DOUBLE-BLIND EVALUATION OF A NEW ANALGESIC AGENT IN POSTEXTRACTION PAIN

Catheter-related bladder discomfort (CRBD) is one of the most difficult symptoms during the postoperative period. Nefopam is a non-narcotic analgesic agent, which also has anticholinergic action. This study was performed to evaluate the effects of nefopam on CRBD in male patients undergoing robotic nephrectomy. A total of 109 male patients were randomly divided into two groups: the control group (n = 55) received 20 mL of normal saline, and the nefopam group (n = 54) received 20 mg of nefopam 1 h before the end of the operation. At postoperative times of 20 min, 1 h, 2 h, and 6 h, the severity of CRBD was measured using an 11-point numeric rating scale, respectively. The severity of CRBD in the nefopam group was significantly lower than that in the control group at 20 min (4.8 ± 1.3 vs. 2.3 ± 1.0, respectively, p = 0.012) and at 1, 2, and 6 h (3.5 ± 1.2, 2.7 ± 0.9, and 2.5 ± 1.0 vs. 4.1 ± 0.8, 1.6 ± 0.8, and 1.3 ± 0.6, respectively, p < 0001). Intraoperative nefopam administration reduced the severity of CRBD in patients undergoing robotic nephrectomy.

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Evaluation of phenazocine with meperidine as an analgesic agent during labor, by the double blind method

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(64)90887-7 ◽

1964 ◽

Vol 88 (5) ◽

pp. 601-605 ◽

Cited By ~ 7

Author(s):

Robert O. Olson ◽

H.L. Riva

Keyword(s):

Analgesic Agent ◽

Double Blind ◽

Double Blind Method

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Alfentanil for Short Duration Laparoscopic Procedures

Anaesthesia and Intensive Care ◽

10.1177/0310057x8601400109 ◽

1986 ◽

Vol 14 (1) ◽

pp. 37-40

Author(s):

K. S. Lee ◽

G. J. Purcell ◽

B. R. Rae ◽

B. White

Keyword(s):

Nitrous Oxide ◽

Short Duration ◽

Normal Saline ◽

Saline Group ◽

Postoperative Recovery ◽

Normal Saline Group ◽

Analgesic Agent ◽

Double Blind ◽

Cardiovascular Depression ◽

Low Dosage

Alfentanil in low dosage (8 μg kg−1) as an analgesic agent for short duration surgery was evaluated. Forty-one women undergoing laparoscopy received double-blind either alfentanil 8 μg kg−1 or normal saline at induction, and all received thiopentone, alcuronium, enflurane, nitrous oxide and oxygen. The fall in mean arterial pressure (MAP) with induction was similar between groups. The MAP following intubation with alfentanil was unchanged, while with normal saline a mean rise of 23 (SD 15.2) mmHg occurred (P<0.001). The pulse rate following intubation showed a smaller rise (P<0.001) with alfentanil of 26 (SD 14.6) beats min−1, than the normal saline group of 46 (SD 13.3) beats min−1. Alfentanil was found to be a safe and effective analgesic agent in short duration surgery, by reducing sympathetic responses to intubation without cardiovascular depression or compromise of postoperative recovery.

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Double Blind Trial of New Antiinflammatory Analgesic Agent, 31252-S on Tonsillectomy of Children

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.71.5special1_633 ◽

1978 ◽

Vol 71 (5special1) ◽

pp. 633-647

Author(s):

Koji Yamaga ◽

Yoshihiko Tsugawa ◽

Kyoji Tanabe ◽

Sanai Konishi

Keyword(s):

Double Blind Trial ◽

Analgesic Agent ◽

Double Blind ◽

Blind Trial

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Influence of CYP2D6 Activity on Pre-emptive Analgesia by the N-Methyl-D-Aspartate Antagonist Dextromethorphan in a Randomized Controlled Trial of Acute Pain

January 2018 - Pain Physician ◽

10.36076/ppj.2013/16/45 ◽

2013 ◽

Vol 1;16 (1;1) ◽

pp. 45-56

Author(s):

Prof. Jules Desmeules

Keyword(s):

Acute Pain ◽

Controlled Trial ◽

Systemic Availability ◽

Population Pharmacokinetic ◽

Analgesic Agent ◽

Double Blind ◽

Knee Ligament ◽

Cyp2d6 Activity ◽

Population Pharmacokinetic Modeling ◽

Knee Ligament Surgery

Background: There is some evidence that dextromethorphan (DM) is effective as a preemptive analgesic agent. DM is mainly metabolized to dextrorphan (DOR) by CYP2D6 whose activity can be inhibited by pharmacologic intervention. Objectives: To investigate the efficacy of DM as a pre-emptive analgesic agent and describe the population pharmacokinetics in the presence of normal and poor CYP2D6 metabolism in acute post-operative pain. Study Design: Double blind, randomized, placebo-controlled trial Setting: Post-surgical analgesic consumption after knee ligament surgery, a setting of acute pain. Methods: Forty patients were randomized to a single oral dose of 50 mg quinidine or placebo, administered 12 hours before 50 mg DM. Patients were genotyped for the major CYP2D6 and ABCB1 variants and phenotyped for CYP2D6 using urine DM/DOR metabolic ratios and blood samples for population pharmacokinetic modeling. Results: Quinidine was effective in inhibiting CYP2D6 activity, with 2-fold reduction of DM to DOR biotransformation clearance, prolonged DM half-life, and increased DM systemic availability. Patients in the quinidine group required significantly less often NSAIDs than patients in the placebo group (35.3% vs. 75.0%, P = 0.022). The odds ratio for NSAID consumption in the placebo vs. quinidine group was 5.5 (95% confidence interval (CI) 1.3 - 22.7) at 48 hours after surgery. Limitations: While this study shows an impact of DM on pre-emptive analgesia and is mechanistically interesting, the findings need to be confirmed in larger trials. Conclusion: CYP2D6 inhibition by quinidine influenced the pre-emptive analgesic effectiveness of DM confirming that CYP2D6 phenotypic switch increases the neuromodulatory effect of oral dextromethorphan. Key words: Pre-emptive analgesia, dextomethorphan, population kinetics, quinidine, cytochrome 2D6

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