 h opioid consumption, postoperative rest and dynamic pain scores up to 72 h, time-to-first analgesic, recovery room and hospital stay durations, patient satisfaction, postoperative nausea and vomiting, respiratory function, and block-related complications. Data from 15 RCTs were pooled using random-effects modelling. Compared with SISB, CISB reduced 24- and 48-h oral morphine consumption by a weighted mean difference [95% confidence interval] of 50.9 mg [-81.6, -20.2], (P=0.001) and 44.7 mg [-80.9, -8.7], (Pshoulder surgery, without increasing side-effects, compared with SISB. The importance of CISB-related changes in respiratory indices is questionable. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial.

LENUS (Irish Health Repository)

McDonnell, John G

2008-01-01

The transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing midline abdominal wall incisions. We evaluated its analgesic efficacy over the first 48 postoperative hours after cesarean delivery performed through a Pfannensteil incision, in a randomized controlled, double-blind, clinical trial.

Switching, Adverse Effects and Use of Over-the-Counter Analgesics among Users of Oral Anticoagulants

DEFF Research Database (Denmark)

Hellfritzsch, Maja; Hyllested, Lea Maria Ronneberg; Meegaard, Line

2017-01-01

) to a NOAC. Switching was most frequently caused by inconvenience (34%) and adverse effects (23%). Although half of all patients had recently bought over-the-counter analgesics, purchase of ibuprofen and aspirin was rare (6%). More VKA users than NOAC users felt limited in their everyday life because...

Pharmacological Treatment of Pain in Cancer Patients : The Role of Adjuvant Analgesics, a Systematic Review

NARCIS (Netherlands)

van den Beuken-van Everdingen, Marieke H J; de Graeff, Alexander; Jongen, Joost L M; Dijkstra, Denise; Mostovaya, Irina; Vissers, Kris C P

2017-01-01

CONTEXT: In patients with cancer, pain is one of the most feared and burdensome symptoms. Adjuvant analgesics are an important cornerstone on which treatment of pain in patients with cancer is based. OBJECTIVES: To update our guidelines for the treatment of pain in patients with cancer, we performed

Phrenic palsy and analgesic quality of continuous supraclavicular vs. interscalene plexus blocks after shoulder surgery.

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Wiesmann, T; Feldmann, C; Müller, H H; Nentwig, L; Beermann, A; El-Zayat, B F; Zoremba, M; Wulf, H; Steinfeldt, T

2016-09-01

Hemidiaphragmatic palsy is a common consequence of the interscalene brachial plexus block. It occurs less commonly with the supraclavicular approach. Register data suggest that the analgesic quality of a supraclavicular blockade is sufficient for arthroscopic shoulder surgery, although data on the post-operative analgesic effect are lacking. After approval by the ethics committee, patients having arthroscopic shoulder surgery under general anaesthesia were randomized to receive a continuous interscalene or supraclavicular blockade. Phrenic nerve function was evaluated through ultrasound examination of the diaphragm in combination with spirometry. Pain scores at rest and activity etc. were determined before catheter insertion, during observation in the post- anaesthesia care unit (PACU) and on post-operative day 1 (POD1). The initial application of 10 ml of ropivacaine 0.2% was followed by continuous application of 4 ml of ropivacaine 0.2%, plus a patient controlled analgesia (PCA) bolus of 4 ml/h. One hundred and twenty patients were randomized, of which 114 data sets were analysed. Complete hemidiaphragmatic paresis occurred in 43% of the interscalene group vs. 24% in the supraclavicular group during PACU stay. Rates of dyspnoea and hoarseness were similar. Horner's syndrome occurred in 21% of the interscalene but only 3% of the supraclavicular group on POD1. Pain scores were comparable for pain at rest and during stress at each time point. This trial showed a significantly greater incidence of phrenic nerve palsy of the interscalene group in PACU, but not on POD1. Post-operative analgesic quality was similar in both groups. Continuous supraclavicular blockade is a suitable alternative to the continuous interscalene technique. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Potent analgesic effects of anticonvulsants on peripheral thermal nociception in rats

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Todorovic, Slobodan M; Rastogi, A J; Jevtovic-Todorovic, Vesna

2003-01-01

Anticonvulsant agents are commonly used to treat neuropathic pain conditions because of their effects on voltage- and ligand-gated channels in central pain pathways. However, their interaction with ion channels in peripheral pain pathways is poorly understood. Therefore, we studied the potential analgesic effects of commonly used anticonvulsant agents in peripheral nociception. We injected anticonvulsants intradermally into peripheral receptive fields of sensory neurons in the hindpaws of adult rats, and studied pain perception using the model of acute thermal nociception. Commonly used anticonvulsants such as voltage-gated Na+ channel blockers, phenytoin and carbamazepine, and voltage-gated Ca2+ channel blockers, gabapentin and ethosuximide, induced dose-dependent analgesia in the injected paw, with ED50 values of 0.30, 0.32 and 8, 410 μg per 100 μl, respectively. Thermal nociceptive responses were not affected in the contralateral, noninjected paws, indicating a lack of systemic effects with doses of anticonvulsants that elicited local analgesia. Hill slope coefficients for the tested anticonvulsants indicate that the dose–response curve was less steep for gabapentin than for phenytoin, carbamazepine and ethosuximide. Our data strongly suggest that cellular targets like voltage-gated Na+ and Ca2+ channels, similar to those that mediate the effects of anticonvulsant agents in the CNS, may exist in the peripheral nerve endings of rat sensory neurons. Thus, peripherally applied anticonvulsants that block voltage-gated Na+ and Ca2+ channels may be useful analgesics. PMID:12970103

The analgesic efficacy of subcostal transversus abdominis plane block with Mercedes incision.

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Guo, Jian-Guo; Li, Hui-Ling; Pei, Qing-Qing; Feng, Zhi-Ying

2018-04-10

Conventional perioperative analgesic modalities (e.g. opioids, epidural analgesia) have their own drawbacks, which limit their clinical application. This study investigated the opioid-sparing effectsof the oblique subcostal transversus abdominis plane (OSTAP) blockade with ropivacaine for the patients undergoing open liver resection with a Mercedes incision. 126 patients who were scheduled for open liver resection were enrolled in this study. Patients were randomly assigned to receive bilateral ultrasound-guided OSTAPblocks with either 0.375% ropivacaine (groupT) or 0.9% isotonic saline (group C). Both groups also received intravenous patient-controlled analgesia and intravenous 40 mg parecoxib every 12 h for a total of 3 days. Preoperative and intraoperative parameters, plus intraoperative and postoperative cumulative sufentanil consumption, were recorded. 70 patients were enrolled in the study finally. There were no significant differences between the two groups with respect to preoperative parameters, and surgical and anesthetic characteristics. The intraoperative sufentanil use, cumulative sufentanil consumption at 5 min after extubation, 2 h, 4 h,12 h and 24 h after operation in group T was significantly less than that in group C (P = 0.001, 0.001, 0.000, 0.000, 0.001 and 0.044, respectively). Compared with group C, postoperative NRS pain scores at rest were significantly lower at 2 h and 4 h postoperatively in group T (P = 0.04and 0.02, respectively); NRS scores at the time of coughing were also significantly lower in group T than in group C at all time points except 5 min after extubation (all P < 0.001). Furthermore, compared with group C, the number of intraoperative vasodilator use, the extubation time and the incidence of nausea was reduced in group T. Ultrasound-guided OSTAP block with ropivacaine can significantly decrease the perioperative cumulative dosage of analgesics and improve analgesic effect without obvious side

Pharmacokinetics and analgesic effects of intravenous propacetamol vs rectal paracetamol in children after major craniofacial surgery

NARCIS (Netherlands)

Prins, Sandra A.; Van Dijk, Monique; Van Leeuwen, Pim; Searle, Susan; Anderson, Brian J.; Tibboel, Dick; Mathot, Ron A. A.

Background: The pharmacokinetics and analgesic effects of intravenous and rectal paracetamol were compared in nonventilated infants after craniofacial surgery in a double-blind placebo controlled study. Methods: During surgery all infants (6 months-2 years) received a rectal loading dose of 40

A facile microwave assisted one pot synthesis of novel xanthene derivatives as potential anti-inflammatory and analgesic agents

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Anupam G. Banerjee

2016-09-01

Full Text Available Microwave assisted irradiation of resorcinol and substituted aryl aldehydes using sulfamic acid as catalyst afforded novel 9-aryl-9H-xanthene-3,6-diol derivatives (1a–f in good yields. The newly synthesized compounds which were previously selected on the basis of PASS prediction were tested for anti-inflammatory activity using carrageenan-induced rat paw edema and analgesic activity using acetic acid induced writhing and formalin-induced paw edema in mice along with the estimation of gastric ulcerogenicity index. Compounds 1e and 1f exhibited significant anti-inflammatory and analgesic activities as compared to standard drug. The study also revealed that compounds (1a–f showed minimum or no ulcerogenicity in mice as that of the standard drug.

The experience of childbrith in first-time mothers who received narcotic analgesics during the first stage of labour

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L. Jantjes

2007-09-01

Full Text Available This research has focused on the birthing experience of first-time mothers who received the narcotic analgesic combination of Pethidine and Hydroxyzine during the first stage of labour. A qualitative research methodology was used to collect data. Unstructured interviews were held with first-time mothers to obtain accounts of their experience of childbirth. These narrations were audio-taped while the participants were still being cared for in the postnatal ward of the hospital where delivery took place. Nine interviews were conducted with first-time mothers who gave birth normally vaginally after a normal pregnancy and who received a narcotic analgesic in the first stage of labour. The transcribed interviews were analyzed using Tesch’s method of descriptive analysis (in Creswell, 1994:115.

Pharmacological screening of plants recommended by folk medicine as anti-snake venom: I. Analgesic and anti-inflammatory activities

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Bettina M. Ruppelt

1991-01-01

Full Text Available We have observed that several plants used popularly as anti-snake venom show anti-inflammatory activity. From the list prepared by Rizzini, Mors and Pereira some species have been selected and tested for analgesic activity (number of contortions and anti-inflammatory activity (Evans blue dye diffusion - 1% solution according to Whittle's technique (intraperitoneal administration of 0.1 N-acetic acid 0.1 ml/10 g in mice. Previous oral administration of a 10% infusion (dry plant or 20% (fresh plant corresponding to 1 or 2 g/Kg of Apuleia leiocarpa, Casearia sylvestris, Brunfelsia uniflora, Chiococca brachiata, Cynara scolymus, Dorstenia brasiliensis, Elephantopus scaber, Marsypianthes chamaedrys, Mikania glomerata and Trianosperma tayuya demonstrated analgesic and/or anti-inflammatory activities of varied intensity

Comparison of analgesic efficacy of intravenous Paracetamol and intravenous dexketoprofen trometamol in multimodal analgesia after hysterectomy.

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Unal, Ciğdem; Cakan, Türkay; Baltaci, Bülent; Başar, Hülya

2013-10-01

[corrected] We aimed to evaluate analgesic efficacy, opioid-sparing, and opioid-related adverse effects of intravenous paracetamol and intravenous dexketoprofen trometamol in combination with iv morphine after total abdominal hysterectomy. Sixty American Society of Anesthesiologist Physical Status Classification I-II patients scheduled for total abdominal hysterectomy were enrolled to this double-blinded, randomized, placebo controlled, and prospective study. Patients were divided into three groups as paracetamol, dexketoprofen trometamol, and placebo (0.9% NaCl) due to their post-operative analgesic usage. Intravenous patient controlled analgesia morphine was used as a rescue analgesic in all groups. Pain scores, hemodynamic parameters, morphine consumption, patient satisfaction, and side-effects were evaluated. Visual Analog Scale (VAS) scores were not statistically significantly different among the groups in all evaluation times, but decrease in VAS scores was statistically significant after the evaluation at 12(th) h in all groups. Total morphine consumption (morphine concentration = 0.2 mg/ml) in group paracetamol (72.3 ± 38.0 ml) and dexketoprofen trometamol (69.3 ± 24.1 ml) was significantly lower than group placebo (129.3 ± 22.6 ml) (P dexketoprofen trometamol after surgery and the increase in global satisfaction score was significant only in group placebo. Dexketoprofen trometamol and Paracetamol didn't cause significant change on pain scores, but increased patients' comfort. Although total morphine consumption was significantly decreased by both drugs, the incidence of nausea and vomiting were similar among the groups. According to results of the present study routine addition of dexketoprofen trometamol and paracetamol to patient controlled analgesia morphine after hysterectomies is not recommended.

Opening of brain blood barrier induced by red light and central analgesic improvement of cobra neurotoxin.

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Ye, Yong; Li, Yue; Fang, Fei

2014-05-05

Cobra neurotoxin (NT) has central analgesic effects, but it is difficult to pass through brain blood barrier (BBB). A novel method of red light induction is designed to help NT across BBB, which is based on photosensitizer activation by red light to generate reactive oxygen species (ROS) to open BBB. The effects were evaluated on cell models and animals in vivo with illumination by semiconductor laser at 670nm on photosensitizer pheophorbide isolated from silkworm excrement. Brain microvascular endothelial cells and astrocytes were co-cultured to build up BBB cell model. The radioactivity of (125)I-NT was measured in cells and tissues for NT permeation. Three ways of cranial irradiation, nasal cavity and intravascular irradiation were tested with combined injection of (125)I-NT 20μg/kg and pheophorbide 100μg/kg to rats, and organs of rats were separated and determined the radioactivity. Paw pressure test in rats, hot plate and writhing test in mice were applied to appraise the analgesic effects. NT across BBB cell model increased with time of illumination, and reached stable level after 60min. So did ROS in cells. NT mainly distributed in liver and kidney of rats, significantly increased in brain after illumination, and improved analgesic effects. Excitation of pheophorbide at red light produces ROS to open BBB, help NT enter brain, and enhance its central action. This research provides a new method for drug across BBB to improve its central role. Copyright © 2014 Elsevier B.V. All rights reserved.

Genetic variation in the serotonin transporter gene (5-HTTLPR, rs25531 influences the analgesic response to the short acting opioid Remifentanil in humans

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Schalling Martin

2009-07-01

Full Text Available Abstract Background There is evidence from animal studies that serotonin (5-HT can influence the antinociceptive effects of opioids at the spinal cord level. Therefore, there could be an influence of genetic polymorphisms in the serotonin system on individual variability in response to opioid treatment of pain. The serotonin transporter (5-HTT is a key regulator of serotonin metabolism and availability and its gene harbors several known polymorphisms that are known to affect 5-HTT expression (e.g. 5-HTTLPR, rs25531. The aim of this study was to investigate if the triallelic 5-HTTLPR influences pain sensitivity or the analgesic effect of opioids in humans. 43 healthy volunteers (12 men, 31 women, mean age 26 years underwent heat pain stimulations before and after intravenous injection of Remifentanil; a rapid and potent opioid drug acting on μ-type receptors. Subjects rated their perceived pain on a visual analogue scale (VAS. All participants were genotyped for the 5-HTTLPR and the rs25531 polymorphism. We recruited by advertising, with no history of drug abuse, chronic pain or psychiatric disorders. Results At baseline, there was no difference in pain ratings for the different triallelic 5-HTTLPR genotype groups. However, the opiod drug had a differential analgesic effect depending on the triallelic 5-HTTLPR genotype. Remifentanil had a significantly better analgesic effect in individuals with a genotype coding for low 5-HTT expression (SA/SA and SA/LG as compared to those with high expression(LA/LA, p Conclusion This is the first report showing an influence of the triallelic 5-HTTLPR on pain sensitivity or the analgesic effect of opioids in humans. Previously the 5-HTTLPR s-allele has been associated with higher risk of developing chronic pain conditions but in this study we show that the genotype coding for low 5-HTT expression is associated with a better analgesic effect of an opioid. The s-allele has been associated with downregulation of

Anti-inflammatory and analgesic activities of solvent fractions of the leaves of Moringa stenopetala Bak. (Moringaceae) in mice models.

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Tamrat, Yohannes; Nedi, Teshome; Assefa, Solomon; Teklehaymanot, Tilahun; Shibeshi, Workineh

2017-09-29

Many people still experience pain and inflammation regardless of the available drugs for treatments. In addition, the available drugs have many side effects, which necessitated a quest for new drugs from several sources in which medicinal plants are the major one. This study evaluated the analgesic and anti- inflammatory activity of the solvent fractions of Moringa stenopetala in rodent models of pain and inflammation. Successive soxhlet and maceration were used as methods of extractions using solvents of increasing polarity; chloroform, methanol and water. Swiss albino mice models were used in radiant tail flick latency, acetic acid induced writhing and carrageenan induced paw edema to assess the analgesic and anti-inflammatory activities. The test groups received different doses (100 mg/kg, 200 mg/kg and 400 mg/kg) of the three fractions (chloroform, methanol and aqueous). The positive control groups received morphine (20 mg/kg) or aspirin (100 mg/kg or 150 mg/kg) based on the respective models. The negative control groups received the 10 ml/kg of vehicles (distilled water or 2% Tween 80). In all models, the chloroform fraction had protections only at a dose of 400 mg/kg. However, the methanol and aqueous fraction at all doses have shown significant central and peripheral analgesic activities with a comparable result to the standards. The aqueous and methanol fractions significantly reduced carrageenan induced inflammation in a dose dependent manner, in which the highest reduction of inflammation was observed in aqueous fraction at 400 mg/kg. This study provided evidence on the traditionally claimed uses of the plant in pain and inflammatory diseases, and Moringa stenopetala could be potential source for development of new analgesic and anti-inflammatory drugs.

Pharmacological interactions of anti-inflammatory-analgesics in odontology.

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Gómez-Moreno, Gerardo; Guardia, Javier; Cutando, Antonio; Calvo-Guirado, José Luis

2009-02-01

In this second article we describe the more interesting pharmacological interactions in dental practice based on the prescription of analgesic narcotics, paracetamol and non-selective non-steroid anti-inflammatory drugs (NSAI) (which inhibit cyclooxigenase 1 -COX 1- and cyclooxigenase 2 -COX 2-) and selective NSAIs (COX 2 inhibitors). The importance of preventing the appearance of these pharmacological interactions is because these are medicaments prescribed daily in odontology for moderate pain treatment and inflammation in the oral cavity. Paracetamol can interact with warfarin and therefore care should be taken with chronic alcoholic patients. All NSAIs reduce renal blood flow and consequently are capable of reducing the efficacy of medicaments used for treating arterial hypertension, which act via a renal mechanism. Especial attention should be taken considering the risk of interaction between the antagonists of AT1 receptors of angiostensin II (ARAII) and the NSAIs.

Overexpression of GDNF in the uninjured DRG exerts analgesic effects on neuropathic pain following segmental spinal nerve ligation in mice.

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Takasu, Kumiko; Sakai, Atsushi; Hanawa, Hideki; Shimada, Takashi; Suzuki, Hidenori

2011-11-01

Glial cell line-derived neurotrophic factor (GDNF), a survival-promoting factor for a subset of nociceptive small-diameter neurons, has been shown to exert analgesic effects on neuropathic pain. However, its detailed mechanisms of action are still unknown. In the present study, we investigated the site-specific analgesic effects of GDNF in the neuropathic pain state using lentiviral vector-mediated GDNF overexpression in mice with left fifth lumbar (L5) spinal nerve ligation (SNL) as a neuropathic pain model. A lentiviral vector expressing both GDNF and enhanced green fluorescent protein (EGFP) was constructed and injected into the left dorsal spinal cord, uninjured fourth lumbar (L4) dorsal root ganglion (DRG), injured L5 DRG, or plantar skin of mice. In SNL mice, injection of the GDNF-EGFP-expressing lentivirus into the dorsal spinal cord or uninjured L4 DRG partially but significantly reduced the mechanical allodynia in association with an increase in GDNF protein expression in each virus injection site, whereas injection into the injured L5 DRG or plantar skin had no effects. These results suggest that GDNF exerts its analgesic effects in the neuropathic pain state by acting on the central terminals of uninjured DRG neurons and/or on the spinal cells targeted by the uninjured DRG neurons. This article shows that GDNF exerts its analgesic effects on neuropathic pain by acting on the central terminals of uninjured DRG neurons and/or on the spinal cells targeted by these neurons. Therefore, research focusing on these GDNF-dependent neurons in the uninjured DRG would provide a new strategy for treating neuropathic pain. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

Combined cannabis/methaqualone withdrawal treated with psychotropic analgesic nitrous oxide.

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Gillman, Mark A; Harker, Nadine; Lichtigfeld, Frederick J

2006-07-01

This article reports the first single-blind study using psychotropic analgesic nitrous oxide (PAN) for treating acute withdrawal states following the abuse of methaqualone combined and smoked with cannabis. Smoked methaqualone combined with cannabis is called "white pipe" (WP). South Africa is the only country in the world where WP is a major form of substance abuse. This article demonstrates in 101 consecutively treated patients given placebo (100% oxygen) followed by PAN that this therapy produced a measurable therapeutic effect (more than 50% improvement) in 87 patients. This study confirms that WP is a form of substance abuse confined mainly to young adult male subjects.

Evaluation of the analgesic, sedative-anxiolytic, cytotoxic and thrombolytic potentials of the different extracts of Kalanchoe pinnata leaves

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Md. Razibul Habib

2015-12-01

Full Text Available Objective: To evaluate the analgesic, neuropharmacological, cytotoxic and thrombolytic potentials of the aqueous, ethanol and ethyl acetate extracts of Kalanchoe pinnata leaves. Methods: At the dose of 400 mg/kg body weight, the analgesic activity of the extracts were evaluated by the acetic acid-induced writhing and formalin-induced persistent pain tests while neuropharmacological activity was evaluated by the open field, hole cross and elevated plus maze tests. The cytotoxic potential was observed by brine shrimp lethality bioassay and the thrombolytic potential was investigated by clot lysis test. Results: The aqueous extract significantly suppressed the number of writhing (96.78% as well as the formalin-induced persistent pain on the early phase (46.92% and on the late phase (40.98%. Again in case of hole cross and open field tests, the locomotor activity was decreased significantly (P < 0.001 mostly by the ethyl acetate extract. Furthermore, the sedative-anxiolytic activity was supported by the increased percent (P < 0.01 of frequency into the open arm on elevated plus maze test. Besides, the extracts showed moderate lethality and thrombolytic activity. Conclusions: The findings showed that activities are comparable to the standards and in some cases are stronger than the standards. Therefore, based on the results, it is evident that it has great analgesic and sedative-anxiolytic activity with moderate cytotoxic and thrombolytic potential.

Comparison of impacts of friction massage, stretching exercises and analgesics on pain relief in primary fibromyalgia syndrome: a randomized clinical trial

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Amanollahi A

2013-01-01

Full Text Available Background: Stretching exercises and massage therapy are both suggested for pain relief in fibromyalgia syndrome. Previous studies have not proved their superiority over each other. This study compared the therapeutic effects of friction massage, stretching exercises, and analgesics on pain relief in patients with fibromyalgia syndrome.Methods: We evaluated 129 female patients with the diagnosis of primary fibromyalgia visited at the physical medicine clinics of Baqiyatallah Hospital in Tehran, Iran during 2010- 2011. Patients were randomly divided into three groups: the first group received 400 mg ibuprofen P.O. (3 times per day and 25 mg nortriptyline (daily P.O. as analgesic, the second group was treated by friction massage and the third group performed stretching exercises. Patients were assessed three times (initially, after one and four weeks by visual analogue scale (VAS.Results: The mean age of participants was 60.46 years. The mean age in each treatment group was 46.66 years in medication group, 46.73 years in stretching group and 46.65 years in friction massage group. Changes in VAS score over 4 weeks were 2.4, 3.1 and 1.9, in the first, second, and third groups, respectively. The changes in VAS were significantly different in the first and second groups rather than the controls (P<0.05.Conclusion: The effect of stretch exercise on pain relief was similar to analgesics, but it was more effective than friction massage. Moreover, the therapeutic effect of stretching exercise on pain relief upon four weeks was more permanent than friction massage but it was similar to analgesics.

Peripheral analgesic effects of ketamine in acute inflammatory pain

DEFF Research Database (Denmark)

Pedersen, J L; Galle, T S; Kehlet, H

1998-01-01

BACKGROUND. This study examined the analgesic effect of local ketamine infiltration, compared with placebo and systemic ketamine, in a human model of inflammatory pain. METHODS: Inflammatory pain was induced by a burn (at 47 degrees C for 7 min; wound size, 2.5 x 5 cm) on the calf in 15 volunteers...... on 3 separate days with 7-day intervals. They received either (1) subcutaneous infiltration with ketamine in the burn area (local treatment) and contralateral placebo injections, or (2) subcutaneous ketamine contralateral to the burn (systemic treatment) and placebo in the burn area, or (3) placebo...... hyperalgesia. Local ketamine infiltration reduced pain during the burn injury compared with systemic treatment and placebo (P ketamine treatment compared with placebo immediately after injection (P

Analgesic efficacy of low-dose intrathecal neostigmine in combination with fentanyl and bupivacaine for total knee replacement surgery

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Amit Jain

2012-01-01

Conclusions: The addition of 1 mcg neostigmine IT increased the duration of analgesia and decreased the analgesic consumption in 24 h in TKR. There was no increase in the incidence of adverse effects.

Effect of preoperative oral analgesics on pulpal anesthesia in patients with irreversible pulpitis-a systematic review and meta-analysis.

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Shirvani, Armin; Shamszadeh, Sayna; Eghbal, Mohammad Jafar; Marvasti, Laleh Alim; Asgary, Saeed

2017-01-01

The objectives of this study were to assess the efficacy of preemptive oral administration of single dose of non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen on the local anesthetic success in adults with irreversible pulpitis and to find the possible covariates that could predict treatment effect. A systematic search using electronic databases up to March 2015 was conducted. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated using random and fixed-effect inverse variance method. Subgroup and meta-regression analyses were conducted to assess the potential source of heterogeneity. Results showed that preemptive analgesics are more effective than placebo in increasing anesthetic success (OR = 0.30, CI% 0.24-0.39, p = 0.000) [Q = 55.860 (p = 0.001)]. In the subgroup analysis, administration of NSAIDs as monotherapy, ibuprofen as mono- vs. combination therapy, oxicam type drugs as monotherapy, and acetaminophen as combination therapy were significantly more effective in increasing anesthetic success OR = 0.25, CI% 0.16-0.38, p = 0.00, Q = 40.539 (p = 0.003); OR = 0.44, CI% 0.26-0.75, p = 0.00, Q = 12.833 (p = 0.011); OR = 0.48, CI% 0.30-0.74, p = 0.002, Q = 15.898 (p = 0.14); OR = 0.30, CI% 0.16-0.38, p = 0.001, Q = 7.506 (p = 0.02); OR = 0.10, CI% 0.16 0.38, p = 0.001, Q = 5.075 (p = 0.07), respectively. However, there was no significant difference in increasing anesthetic success between treatment and placebo arms when acetaminophen was administrated alone. In meta-regression analysis, an association between different types of NSAIDs (indomethacin, diclofenac potassium, and oxicam-type drugs) and articaine with treatment effect was observed. The administration of preemptive analgesics can induce superior intraoperative analgesia for patients with irreversible pulpitis. However, strategies such as co-administration of certain types of analgesics and anesthetic solution might be predictors

Analgesic, anti-inflmmatory and antipyretic activities of methanolic leaf extract of Maerua crassifolia

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Godwin Christian Akuodor

2016-03-01

Full Text Available Objective: To investigate the the analgesic, anti-inflammatory and antipyretic activities of the methanolic leaf extract of Maerua crassifolia in mice and rats. Methods: Acetic acid-induced writhing and tail immersion methods were used to assess analgesic activity, while xylene and carrageenan-induced paw oedema methods were used to evaluate the anti-inflammatory effect of the leaf extract. Yeast and amphetamine-induced pyrexia were used to investigate the antipyretic activity. The phytochemical analysis and oral acute toxicity of the methanolic leaf extract of Maerua crassifolia were also evaluated. Results: The leaf extract (100, 200, and 400 mg/kg showed a dose dependent and significant (P < 0.05 inhibition of pain in acetic acid-induced writhing and tail immersion tests. The extract also produced significant (P < 0.05 anti-inflammatory activity in both paradigms. A significant (P < 0.05 reduction in hyperpyrexia was also observed with the leaf extract. The phytochemical screening revealed the presence of alkaloids, flavonoids, terpenoids, tannins, steroids, resins, saponins and cardiac glycosides. The oral median lethal dose of the leaf extract was estimated to be greater than 5 000 mg/kg in rats. Conclusions: The findings confirmed its ethnomedical use in the treatment of pains and feverish conditions.

Pharmacokinetics and analgesic effects of intravenous propacetamol vs rectal paracetamol in children after major craniofacial surgery

NARCIS (Netherlands)

Prins, Sandra A.; van Dijk, Monique; van Leeuwen, Pim; Searle, Susan; Anderson, Brian J.; Tibboel, Dick; Mathot, Ron A. A.

2008-01-01

The pharmacokinetics and analgesic effects of intravenous and rectal paracetamol were compared in nonventilated infants after craniofacial surgery in a double-blind placebo controlled study. During surgery all infants (6 months-2 years) received a rectal loading dose of 40 mg.kg(-1) paracetamol 2 h

The analgesic efficacy of intravenous versus oral tramadol for preventing postoperative pain after third molar surgery

NARCIS (Netherlands)

Ong, Cliff K. S.; Lirk, Phillip; Tan, Juliana M. H.; Sow, Belle W. Y.

2005-01-01

The aim of this study was to compare the analgesic efficacy of single-dose preoperative intravenous versus oral tramadol for preventing pain after third molar surgery. Seventy-two patients undergoing elective third molar surgery were randomized to receive either intravenous (n = 36) or oral (n = 36)

Analysis of Currently Available Analgesic Tablets by Modern Liquid Chromatography: An Undergraduate Laboratory Introduction to HPLC.

Science.gov (United States)

Kagel, R. A.; Farwell, S. O.

1983-01-01

Background information, procedures, and results, are provided for an undergraduate experiment in which analgesic tablets are analyzed using liquid chromatography. The experiment, an improved, modified version of the Waters Associates Inc. experiment, is simple to prepare, requiring little glassware and minimal sample manipulation by students. (JN)

[Pharmacological study on hemostasis, analgesic and anti inflammation effects of the alcohol extract of Hibiscus tiliaceus].

Science.gov (United States)

Qiu, Fen; Tian, Hui; Zhang, Zhi; Yuan, Xian-Ling; Tan, Yuan-Feng; Ning, Xiao-Qing

2013-10-01

To study the effects of hemostasis, analgesic and anti inflammation of the alcohol extract of Hibiscus tiliaceus and offer pharmacological and experimental basis for its safe and effective use in clinic. The effects of hemostasist were observed with tail breaking method, capillary tube method and slide method; Hot board and body distortion induced by acetic acid methods were applied in mice analgesia experiment, the mice model of acute auricle swelling induced by dmi ethylbenzene and capillary permeability induced by acetic acid were applied to observe the anti inflammatory effects. The alcohol extract of Hibiscus tiliaceus could significantly reduce the bleeding time and the clotting time, delay the plant reaction time and reduce the writhing times of the mice, and it also had effect on inhibiting swelling of mice ear and the permeability of the capillary. These results suggest that the alcohol extract of Hibiscus tiliaceus has the effects of hemostasis, analgesic and anti inflammation.

Comparison of the preventive analgesic effect of rectal ketamine and rectal acetaminophen after pediatric tonsillectomy

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S Morteza Heidari

2012-01-01

Full Text Available Objectives: There is a little data about rectal administration of Ketamine as a postoperative analgesic, so we compared the efficacy of rectal ketamine with rectal acetaminophen, which is applied routinely for analgesia after painful surgeries like tonsillectomy. Methods: In this single-blinded comparative trial, we enrolled 70 children undergoing elective tonsillectomy, and divided them randomly in two groups. Patients received rectal ketamine (2 mg / kg or rectal acetaminophen (20 mg / kg at the end of surgery. The children′s Hospital of Eastern Ontario Pain scale was used to estimate pain in children. Also the vital signs, Wilson sedation scale, and side effects in each group were noted and compared for 24 hours. Results: The ketamine group had a lower pain score at 15 minutes and 60 minutes after surgery in Recovery (6.4 ± 0.8, 7.4 ± 1 vs. 7.1 ± 1.2, 7.8 ± 1.2 in the acetaminophen group, P < 0.05 and one hour and two hours in the ward (7.2 ± 0.7, 7 ± 0.5 vs. 7.9 ± 1.2, 7.5 ± 1.2 in the acetaminophen group, P < 0.05, with no significant differences till 24 hours. Dreams and hallucinations were not reported in the ketamine group. Systolic blood pressure was seen to be higher in the ketamine group (104.4 ± 7.9 vs. 99.8 ± 7.7 in the acetaminophen group and nystagmus was reported only in the ketamine group (14.2%. Other side effects were equivalent in both the groups. Conclusions: With low complications, rectal ketamine has analgesic effects, especially in the first hours after surgery in comparison with acetaminophen, and it can be an alternative analgesic with easy administration in children after tonsillectomy.

Toxicity, analgesic and sedative potential of crude extract of soil-borne phytopathogenic fungi Aspergillus flavus

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Bashir Ahmad

2016-11-01

Full Text Available Background: Aspergillus flavus is one of the most abundant mold present around the world. The present study was conducted to investigate the acute toxicity, analgesic and sedative effect of the crude extract obtained from soil borne fungi A. flavus. Methods: The fungi was isolated from soil samples and identified morphologically and microscopically. The growth condition i.e. media, temperature, pH, and incubation period were optimized. In these optimized growth condition, A. flavus was grown in batch culture in shaking incubator. Crude contents were extracted by using ethyl acetate solvent. Crude secondary metabolites were screened for acute toxicity, analgesic and sedative effect. Results: Upon completion of the experiment, blood was collected from the tail vein of albino mice, and different haematological tests were conducted. White blood cells counts displayed a slight increase (10.6× 109/L above their normal range (0.8–6.8 × 109/L, which may be due to the increment in the number of lymphocytes or granulocytes. However, the percentage of lymphocytes was much lower (17.7%, while the percentage of the granulocytes was higher (61.4% than its normal range (8.6–38.9%. A reduction in the mean number of writhing in the different test groups was caused by the application of the crude ethyl acetate extract through the i.p. route at different doses (50, 100, and 150 mg/kg body weight. The results of our investigation showed the EtOAc extract of A. flavus can cause a significant sedative effect in open field. Conclusion: It was concluded from the present study that the A. flavus has the potential to produce bioactive metabolites which have analgesic and sedative effect.

Analgesic and Anti-Inflammatory Activities of Methanol Extract of Ficus pumila L. in Mice

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Chi-Ren Liao

2012-01-01

Full Text Available This study investigated possible analgesic and anti-inflammatory mechanisms of the methanol extract of Ficus pumila (FPMeOH. Analgesic effects were evaluated in two models including acetic acid-induced writhing response and formalin-induced paw licking. The results showed FPMeOH decreased writhing response in the acetic acid assay and licking time in the formalin test. The anti-inflammatory effect was evaluated by λ-carrageenan-induced mouse paw edema and histopathological analyses. FPMeOH significantly decreased the volume of paw edema induced by λ-carrageenan. Histopathologically, FPMeOH abated the level of tissue destruction and swelling of the edema paws. This study indicated anti-inflammatory mechanism of FPMeOH may be due to declined levels of NO and MDA in the edema paw through increasing the activities of SOD, GPx, and GRd in the liver. Additionally, FPMeOH also decreased the level of inflammatory mediators such as IL-1β, TNF-α, and COX-2. HPLC fingerprint was established and the contents of three active ingredients, rutin, luteolin, and apigenin, were quantitatively determined. This study provided evidence for the classical treatment of Ficus pumila in inflammatory diseases.

Analgesic effect of the electromagnetic resonant frequencies derived from the NMR spectrum of morphine.

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Verginadis, Ioannis I; Simos, Yannis V; Velalopoulou, Anastasia P; Vadalouca, Athina N; Kalfakakou, Vicky P; Karkabounas, Spyridon Ch; Evangelou, Angelos M

2012-12-01

Exposure to various types of electromagnetic fields (EMFs) affects pain specificity (nociception) and pain inhibition (analgesia). Previous study of ours has shown that exposure to the resonant spectra derived from biologically active substances' NMR may induce to live targets the same effects as the substances themselves. The purpose of this study is to investigate the potential analgesic effect of the resonant EMFs derived from the NMR spectrum of morphine. Twenty five Wistar rats were divided into five groups: control group; intraperitoneal administration of morphine 10 mg/kg body wt; exposure of rats to resonant EMFs of morphine; exposure of rats to randomly selected non resonant EMFs; and intraperitoneal administration of naloxone and simultaneous exposure of rats to the resonant EMFs of morphine. Tail Flick and Hot Plate tests were performed for estimation of the latency time. Results showed that rats exposed to NMR spectrum of morphine induced a significant increase in latency time at time points (p spectrum of morphine. Our results indicate that exposure of rats to the resonant EMFs derived from the NMR spectrum of morphine may exert on animals similar analgesic effects to morphine itself.

Study on analgesic and anti-inflammatory properties of Cordia myxa fruit hydro-alcoholic extract.

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Ranjbar, Mohammadmehdi; Varzi, Hossein Najafzadeh; Sabbagh, Atefeh; Bolooki, Adeleh; Sazmand, Alireza

2013-12-15

Cordia myxa is a plant which is used in tropical regions of the world. Analgesic and anti-inflammatory effect of fruit of this medicinal plant was investigated in mice. Hydro-alcoholic extract of it was prepared by maceration method. Formalin test was conducted in six groups of mice (6 animals in each group) and acetic acid test in another six groups (6 mice). Groups one to six in each test were administered normal saline, oral indomethacin, intraperitoneal tramadol, 100 mg kg(-1) oral extract, 200 mg kg(-1) oral extract and 100 mg kg(-1) intraperitoneal extract, respectively. The duration of foot lickings were calculated in formalin- administered (1st) group within min 0 to 5 (acute phase) and 15 to 25 (chronic phase). Acetic acid-induced writhings were counted within 10 min in the 2nd group. The results showed that hydro-alcoholic extract of Cordia myxa fruit was considerably effective in formalin test. Also, analgesic and anti-inflammatory properties of this plant's fruit in both acute and chronic phase are somewhat similar to these properties in the study on animal model of experimental colitis.

Effect of gender on pain perception and analgesic consumption in laparoscopic cholecystectomy: An observational study

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Aziza M Hussain

2013-01-01

Full Text Available Background: Evidence regarding gender affecting the response to pain and its treatment is inconsistent in literature. The objective of this prospective, observational study was to determine the effect of gender on pain perception and postoperative analgesic consumption in patients undergoing laparoscopic cholecystectomy. Materials and Methods: We recruited 60 male and 60 female patients undergoing elective laparoscopic cholecystectomy. Patients were observed for additional intraoperative and postoperative analgesia. Numerical rating scale was documented at 10 min interval for 1 h in post-anesthesia recovery room and at 4, 8, and 12 h postoperatively. Boluses of tramadol given as rescue analgesia were also noted. There were no dropouts. Results: The mean pain scores were significantly higher in female patients at 20 and 30 min following surgery. Mean dose of tramadol consumption was significantly higher in female patients for the first postoperative hour (P = 0.002, but not in the later period. Conclusion: Female patients exhibited greater intensity of pain and required higher doses of analgesics compared to males in in the immediate postoperative period in order to achieve a similar degree of analgesia.

Long-term usage of narcotic analgesics by chronic intractable noncancer pain patients in Taiwan from 2003 to 2012

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I-Chen Cheng

2016-09-01

Conclusion: To decrease malaise and addiction in patients with CINCP, Taiwan's physicians need more education on narcotic analgesics, and greater professional cooperation to develop therapeutic guidelines that will improve pain care for patients with CINCP.

An Examination of the Situational Factors Associated with the Misuse of Prescription Analgesics among College Students

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Gallucci, Andrew R.; Wynveen, Chris; Hackman, Christine; Meyer, Andrew; Usdan, Stuart

2014-01-01

The current study examined the effect that students' educational environment has on the prevalence and motivations associated with the misuse of prescription analgesics (MPA). A sample of 893 undergraduate students was recruited from one religiously affiliated private university and one public university in the Southern United States. Participants…

The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial.

LENUS (Irish Health Repository)

McDonnell, John G

2007-01-01

The transversus abdominis plane (TAP) block is a novel approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. We evaluated its analgesic efficacy in patients during the first 24 postoperative hours after abdominal surgery, in a randomized, controlled, double-blind clinical trial.

Central analgesic activity of the aqueous and ethanolic extracts of the leaves of Albizia lebbeck: role of the GABAergic and serotonergic pathways.

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Meshram, Girish G; Kumar, Anil; Rizvi, Waseem; Tripathi, C D; Khan, R A

2015-01-01

Albizia lebbeck Benth. is extensively used in Indian traditional medicine for treating several painful and inflammatory disorders. The possible central analgesic activity and the underlying mechanism of action of the aqueous (AE) and ethanolic extracts (EE) of the leaves of A. lebbeck were investigated in Wistar rats using Eddy's hot plate and the tail flick tests. In order to investigate the underlying mechanism of action, rats were pretreated with naloxone, bicuculline or methysergide and then were administered a per os (p.o.) dose of AE or EE. AE and EE caused a significant (p<0.05) elevation in the mean basal reaction time in the hot plate method and an increase in the latency time in the tail flick method. In rats pretreated with bicuculline and methysergide, a significant (p<0.05) reduction in the analgesic activity was observed in comparison to AE and EE. Thus, AE and EE exhibited significant central analgesic activity and act possibly via the GABAergic and serotonergic pathways. The flavonoids and saponins found in the leaves could be responsible for the observed effect.

Repetitive transcranial magnetic stimulation of the left premotor/dorsolateral prefrontal cortex does not have analgesic effect on central poststroke pain.

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de Oliveira, Rogério Adas Ayres; de Andrade, Daniel Ciampi; Mendonça, Melina; Barros, Rafael; Luvisoto, Tatiana; Myczkowski, Martin Luiz; Marcolin, Marco Antonio; Teixeira, Manoel Jacobsen

2014-12-01

Central poststroke pain (CPSP) is caused by an encephalic vascular lesion of the somatosensory pathways and is commonly refractory to current pharmacologic treatments. Repetitive transcranial magnetic stimulation (rTMS) of the premotor cortex/dorsolateral prefrontal cortex (PMC/DLPFC) can change thermal pain threshold toward analgesia in healthy subjects and has analgesic effects in acute postoperative pain as well as in fibromyalgia patients. However, its effect on neuropathic pain and in CPSP, in particular, has not been assessed. The aim of this prospective, double-blind, placebo-controlled study was to evaluate the analgesic effect of PMC/DLPFC rTMS in CPSP patients. Patients were randomized into 2 groups, active (a-) rTMS and sham (s-) rTMS, and were treated with 10 daily sessions of rTMS over the left PMC/DLPFC (10 Hz, 1,250 pulses/d). Outcomes were assessed at baseline, during the stimulation phase, and at 1, 2, and 4 weeks after the last stimulation. The main outcome was pain intensity changes measured by the visual analog scale on the last stimulation day compared to baseline. Interim analysis was scheduled when the first half of the patients completed the study. The study was terminated because of a significant lack of efficacy of the active arm after 21 patients completed the whole treatment and follow-up phases. rTMS of the left PMC/DLPFC did not improve pain in CPSP. The aim of this double-blind, placebo-controlled study was to evaluate the analgesic effects of rTMS to the PMC/DLPFC in CPSP patients. An interim analysis showed a consistent lack of analgesic effect, and the study was terminated. rTMS of the PMC/DLPFC is not effective in relieving CPSP. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

Postoperative analgesic efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block compared with medial transverse abdominis plane block in inguinal hernia repair: A prospective, randomised trial.

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Bhatia, Nidhi; Sen, Indu Mohini; Mandal, Banashree; Batra, Ankita

2018-03-29

Analgesic efficacy of ultrasound-guided transverse abdominis plane block, administered a little more medially, just close to the origin of the transverse abdominis muscle has not yet been investigated in patients undergoing unilateral inguinal hernia repair. We hypothesised that medial transverse abdominis plane block would provide comparable postoperative analgesia to ilioinguinal-iliohypogastric nerve block in inguinal hernia repair patients. This prospective, randomised trial was conducted in 50 ASA I and II male patients≥18 years of age. Patients were randomised into two groups to receive either pre-incisional ipsilateral ultrasound-guided ilioinguinal-iliohypogastric nerve block or medial transverse abdominis plane block, with 0.3ml/kg of 0.25% bupivacaine. Our primary objective was postoperative 24-hour analgesic consumption and secondary outcomes included pain scores, time to first request for rescue analgesic and side effects, if any, in the postoperative period. There was no significant difference in the total postoperative analgesic consumption [group I: 66.04mg; group II: 68.33mg (P value 0.908)]. Time to first request for rescue analgesic was delayed, though statistically non-significant (P value 0.326), following medial transverse abdominis plane block, with excellent pain relief seen in 58.3% patients as opposed to 45.8% patients in ilioinguinal-iliohypogastric nerve block group. Medial transverse abdominis plane block being a novel, simple and easily performed procedure can serve as an useful alternative to ilioinguinal-iliohypogastric nerve block for providing postoperative pain relief in inguinal hernia repair patients. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Development of transmucosal patch loaded with anesthetic and analgesic for dental procedures and in vivo evaluation

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Nidhi M

2016-06-01

Full Text Available Malviya Nidhi,1 M Nagaraju Patro,1 Somisetty Kusumvalli,2 Vemula Kusumdevi1 1Department of Pharmaceutics, Al-Ameen College of Pharmacy, 2Department of Endodontics and Conservative Dentistry, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru, Karnataka, India Abstract: Most of the dental surgeries require preoperative anesthetic and postoperative analgesic for painless procedures. A multidrug transmucosal drug delivery system loaded with lignocaine (Lig base for immediate release and solid lipid nanoparticles (SLNs of diclofenac (Dic diethylamine for prolonged release was developed. SLNs were prepared by solvent emulsion–evaporation method with Precirol ATO 5 and Geleol as lipids and Pluronic F 68 as surfactant and optimized with Box–Behnken design for particle size and entrapment efficiency. SLNs were incorporated into the transmucosal patch (TP prepared with hydroxypropyl cellulose-LF (HPC-LF and with a backing layer of ethyl cellulose. Optimized SLNs and TP were characterized for Fourier transform infrared spectrophotometry, differential scanning calorimetry, scanning electron microscopy, X-ray diffraction, in vitro release, ex vivo permeation through porcine buccal mucosa, Caco-2 permeability, and residual solvent analysis by gas chromatography. The TP was also evaluated for swelling index, in vitro residence time, tensile strength, and mucoadhesive strength. Preclinical pharmacokinetic, pharmacodynamic, and histopathological studies by application of TP on the gingiva of New Zealand rabbits were carried out. Particle size and entrapment efficiency of the optimized SLN “S8” were determined as 98.23 nm and 84.36%, respectively. The gingival crevicular fluid and tissue concentrations were greater than plasma concentrations with increase in Cmax and area under the curve (AUC of Lig and Dic when compared to the control group. Pain perception by needle prick showed prolonged combined anesthetic and analgesic effect. The developed TP

ULTRASOUND GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK VERSUS STANDARD ANALGESIC CARE FOR POSTOPERATIVE PAIN RELIEF FOLLOWING TOTAL ABDOMINAL HYSTERECTOMY, AN OBSERVATIONAL STUDY

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Elizabeth Joseph

2018-02-01

Full Text Available BACKGROUND The transversus abdominis plane (TAP block is a technique which blocks the sensory nerves supplying the anterior abdominal wall. This prospective cohort study was done to evaluate the effectiveness of TAP block for postoperative pain in patients undergoing total abdominal hysterectomy. MATERIALS AND METHODS Sixty patients of ASA Grade 1 and 2 undergoing open abdominal hysterectomy were prospectively allocated into Group A and Group B. Group A patients (n = 30, received ultrasound guided TAP block along with 1 gm paracetamol 8th hourly and tramadol 1 mg/ kg as rescue analgesic. Group B patients (n = 30 received standard analgesic care with 1 gm paracetamol 8th hourly and tramadol 1 mg/ kg as rescue analgesic. TAP block was performed on completion of surgery in Group A patients by instilling 20 ml of 0.25% levobupivacaine into the transversus abdominis plane on each side under ultrasound guidance. Postoperatively Verbal Numerical Rating Scale, Sedation score, Nausea categorical scoring scale at 2, 4, 6, 12 and 24 hours and total tramadol requirement in first 24 hours were assessed in each group. RESULTS Verbal Numerical Rating Scale score was significantly reduced in Group A compared to Group B at 2, 4, 6 and 24 hours postoperatively and there was no difference in scores 12 hours postoperatively. Nausea was significantly lower in Group A patients at 2, 4 and 6 hours postoperatively with no difference at 12 and 24 hours postoperatively. There was significant difference in the sedation scale at 4, 6 and 24 hours postoperatively and no difference between both groups at 2 hours and 12 hours postoperatively. Total tramadol requirement in first 24 hours postoperatively was significantly lower in Group A compared to Group B (60.83 ± 14.208 mg Vs. 121.67 ± 19.402 mg, P value< 0.00. CONCLUSION Ultrasound guided TAP block along with standard analgesic care provided better analgesia as compared to standard analgesic care alone in the first 24

Antitussive, expectorant and analgesic effects of the ethanol seed extract of Picralima nitida (Stapf) Th. & H. Durand.

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Dapaah, Gabriel; Koffuor, George Asumeng; Mante, Priscilla Kolibea; Ben, Inemesit Okon

2016-01-01

Picralima nitida is used traditionally for management of cough. This study, therefore, investigated the antitussive, expectorant, and analgesic properties of the ethanolic seed extract of Picralima nitida (PNE), and ascertained its safety for use. Presence of secondary metabolites, and safety of PNE (10-2000 mg/kg) were evaluated by preliminary phytochemical screening, and by Irwin's test respectively. Percentage reduction in cough count, percentage increase in latency of cough, and percentage protection offered by PNE were established by the citric acid-induced cough, acetylcholine- and Histamine-induced bronchoconstriction models. Dunkin-Hartley guinea pigs were treated with 100-500 mg/kg PNE or reference drugs, dihydrocodiene, atropine, mepyramine. Expectorant property of PNE (100-1000 mg/kg) was determined using the tracheal phenol red secretion; with ammonium chloride as a reference medication. Percentage maximal possible analgesic effect in the tail immersion test and the total nociceptive score in acetic acid-induced abdominal writhes, after treatment of BALB/c mice with PNE (100-500 mg/kg), diclofenac, and morphine were also estimated. Phytochemical screening revealed the presence of tannins, alkaloids, glycosides, saponins, steroids, terpenoids and anthraquinones. PNEdid not cause any extract-related physical, pharmacological and CNS toxicities or mortality; sedation was observed at doses 1000-2000 mg/kg. It showed significant dose-dependent reduction in cough count, and increased cough latency. PNE (1000 mg/kg) enhanced tracheal phenol red secretion. PNE (100-500 mg/kg) significantly and dose dependently increased tail withdrawal latencies, and nociceptive score. PNE has antitussive, expectorant, and analgesic properties, with an LD50>2000 mg/kg.

The use of dipyrone (metamizol) as an analgesic in children: What is the evidence? A review

NARCIS (Netherlands)

Leeuw, T.G. de; Dirckx, M.; Candel, A.G.; Scoones, G.P.; Huygen, F.; Wildt, S.N. de

2017-01-01

Dipyrone has analgesic, spasmolytic, and antipyretic effects and is used to treat pain. Due to a possible risk of agranulocytosis with the use of dipyrone, it has been banned in a number of countries. The most commonly used data for the use of dipyrone are related to adults. Information relating to

The effect of local/topical analgesics on incisional pain in a pig model

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Castel D

2017-09-01

Full Text Available David Castel,1 Itai Sabbag,2 Sigal Meilin3 1The Neufeld Cardiac Research Institute, Sheba Medical Centre, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, 2Lahav Research Institute, Kibutz Lahav, Negev, 3Neurology R&D Division, MD Biosciences, Nes-Ziona, Israel Abstract: Interest in the development of new topical/local drug administration for blocking pain at peripheral sites, with maximum drug activity and minimal systemic effects, is on the rise. In the review article by Kopsky and Stahl, four critical barriers in the process of research and development of topical analgesics were indicated. The active pharmaceutical ingredient (API and the formulation are among the major challenges. The road to the development of such drugs passes through preclinical studies. These studies, if planned correctly, should serve as guidance for choosing the right API and formulation. Although rodent models for pain continue to provide valuable data on the mechanisms driving pain, their use in developing topical and localized treatment approaches is limited for technical (intraplate injection area is small as well as mechanical reasons (non-similarity to human skin and innervation. It has been previously shown that pigs are comparable to humans in ways that make them a better choice for evaluating topical and local analgesics. The aim of this study was to summarize several experiments that used pigs for testing postoperative pain in an incisional pain model (skin incision [SI] and skin and muscle incision [SMI]. At the end of the surgery, the animals were treated with different doses of bupivacaine solution (Marcaine®, bupivacaine liposomal formulation (Exparel® or ropivacaine solution (Naropin. Von Frey testing demonstrated a decrease in the animals’ sensitivity to mechanical stimulation expressed as an increase in the withdrawal force following local treatment. These changes reflect the clinical condition in the level as well as in the duration of

Face-to-face comparison of the predictive validity of two models of neuropathic pain in the rat: analgesic activity of pregabalin, tramadol and duloxetine.

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Le Cudennec, Camille; Castagné, Vincent

2014-07-15

We compared the preclinical analgesic activity of three marketed drugs with different pharmacological properties, pregabalin, tramadol and duloxetine, described as effective against neuropathic pain in the clinic. These drugs were tested against evoked pain in two different neuropathic models in the rat, the Bennett (CCI) and the Chung (SNL) models. The selected endpoints were tactile allodynia, tactile hyperalgesia, heat hyperalgesia and cold allodynia. Although all three drugs displayed analgesic activity, the effects observed varied according to the behavioral evaluation. Pregabalin showed clear analgesic effects against cold allodynia and tactile hyperalgesia in both the CCI and Chung models. Tramadol was active against all four endpoints in the Chung model with similar effects in the CCI model, apart from tactile allodynia. Duloxetine inhibited tactile allodynia and heat hyperalgesia in both neuropathic pain models. It also displayed efficacy against tactile hyperalgesia in the CCI model and against cold allodynia in the Chung model. These data confirm that the CCI and the Chung models of neuropathic pain do not detect the activity of analgesics with the same sensitivity. Furthermore, the mode of stimulation (tactile or thermal) and the type of endpoint (allodynia or hyperalgesia) can further influence the observed efficacy of gold standards as well as novel compounds developed for treating neuropathic pain symptoms. Copyright © 2014. Published by Elsevier B.V.

Transformation of Lactuca sativa L. with rol C gene results in increased antioxidant potential and enhanced analgesic, anti-inflammatory and antidepressant activities in vivo.

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Ismail, Hammad; Dilshad, Erum; Waheed, Mohammad Tahir; Sajid, Moniba; Kayani, Waqas Khan; Mirza, Bushra

2016-12-01

Lettuce is an important edible crop which possesses various medicinal properties. In this study Lactuca sativa L. (cv Grand Rapids) was transformed by Agrobacterium-mediated transformation with rol C gene. Transgene integration and expression was confirmed through PCR and semiquantitative RT-PCR. The transformed extracts were evaluated for their in vitro antioxidant and in vivo analgesic, anti-inflammatory and antidepressant activities in rats. The transformed plants showed 53-98 % increase in total phenolic and 45-58 % increase in total flavonoid contents compared with untransformed plants. Results of total reducing power and total antioxidant capacity exhibited 90-118 and 61-75 % increase in transformed plants, respectively. In contrast to control, DPPH, lipid peroxidation and DNA protection assay showed up to 37, 20 and 50 % enhancement in transformed plants, respectively. The extracts showed similar but significant enhancement behavior in hot plate analgesic and carrageenan-induced hind paw edema test. The transformed extracts showed 72.1 and 78.5 % increase for analgesic and anti-inflammatory activities, respectively. The transformants of rol C gene exhibited prominent antidepressant activity with 64-73 % increase compared with untransformed plants. In conclusion, the present work suggests that transformation with rol C gene can be used to generate lettuce with enhanced medicinally important properties, such as antioxidant, analgesic, anti-inflammatory and antidepressant potential.

Analysis of Adverse Reaction of Analgesics, Antipyretics and Non-Steroidal Anti-Inflammatory Drugs Prescribed by Physicians of Health Care Facilities in Podilskyi Region during 2015

OpenAIRE

Stepaniuk, N. H.; Hladkykh, F. V.; Basarab, O. V.

2016-01-01

The problem of medicines rational use exists all over the world. It concerns particularly analgesics, antipyretics and non-steroidal anti-inflammatory drugs (NSAIDs). In Ukraine the side effects caused by non-steroidal antiphlogistics rank the second place according to the prevalence among all registered cases.The objective of the research was to analyze adverse drug reaction report forms concerning adverse reactions caused by the use of NSAIDs, analgesics, antipyretics, and were submitted du...

SEDATIVE AND ANALGESIC EFFECTS OF DETOMIDINE HYDROCHLORIDE IN GOATS

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A. N. Tunio., A. B. Kalhoro and I.H. Kathio1

2003-07-01

Full Text Available The sedative and analgesic effects of three dose rates of detomidine (40, 50 and 60µg/kg body weight were studied in six goats. Moderate to deep sedation occurred after administration of 40µg/kg of detomidine as compared to deep sedation produced by 50 and 60µg/kg of detomidine. The degree, onset and duration of sedation and onset and duration of maximum sedation were all dose dependent. Skin analgesia and recumbency were produced in all animals with higher doses (50 and 60µg/kg and in three animals with lower dose (40µg/kg. Duration of recumbency was 22.66 ± 1.45, 35.16 ± 1.68 and 55.66 ± 1.64 minutes after administration of 40, 50 and 60µg/kg of detomidine, respectively.

Does Merger Simulation Work? A "Natural Experiment" in the Swedish Analgesics Market Market

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Björnerstedt, Jonas; Verboven, Frank

2012-01-01

We exploit a natural experiment associated with a large merger in the Swedish market for analgesics (painkillers). We confront the predictions from a merger simulation study, as conducted during the investigation, with the actual merger effects over a two-year comparison window. The merger simulation model is based on a constant expenditures specification for the nested logit model (as an alternative to the typical unit demand specification). The model predicts a large price increase of 34% b...

Experimental substantiation of effectively administration of vinboron for analgesic activity increase of ibuprofen

OpenAIRE

F. V. Hladkykh; N. H. Stepaniuk

2016-01-01

Background. The increase of NSAIDs safety is current direction of modern pharmacology, because of so-called "class-specific" adverse reactions, which are common to this class, and the leading place among them is occupied by gastro-intestinal toxicity. In previous studies we have proved the ability of vinboron to neutralize ulcerogenic effect of ibuprofen (Hladkykh F.V. and al., 2014). The presence of the proven analgesic activity in the domestic antispasmodics (Stepaniuk H.I. and al., 2007) s...

Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess: a randomized clinical trial.

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Santini, Manuela Favarin; Rosa, Ricardo Abreu da; Ferreira, Maria Beatriz Cardoso; Fischer, Maria Isabel; Souza, Erick Miranda; Só, Marcus Vinícius Reis

2017-01-01

Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain. The aim of this study was to compare the overall analgesic effectiveness of two combinations of opioid and non-opioid analgesics for acute periradicular abscess. This study included 26 patients who sought emergency care in a Brazilian dental school. The patients were randomly divided into two groups: Co/Ac - oral prescription of codeine (30 mg) plus acetaminophen (500 mg), every 4 h, for 3 days or Tr/Ac - oral prescription of tramadol hydrochloride (37.5 mg) plus acetaminophen (500 mg) on the same schedule. Two factors were evaluated: (1) pain scores recorded by the patients in a pain diary 6, 12, 24, 48, and 72 h after treatment, using the Visual Analogue Scale; and (2) the occurrence of adverse effects. In both groups, there was a reduction in pain scores over time. For the Co/Ac group, there was a significant reduction in the scores 12, 24, 48, and 72 hours after treatment (P0.05), i.e., both treatments were effective in controlling pain caused by APA; however, the combination of Tr/Ac caused more adverse reactions as two patients had to stop using the medication. This study suggests that, considering both analgesic efficacy and safety, the combination of codeine and acetaminophen is more effective to control moderate to severe pain from acute periradicular abscesses.

The experience of childbrith in first-time mothers who received narcotic analgesics during the first stage of labour.

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Jantjes, L; Strümpher, J; Kotzé, W J

2007-06-01

This research has focused on the birthing experience of first-time mothers who received the narcotic analgesic combination of Pethidine and Hydroxyzine during the first stage of labour. A qualitative research methodology was used to collect data. Unstructured interviews were held with first-time mothers to obtain accounts of their experience of childbirth. These narrations were audio-taped while the participants were still being cared for in the postnatal ward of the hospital where delivery took place. Nine interviews were conducted with first-time mothers who gave birth normally vaginally after a normal pregnancy and who received a narcotic analgesic in the first stage of labour. The transcribed interviews were analyzed using Tesch's method of descriptive analysis (in Creswell, 1994:115). Four themes with sub-themes emerged from the analysis. The participants reported on the physical experience of labour and described experiencing a lot of pain for which analgesics were given. They also described how these drugs dulled the pain but made them sleepy and unable to cooperate with the midwives. They described their emotional experiences, which included joy and happiness as well as anxiety, anger and despondence. They also reported that they were not sufficiently informed about labour and child-birth. In the last theme they described the methods they used to help them cope with labour including distracting techniques, leaning on a supportive person or praying. Guidelines to help midwives overcome these problems were developed.

Intravenous flurbiprofen axetil enhances analgesic effect of opioids in patients with refractory cancer pain by increasing plasma β-endorphin.

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Wu, Ting-Ting; Wang, Zhi-Gang; Ou, Wu-Ling; Wang, Jun; Yao, Guo-Qing; Yang, Bo; Rao, Zhi-Guo; Gao, Jian-Fei; Zhang, Bi-Cheng

2014-01-01

The study aimed to investigate the analgesic effect of a combination of intravenous flurbiprofen axetil and opioids, and evaluate the relationship between refractory pain relief and plasma β-endorphin levels in cancer patients. A total of 120 cancer patients was randomly divided into two groups, 60 patients took orally morphine sulfate sustained-release tablets in group A, and another 60 patients receiving the combination treatment of intravenous flurbiprofen axetil and opioid drugs in group B. After 7 days, pain relief, quality of life improvement and side effects were evaluated. Furthermore, plasma β-endorphin levels were measured by radioimmunoassay. With the combination treatment of intravenous intravenous flurbiprofen axetil and opioids, the total effective rate of pain relief rose to 91.4%, as compared to 82.1% when morphine sulfate sustained-release tablet was used alone. Compared with that of group A, the analgesic effect increased in group B (p=0.031). Moreover, satisfactory pain relief was associated with a significant increase in plasma β-endorphin levels. After the treatment, plasma β-endorphin level in group B was 62.4±13.5 pg/ml, which was higher than that in group A (45.8±11.2 pg/ml) (pflurbiprofen axetil and opioids can enhance the analgesic effect of opioid drugs by increasing plasma β-endorphin levels, which would offer a selected and reliable strategy for refractory cancer pain treatment.

Analgesic efficacy of intracapsular and intra-articular local anaesthesia for knee arthroplasty

DEFF Research Database (Denmark)

Andersen, L Ø; Husted, H; Kristensen, B B

2010-01-01

The optimal site for wound delivery of local anaesthetic after total knee arthroplasty is undetermined. Sixty patients having total knee arthroplasty received intra-operative infiltration analgesia with ropivacaine 0.2% and were then were randomly assigned to receive either intracapsular or intra......-articular catheters with 20 ml ropivacaine 0.5% given at 6 h and again at 24 h, postoperatively. Analgesic efficacy was assessed for 3 h after each injection, using a visual analogue score, where 0 = no pain and 100 = worst pain. There was no statistically significant difference between groups. Maximum pain relief...

[A novel analgesics made from Cannabis].

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Szendrei, Kálmán

2004-01-20

Bayer AG has recently announced that it acquired exclusive rights for the marketing of GW Pharmaceuticals' new medicine Sativex in Europe and in other regions. Sativex is a sublingual spray on Cannabis extract basis, and is equipped with an electronic tool to facilitate accurate dosing and to prevent misuses. It is standardized for the THC and CBD. The new analgesic is proposed for the treatment of muscle spasticity and pains accompanying multiple sclerosis and as an efficient analgetic for neurogenic pain not responding well to opioids and to other therapies available. The entirely new mechanism of action through the recently discovered cannabinoid receptor system may offer a real therapeutic potential to the drug. Although the Government of Netherlands has authorized the sale of pharmaceutical grade Cannabis herb by pharmacies in the Netherlands, the availability on the pharmaceutical market of the registered preparation may render requests for the authorization of the smoking of Cannabis herb (marihuana) by individuals suffering of multiple sclerosis, neurogenic pain, AIDS wasting syndrome unnecessary. Nevertheless, the "old chameleon" plant Cannabis appears to gradually regain its previous status in mainstream therapy and pharmacy. As long as the plant Cannabis and its products continue to be classified as narcotic drugs, medical use of the new preparation will need close supervision.

Comparison of analgesic efficacy of intravenous Paracetamol and intravenous dexketoprofen trometamol in multimodal analgesia after hysterectomy

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Çiğdem Ünal

2013-01-01

Full Text Available Backround: We aimed to evaluate analgesic efficacy, opioid-sparing, and opioid-related adverse effects of intravenous paracetamol and intravenous dexketoprofen trometamol in combination with iv morphine after total abdominal hysterectomy. Materials and Methods: Sixty American Society of Anesthesiologist Physical Status Classification I-II patients scheduled for total abdominal hysterectomy were enrolled to this double-blinded, randomized, placebo controlled, and prospective study. Patients were divided into three groups as paracetamol, dexketoprofen trometamol, and placebo (0.9% NaCl due to their post-operative analgesic usage. Intravenous patient controlled analgesia morphine was used as a rescue analgesic in all groups. Pain scores, hemodynamic parameters, morphine consumption, patient satisfaction, and side-effects were evaluated. Results: Visual Analog Scale (VAS scores were not statistically significantly different among the groups in all evaluation times, but decrease in VAS scores was statistically significant after the evaluation at 12 th h in all groups. Total morphine consumption (morphine concentration = 0.2 mg/ml in group paracetamol (72.3 ± 38.0 ml and dexketoprofen trometamol (69.3 ± 24.1 ml was significantly lower than group placebo (129.3 ± 22.6 ml (P < 0.001. Global satisfaction scores of the patients in group placebo was significantly lower than group dexketoprofen trometamol after surgery and the increase in global satisfaction score was significant only in group placebo. Conclusion: Dexketoprofen trometamol and Paracetamol didn′t cause significant change on pain scores, but increased patients′ comfort. Although total morphine consumption was significantly decreased by both drugs, the incidence of nausea and vomiting were similar among the groups. According to results of the present study routine addition of dexketoprofen trometamol and paracetamol to patient controlled analgesia morphine after hysterectomies is not

Basil, tea tree and clove essential oils as analgesics and anaesthetics in Amphiprion clarkii (Bennett, 1830

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A. M. Correia

2017-11-01

Full Text Available Abstract In this study were evaluated the anaesthesia and analgesic effects of clove Eugenia caryophyllata, tea tree Melaleuca alternifolia and basil Ocimum basilicum essential oils (EO during handling of yellowtail clownfish Amphiprion clarkii. Juveniles (3.70 ± 0.75 cm and 1.03 ± 0.50 g; mean ± standard deviation were submitted to concentrations of 40, 50, 60, 70 and 80 µl L-1 of clove, 150, 200, 250, 300 and 350 µl L-1 of basil and 200, 300, 400, 500 and 600 µl L-1 of tea tree oils (n=10/concentration, previously defined in pilot tests. Individually and only once, fish from each treatment were placed in a glass recipient containing 1 L of seawater at a temperature of 25 °C, salinity of 35 g L-1 and the specific concentration of diluted EO (stock solution. Control (only seawater and blank (seawater and ethanol at the highest concentration used to dilute the oils treatments were also conducted. After reaching the stage of surgical anaesthesia, fish were submitted to biometry and a sensibility test. After that, they were transferred to clean seawater for anaesthesia recovery. The times of induction needed to reach each anaesthesia stage and anaesthesia recovery were recorded. Animals were observed for 72 hours after the procedures. All the EO provoked anaesthesia and analgesic effects in A. clarkii, but basil oil is not recommended because it caused involuntary muscle contractions and mortality in 100% and 12% of fish, respectively. The lower concentrations that promote suitable induction and recovery times are 50 µl L-1 of clove oil and 500 µl L-1 of tea tree oil. However, due to its complementary high analgesic efficiency, clove oil is recommended as the ideal anaesthetic for A. clarkii.

On analgesic and narcotic plants: Pliny and his Greek sources, the history of a complex graft.

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Bonet, Valérie

2014-01-01

Grafting is an important concept in the study of Pliny the Elder, who is a compiler of written sources. We intend to examine how this grafting works in Pliny's discussion of analgesic and narcotic plants, especially the most famous: opium poppy, henbane, mandrake, and hound's berry. We will study Pliny's use of Greek sources and ask how he took up his predecessors' works while integrating the changes that took place during the centuries in the diagnosis and treatment of pain. This cultural graft remains elusive because we do not have access to all of Pliny's Greek sources. When Pliny speaks about these plants, he sometimes copies out information, adding or removing details, and occasionally makes significant mistakes. The graft was particularly difficult in this case because these analgesic plants were considered so special and poisonous that they were sometimes rejected or even condemned. Nevertheless, we can say that this cultural graft succeeded, despite some obstacles, because Pliny assimilated and adapted these old Greek materials to his own time, society, and project.

Evaluation of pain relief sufficiency using the Cumulative Analgesic Consumption Score (CACS) and its modification (MACS).

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Frank, Alexander Harald Ralf; Groene, Philipp; von Ehrlich-Treuenstätt, Viktor; Heiliger, Christian; Werner, Jens; Karcz, Konrad

2017-12-01

Postoperative pain is one of the major complications in general and bariatric surgery, associated with ongoing problems such as ileus, pneumonia and prolonged mobilization. In this study, patients undergoing bariatric surgery were analyzed according to their postoperative pain relief regime. In one group patients were treated with a patient-controlled analgesia (PCA) device, while the other group was treated with oral and intravenous analgesic medication. The aim of this study was to analyze which postoperative pain relief therapy would be more appropriate. We chose the Cumulative Analgesic Consumption Score (CACS) and Numeric Rating Scale (NRS) for pain measurement. For better comparison, we performed a modification of CACS according to PCA treatment. We observed better pain relief in the PCA group. Furthermore, we observed an advantage of treatment with laxatives in patients treated with PCA. In conclusion, PCA devices are appropriate instruments for postoperative pain relief in bariatric patients. CACS is a practical tool for postoperative pain measurement, describing individual pain sensation more objectively, although holding further potential in modification.

Ketamine as an Analgesic Adjuvant in Adult Trauma Intensive Care Unit Patients With Rib Fracture.

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Walters, Mary K; Farhat, Joseph; Bischoff, James; Foss, Mary; Evans, Cory

2018-03-01

Rib fracture associated pain is difficult to control. There are no published studies that use ketamine as a therapeutic modality to reduce the amount of opioid to control rib fracture pain. To examine the analgesic effects of adjuvant ketamine on pain scale scores in trauma intensive care unit (ICU) rib fracture. This retrospective, case-control cohort chart review evaluated ICU adult patients with a diagnosis of ≥1 rib fracture and an Injury Severity Score >15 during 2016. Patients received standard-of-care pain management with the physician's choice analgesics with or without ketamine as a continuous, fixed, intravenous infusion at 0.1 mg/kg/h. A total of 15 ketamine treatment patients were matched with 15 control standard-of-care patients. Efficacy was measured via Numeric Pain Scale (NPS)/Behavioral Pain Scale (BPS) scores, opioid use, and ICU and hospital length of stay. Safety of ketamine was measured by changes in vital signs, adverse effects, and mortality. Average NPS/BPS, severest NPS/BPS, and opioid use were lower in the ketamine group than in controls (NPS: 4.1 vs 5.8, P rib fracture.

The anti-inflammatory and analgesic effects of a crude extract of Petiveria alliacea L. (Phytolaccaceae).

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Lopes-Martins, R A B; Pegoraro, D H; Woisky, R; Penna, S C; Sertié, J A A

2002-04-01

Petiveria alliacea L (Phytolaccaceae) is a perennial bush plant that grows widely in Brazil. The roots and leaves of P. alliacea have been used in folk medicine for their antispasmodic, sedative, diuretic and antihelminthic actions. We recently described the anti-inflammatory properties of P. alliacea administered topically and orally in different animal models. In the present study, we investigated the anti-inflammatory activity of a crude lyophilized extract of P. alliacea roots administered to rats with pleurisy. The oral administration of P. alliacea root extract did not significantly reduce the total number of leukocytes at the doses tested. By contrast, the highest dose of extract tested (43.9 mg/kg body wt.) significantly reduced the number of migrating neutrophils, mononuclear cells and eosinophils; the dose of 31.4 mg/kg body wt. also reduced mononuclear cell migration. The P. alliacea root extract also showed a significant analgesic effect in the experimental model used. The results of this study provide a basis for the use of P. alliacea extracts in popular folk medicine, but further studies are necessary to elucidate the mechanism of its anti-inflammatory and analgesic actions.

Phytochemical screening and study of antioxidant, antimicrobial, antidiabetic, anti-inflammatory and analgesic activities of extracts from stem wood of Pterocarpus marsupium Roxburgh.

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Pant, Dipak Raj; Pant, Narayan Dutt; Saru, Dil Bahadur; Yadav, Uday Narayan; Khanal, Dharma Prasad

2017-01-01

The main aims of the study were to evaluate the phytochemical constituents and to study the antioxidant, antimicrobial, antidiabetic, anti-inflammatory, and analgesic activities of extracts from stem wood of Pterocarpus marsupium . Ethanol, acetone and isopropyl alcohol (IPA) (1:1) extracts of stem wood of P. marsupium were subjected to phytochemical screening and analysis of biological activities from August 2015 to January 2016. The antioxidant assay was carried out using 2, 2-diphenyl-1-picrylhydrazyl scavenging method, antimicrobial activity testing by cup diffusion method, antidiabetic test evaluation by oral glucose tolerance test in mice, anti-inflammatory effect was evaluated by hind paw edema method in mice and analgesic test evaluation by a chemical writhing method in mice. The results of the study revealed that P. marsupium is a source of various phytoconstituents such as alkaloids, glycosides, saponins, tannins, proteins, carbohydrates, cardiac glycosides, flavonoids, and terpenoids. Both the acetone and IPA extract as well as the ethanol extract of stem wood of P. marsupium exhibited a dose-dependent antioxidant activity. Acetone and IPA extract showed antibacterial activity against Gram-positive bacteria, while the ethanolic extract was found to possess antidiabetic activity. The antidiabetic activity of the extract was found to be time and dose-dependent. Similarly, the acetone and IPA extract was found to have anti-inflammatory activity, which was also time and dose-dependent. Furthermore, the ethanolic extract showed analgesic activity, which was dose-dependent. The ethanolic extract was found to be nontoxic. Thus, this study laid sufficient background for the further research on extracts from stem wood of P. marsupium for identification, subsequent purification and isolation of compounds having antibacterial, antidiabetic, anti-inflammatory, and analgesic activities.

Analgesic and anti-inflammatory activities of the methanol extract of Kalanchoe gracilis (L.) DC stem in mice.

Science.gov (United States)

Lai, Zhen-Rung; Peng, Wen-Huang; Ho, Yu-Ling; Huang, Shun-Chieh; Huang, Tai-Hung; Lai, Shang-Chih; Ku, Yoe-Ray; Tsai, Jen-Chieh; Wang, Ching-Ying; Chang, Yuan-Shiun

2010-01-01

In this study, we evaluated the analgesic effect of the methanol extract of Kalanchoe gracilis (MKGS) stem in animal models by inducing writhing response with acetic acid and conducting formalin test. The anti-inflammatory effect of MKGS was also estimated on mice with lambda-carrageenan induced paw edema model. In order to investigate the anti-inflammatory mechanism of MKGS, we analyzed the activities of glutathione peroxidase (GPx) and glutathione reductase (GRx) in the liver, and the levels of interleukin-1beta (IL-1beta), tumor necrosis factor (TNF-alpha), malondialdehyde (MDA) and nitric oxide (NO) in the edema paw tissue. In the analgesic tests, MKGS (0.5 and 1.0 g/kg) decreased both the acetic acid-induced writhing response and the licking time in the late phase of the formalin test. In the anti-inflammatory test, MKGS (0.1, 0.5 and 1.0 g/kg) decreased paw edema at the third, fourth, fifth and sixth hours after lambda-carrageenan had been administrated. Furthermore, MKGS increased the activities of SOD and GRx in liver tissues and decreased MDA level in the edema paws three hours after lambda-carrageenan was injected. MKGS also affected the levels of IL-1beta, TNF-alpha and NO induced by lambda-carrageenan. All these results suggested that MKGS possessed analgesic and anti-inflammatory effects. The anti-inflammatory mechanism of MKGS might be related to the lowering of MDA level in the edema paw via increasing the activities of superoxide dismutase (SOD) and GRx in the liver, as well as the decreases in the levels of TNF-alpha and NO, and the production of IL-1beta in inflamed tissues.

Vasorelaxant effect of the analgesic clonixin on rat aorta.

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Morales, M A; Silva, A; Brito, G; Bustamante, S; Ponce, H; Paeile, C

1995-03-01

1. A novel vasorelaxant effect of clonixinate of L-lysine (Clx), analgesic and anti-inflammatory, was studied in rat aortic rings. 2. Clx completely relaxed aortic rings contracted by KCl 70 mM and together with its analog flunixin exhibited lesser potency but equal efficacy than verapamil. In comparison, indomethacin, which is a more potent cyclo-oxygenase inhibitor relaxed only about 40% of the maximal contraction of aortic rings. 3. Furthermore, Clx antagonized Ca2+ dependent aortic contraction and BAY K-8644 induced aortic contraction suggesting its calcium antagonist character. 4. From these results it can be concluded that the hypotensive effect seen in rats in vivo after Clx i.v. injection arises because of vasodilatory effect of Clx and gives further support to the proposal that the pharmacological mechanism of action of Clx should be calcium antagonism.

The PECS II block as a major analgesic component for clavicle operations: A description of 7 case reports.

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Schuitemaker R, J B; Sala-Blanch, X; Rodriguez-Pérez, C L; Mayoral R, J T; López-Pantaleon, L A; Sánchez-Cohen, A P

2018-01-01

Clavicle fractures correspond to 35% of traumatic fractures of the shoulder girdle. Regional anaesthesia has shown better analgesic results than systemic treatment for perioperative management. Innervation of the clavicle is complex, at present its knowledge raises controversy. The lateral pectoral nerve through the innervating musculature predominantly participates in the lateral and anterior part of the clavicle. The following report of 7 cases describes the effective postoperative analgesia of modified PEC II block in patients with middle third clavicle fracture or acromioclavicular dislocation who underwent a modified PEC II block for postoperative pain management, in the context of a multimodal analgesia. The potential advantage of this management over other analgesic procedures should be evaluated in specific clinical trials. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia.

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Eslamian, Laleh; Jalili, Zorvan; Jamal, Ashraf; Marsoosi, Vajiheh; Movafegh, Ali

2012-06-01

It is reported that following abdominal surgery, transversus abdominis plane (TAP) block can reduce postoperative pain. The primary outcome of this study was the evaluation of the efficacy of TAP block on pain intensity following cesarean delivery with Pfannenstiel incision. Fifty pregnant women were randomized blindly to receive either a TAP block with 15 ml 0.25% bupivacaine in both sides (group T, n = 25) or no blockade (group C, n = 25) at the end of the surgery, which was performed with a Pfannenstiel incision under general anesthesia. The pain intensity in the patients was assessed by a blinded investigator at the time of discharge from recovery and at 6, 12, and 24 h postoperatively, with a visual analogue scale (VAS) for pain. The women in the TAP block group had significantly lower VAS pain scores at rest and during coughing and consumed significantly less tramadol than the women in group C [50 mg (0-150) vs. 250 mg (0-400), P = 0.001]. There was a significantly longer time to the first request for analgesic in the TAP block group [210 min (0-300) vs. 30 min (10-180) in group C, P = 0.0001]. Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.

High-throughput identification of off-targets for the mechanistic study of severe adverse drug reactions induced by analgesics

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Pan, Jian-Bo [Department of Chemical Biology, College of Chemistry and Chemical Engineering, The Key Laboratory for Chemical Biology of Fujian Province, Xiamen University, Xiamen, Fujian 361005 (China); Ji, Nan; Pan, Wen; Hong, Ru [State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102 (China); Wang, Hao [Department of Chemical Biology, College of Chemistry and Chemical Engineering, The Key Laboratory for Chemical Biology of Fujian Province, Xiamen University, Xiamen, Fujian 361005 (China); Ji, Zhi-Liang, E-mail: appo@xmu.edu.cn [State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102 (China); Department of Chemical Biology, College of Chemistry and Chemical Engineering, The Key Laboratory for Chemical Biology of Fujian Province, Xiamen University, Xiamen, Fujian 361005 (China)

2014-01-01

Drugs may induce adverse drug reactions (ADRs) when they unexpectedly bind to proteins other than their therapeutic targets. Identification of these undesired protein binding partners, called off-targets, can facilitate toxicity assessment in the early stages of drug development. In this study, a computational framework was introduced for the exploration of idiosyncratic mechanisms underlying analgesic-induced severe adverse drug reactions (SADRs). The putative analgesic-target interactions were predicted by performing reverse docking of analgesics or their active metabolites against human/mammal protein structures in a high-throughput manner. Subsequently, bioinformatics analyses were undertaken to identify ADR-associated proteins (ADRAPs) and pathways. Using the pathways and ADRAPs that this analysis identified, the mechanisms of SADRs such as cardiac disorders were explored. For instance, 53 putative ADRAPs and 24 pathways were linked with cardiac disorders, of which 10 ADRAPs were confirmed by previous experiments. Moreover, it was inferred that pathways such as base excision repair, glycolysis/glyconeogenesis, ErbB signaling, calcium signaling, and phosphatidyl inositol signaling likely play pivotal roles in drug-induced cardiac disorders. In conclusion, our framework offers an opportunity to globally understand SADRs at the molecular level, which has been difficult to realize through experiments. It also provides some valuable clues for drug repurposing. - Highlights: • A novel computational framework was developed for mechanistic study of SADRs. • Off-targets of drugs were identified in large scale and in a high-throughput manner. • SADRs like cardiac disorders were systematically explored in molecular networks. • A number of ADR-associated proteins were identified.

Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial.

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Rio, Ebonie; van Ark, Mathijs; Docking, Sean; Moseley, G Lorimer; Kidgell, Dawson; Gaida, Jamie E; van den Akker-Scheek, Inge; Zwerver, Johannes; Cook, Jill

2017-05-01

This study aimed to compare the immediate analgesic effects of 2 resistance programs in in-season athletes with patellar tendinopathy (PT). Resistance training is noninvasive, a principle stimulus for corticospinal and neuromuscular adaptation, and may be analgesic. Within-season randomized clinical trial. Data analysis was conducted blinded to group. Subelite volleyball and basketball competitions. Twenty jumping athletes aged more than 16 years, participating in games/trainings 3 times per week with clinically diagnosed PT. Two quadriceps resistance protocols were compared; (1) isometric leg extension holds at 60 degrees knee flexion (80% of their maximal voluntary isometric contraction) or (2) isotonic leg extension (at 80% of their 8 repetition maximum) 4 times per week for 4 weeks. Time under load and rest between sets was matched between groups. (1) Pain (0-10 numerical rating score) during single leg decline squat (SLDS), measured preintervention and postintervention sessions. (2) VISA-P, a questionnaire about tendon pain and function, completed at baseline and after 4 weeks. Twenty athletes with PT (18 men, mean 22.5 ± 4.7 years) participated (isotonic n = 10, isometric n = 10). Baseline median SLDS pain was 5/10 for both groups (isotonic range 1-8, isometric range 2-8). Isometric contractions produced significantly greater immediate analgesia (P < 0.002). Week one analgesic response positively correlated with improvements in VISA-P at 4 weeks (r = 0.64). Both protocols appear efficacious for in-season athletes to reduce pain, however, isometric contractions demonstrated significantly greater immediate analgesia throughout the 4-week trial. Greater analgesia may increase the ability to load or perform.

High-throughput identification of off-targets for the mechanistic study of severe adverse drug reactions induced by analgesics

International Nuclear Information System (INIS)

Pan, Jian-Bo; Ji, Nan; Pan, Wen; Hong, Ru; Wang, Hao; Ji, Zhi-Liang

2014-01-01

Drugs may induce adverse drug reactions (ADRs) when they unexpectedly bind to proteins other than their therapeutic targets. Identification of these undesired protein binding partners, called off-targets, can facilitate toxicity assessment in the early stages of drug development. In this study, a computational framework was introduced for the exploration of idiosyncratic mechanisms underlying analgesic-induced severe adverse drug reactions (SADRs). The putative analgesic-target interactions were predicted by performing reverse docking of analgesics or their active metabolites against human/mammal protein structures in a high-throughput manner. Subsequently, bioinformatics analyses were undertaken to identify ADR-associated proteins (ADRAPs) and pathways. Using the pathways and ADRAPs that this analysis identified, the mechanisms of SADRs such as cardiac disorders were explored. For instance, 53 putative ADRAPs and 24 pathways were linked with cardiac disorders, of which 10 ADRAPs were confirmed by previous experiments. Moreover, it was inferred that pathways such as base excision repair, glycolysis/glyconeogenesis, ErbB signaling, calcium signaling, and phosphatidyl inositol signaling likely play pivotal roles in drug-induced cardiac disorders. In conclusion, our framework offers an opportunity to globally understand SADRs at the molecular level, which has been difficult to realize through experiments. It also provides some valuable clues for drug repurposing. - Highlights: • A novel computational framework was developed for mechanistic study of SADRs. • Off-targets of drugs were identified in large scale and in a high-throughput manner. • SADRs like cardiac disorders were systematically explored in molecular networks. • A number of ADR-associated proteins were identified

Comparison of two combinations of opioid and non-opioid analgesics for acute periradicular abscess: a randomized clinical trial

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Manuela Favarin Santini

Full Text Available Abstract Acute periradicular abscess is a condition characterized by the formation and propagation of pus in the periapical tissues and generally associated with debilitating pain. Objective: The aim of this study was to compare the overall analgesic effectiveness of two combinations of opioid and non-opioid analgesics for acute periradicular abscess. Material and Methods: This study included 26 patients who sought emergency care in a Brazilian dental school. The patients were randomly divided into two groups: Co/Ac - oral prescription of codeine (30 mg plus acetaminophen (500 mg, every 4 h, for 3 days or Tr/Ac - oral prescription of tramadol hydrochloride (37.5 mg plus acetaminophen (500 mg on the same schedule. Two factors were evaluated: (1 pain scores recorded by the patients in a pain diary 6, 12, 24, 48, and 72 h after treatment, using the Visual Analogue Scale; and (2 the occurrence of adverse effects. Results: In both groups, there was a reduction in pain scores over time. For the Co/Ac group, there was a significant reduction in the scores 12, 24, 48, and 72 hours after treatment (P0.05, i.e., both treatments were effective in controlling pain caused by APA; however, the combination of Tr/Ac caused more adverse reactions as two patients had to stop using the medication. Conclusion: This study suggests that, considering both analgesic efficacy and safety, the combination of codeine and acetaminophen is more effective to control moderate to severe pain from acute periradicular abscesses.

Non-analgesic effects of opioids: management of opioid-induced constipation by peripheral opioid receptor antagonists: prevention or withdrawal?

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Holzer, Peter

2012-01-01

The therapeutic action of opioid analgesics is compromised by peripheral adverse effects among which opioid-induced constipation (OIC) is the most disabling, with a prevalence reported to vary between 15 and 90 %. Although OIC is usually treated with laxatives, there is insufficient clinical evidence that laxatives are efficacious in this indication. In contrast, there is ample evidence from double- blind, randomized and placebo-controlled trials that peripheral opioid receptor antagonists (PORAs) counteract OIC. This specific treatment modality is currently based on subcutaneous methylnaltrexone for the interruption of OIC in patients with advanced illness, and a fixed combination of oral prolonged-release naloxone with prolonged-release oxycodone for the prevention of OIC in the treatment of non-cancer and cancer pain. Both drugs counteract OIC while the analgesic effect of opioids remains unabated. The clinical studies show that more than 50 % of the patients with constipation under opioid therapy may benefit from the use of PORAs, while PORA-resistant patients are likely to suffer from non-opioid-induced constipation, the prevalence of which increases with age. While the addition of naloxone to oxycodone seems to act by preventing OIC, the intermittent dosing of methylnaltrexone every other day seems to stimulate defaecation by provoking an intestinal withdrawal response. The availability of PORAs provides a novel opportunity to specifically control OIC and other peripheral adverse effects of opioid analgesics (e.g., urinary retention and pruritus). The continuous dosing of a PORA has the advantage of few adverse effects, while intermittent dosing of a PORA can be associated with abdominal cramp-like pain.

Parenteral Opioid Analgesics Utilization Pattern in Amir-al-Momenin Hospital, Zabol-IRAN

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Hossein Vatanpour

2016-08-01

Full Text Available Opioids are the most available medicines to get rid of any general severe pain and avoiding of any deleterious sequential that can worsen patient outcomes. Rational prescription of opioid analgesics with respect to the possibility of abuse is a big concern in the medical care costs. Zabol, where is located in eastern part of Iran and has common border with Afghanistanhas the most opioid traffic in the region. In this study the rational prescription of parenteral opioid in Amir-al-Momenin general hospital was investigated. A retrospective drug utilization review was performed on 509 in-patients who received parenteral opioids including Morphine, Pethidin, Pentazocin, Fentanyl, Alfentanil, Sufentanil and Methadone from March 21sttoSeptember 23rd, 2011. Multivariate conditional regression modeling was used to determine independent predictors for daily parenteral opioid consumption. Total daily parenteral opioid consumption was 38.63 DDDs/100bed-days for Morphine, Pethidine and Pentazocin and 84564.78 PFEQs/100bed-days for Fentanyl, Alfentanil and Sufentanil and 766 mg for Methadone. Pethidine was the most frequently prescribed parenteral opioid. Most patients who were prescribed by the intramuscular routes, ordered PRN. Daily parenteral opioid consumption was the highest in the emergency ward whereas it was considered as the lowest in the intensive care unit[ICU]. According to our findings, total daily parenteral opioid consumption was almost high in Amir-al-Momenin Hospital. Unlike to some relevant factors that can effect on the consumption of analgesic opioids like gender, age, drug-drug interaction and etc, we found no rational prescription and consumption in the mentioned hospital.

Analgesic and anti-inflammatory effects of honey: the involvement of autonomic receptors.

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Owoyele, Bamidele Victor; Oladejo, Rasheed Olajiire; Ajomale, Kayode; Ahmed, Rasheedat Omotayo; Mustapha, Abdulrasheed

2014-03-01

The use of honey for therapeutic purposes is on the increase and many studies have shown that honey has the ability to influence biological systems including pain transmission. Therefore, this study was designed to investigate the analgesic and anti-inflammatory effects of honey and the effects of concurrent administration of autonomic nervous system blocking drugs. Studies on analgesic activities was carried out using hotplate and formalin-induced paw licking models while the anti-inflammatory activity was by the carrageenan paw oedema method. Animals were distributed into six groups consisting of five animals each. They were administered saline, honey (600 mg/kg), indomethacin (5 mg/kg), autonomic blockers (3 μg/kg of tamsulosin, 20 mg/kg (intraperitoneally) of propranolol, 2 ml/kg of atropine or 10 mg/kg (intra muscularly) of hexamethonium) or honey (200 and 600 mg/kg) with one of the blockers. The results showed that honey reduced pain perception especially inflammatory pain and the administration of tamsulosin and propranolol spared the effect of honey. Hexamethonium also spared the effects of honey at the early and late phases of the test while atropine only inhibited the early phase of the test. However, atropine and hexamethonium spared the anti-inflammatory effects of honey but tamsulosin abolished the effects while propranolol only abolished the anti-inflammatory effects at the peak of the inflammation. The results suggest the involvement of autonomic receptors in the anti-nociceptive and anti-inflammatory effects of honey although the level of involvement depends on the different types of the receptors.