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Ledin, Eriksson Susanne. "Central-block techniques for relief of labour pain /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-911-0/.
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Camacho, Meneses Martha, and de la Cruz Patricia Mello. "Dolor postoperatorio: analgesia preventiva versus analgesia postoperatoria con ketorolaco en colecistectomía videolaparoscópica." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2002. https://hdl.handle.net/20.500.12672/2061.
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Objetivo: Determinar si la Analgesia Preventiva es mejor que la Analgesia Postoperatoria, usando Ketorolaco.
Pacientes y Método: Estudio prospectivo de 60 pacientes, sometidos a Colecistectomía Laparoscopica electiva; divididos en dos grupos: 1)ketorolaco preventivo 2)Ketorolaco postoperatorio. La Inducción fue con Fentanilo 2 ugr/Kg, Rocuronio 0.6 mg/kg y Tiopental 6mg/kg. Durante la colocación de los campos operatorios se administró Ketorolaco 60mg EV, en el grupo 1. En el mantenimiento: Sevorane, Fentanilo 50 ugr cada 30 minutos y Rocuronio 10mg cada 35 min. Se controló las funciones vitales y saturación arterial. Para el grupo 2 se administró Ketorolaco EV 60 mg terminada la cirugía y antes de la extubación. La dosis de rescate fue con Metamizol 2gr EV. Se usó la Escala Análoga Visual para la valoración del dolor; ambos grupos se compararon con el método estadístico MANOVAr, considerando un nivel de significancia de 5%.
Resultados: El EVA promedio postoperatorio fue 2 para el grupo 1 y 5 para el grupo 2, después de 24 horas fue 3 y 4 respectivamente (p menor a 0.05). Los efectos adversos, fueron 5/30 (17%) en el Grupo 1:sangrado, y 3/30 (10%) en el Grupo 2: 1 con urticaria y 2 con nauseas (p mayor a 0.05). La dosis de rescate fue necesaria en 7% de los pacientes en el Grupo 1 y 53% en el Grupo 2 (p menor a 0.001).
Conclusión: La Analgesia Preventiva es superior a la Analgesia postoperatoria, con Ketorolaco, disminuyendo los requerimientos de analgésicos de rescate.Tesis de segunda especialidad
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Lorena, Sílvia Elaine Rodolfo de Sá [UNESP]. "Estudo demográfico sobre as condutas de avaliação e tratamento da dor dos médicos veterinários brasileiros no período perioperatório de grandes e pequenos animais." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/101036.
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lorena_sers_dr_botfmvz.pdf: 632999 bytes, checksum: 35174e377fd65ef6483f2f8509b96974 (MD5)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
O uso de analgésicos em animais é justificado moral e cientificamente. Para tal, é necessário que os profissionais saibam reconhecer e tratar a dor de forma adequada em animais. Objetivou-se correlacionar diversos dados demográficos para obter o perfil do médico veterinário brasileiro de grandes e pequenos animais. O questionário da pesquisa foi composto por: dados pessoais, utilização de fármacos analgésicos, analgesia, conduta no alívio da dor, uso de analgésicos em diversos procedimentos de grandes e pequenos animais, avaliação da dor e atualizações. A estatística foi realizada pelo programa SAS for Windows versão 9.1.3 com estatística descritiva com análise de frequência. Para as comparações simples foi utilizado o teste de qui-quadrado (x2). Foram obtidos 1.298 questionários de pequenos animais e 713 de grandes. Mulheres e profissionais graduados havia menos de dez anos conferiram maiores escores de dor que homens e profissionais formados havia mais de dez anos, porém a duração do tratamento não diferiu entre os gêneros. Os opioides mais utilizados para a analgesia foram tramadol (79%) e morfina (50,5%), em cães e gatos, e butorfanol (43,4%) e tramadol (39%) em grandes animais. Os efeitos adversos mais reportados dos opioides em gatos foram depressão respiratória e excitação. Em cães os principais efeitos adversos assinalados foram depressão respiratória e êmese. Para grandes animais, as preocupações com o uso desses fármacos foram: risco de excitação e síndrome cólica equina. Mais de 50% dos veterinários não utilizava opioides em bovinos. Os anti-inflamatórios não esteroidais (AINEs) mais escolhidos para pequenos animais foram meloxicam (81%) e cetoprofeno (70,4%), e flunixin meglumine (83,2%) e cetoprofeno (67,6%) em grandes animais. Os efeitos...
The use of analgesics in animals is morally and scientifically justified. According to that, the professionals should know how to recognize and treat pain in animals. The aim of this study was to correlate the demographic data of the Brazilian veterinarians, with the use of analgesics, the factors that affected the decision on the use of analgesia, attitudes, knowledge and methods of obtaining information on the evaluation and treatment of pain in animals. The questionnaire was composed of demographics, personal data, use of analgesics in general and specific procedures, analgesia, attitudes in the assessment and relief of pain and types of information in the area. The descriptive statistics with frequency analysis was performed using SAS for Windows 9.1.3. Chi-square (x2) for simple comparisons test was used. Questionnaires were obtained from 1298 small and 713 large animal veterinarians. Women and veterinarians graduated for less than ten years attributed higher pain scores than men, and veterinarians graduated for over ten years, but the frequency and duration of analgesic treatment did not differ between gender. The most commonly used opioid for analgesia of small animals were tramadol (79%) and morphine (50.5%) for dogs and cats, and butorphanol (43.4%) and tramadol (39%) for large animals. The most important side effects of opioids in small animals were respiratory depression and excitement, for cats and emesis in dogs and excitement and colic syndrome in 4 horses. NSAIDs of choice for small animals were meloxicam (81%) and ketoprofen (70.4%) and for large animals, flunixin meglumine (83.2%) and ketoprofen (67.6%). Side effects of NSAIDs most frequently reported for all species were gastric changes and nephrotoxicity. The most important limiting factors for the use of NSAIDs and opiods were the side effects for horses and the cost for cattles. The cats received lower pain... (Complete abstract click electronic access below)
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Brooks, Jason Whitworth. "Aspects of cannabinoid analgesia." Thesis, Imperial College London, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408407.
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Bortolami, Elisa. "Advances in sheep analgesia." Doctoral thesis, Università degli studi di Padova, 2015. http://hdl.handle.net/11577/3424188.
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Sheep (Ovis aries) are widely used in experimental settings and breeding system, nevertheless pain treatment in this species seems to be overlooked.
The first two studies described in this thesis were designed to evaluate administration of analgesics both in the experimental and clinical setting. The third study evaluated the pharmacokinetics and antinociceptive effects of tramadol and its metabolite O-desmethyltramadol (M1) in sheep in a preclinical model of pain.
The first study consisted of a meta-analysis of the reported use of analgesics in sheep for experimental purposes. Studies involving experimental procedures in sheep carried out in selected years (2008-2011-2014) were identified using a search engine. A total of 75 papers were selected. The study showed that analgesic treatment was often not accurately reported.
The second study consisted of an on-line questionnaire evaluating the current attitudes of Italian practitioners to assessment and treatment of pain in sheep. The questionnaire consisted of five sections regarding the demographic data, analgesic drugs and techniques used to treat pain, attitudes to pain relief and assessment of pain and the knowledge on the topic of sheep analgesia. Only a modest number of questionnaires were returned. The most commonly used drugs by sheep practitioners who replied to the questionnaire were non steroidal anti-inflammatory drugs and local anaesthetics. In the practitioners’ opinion the main reasons for analgesic drugs not to be administered to sheep was the lack of licensed drugs followed by costs, withholding times and regulations. The vast majority of practitioners were interested in improving their knowlwdge on sheep analgesia.
The third study investigated the pharmacokinetic profile and antinociceptive effect of tramadol and M1 following intravenous administration in sheep. Six healthy adult sheep were administered 4 (T4) and 6 (T6) mg/kg of tramadol (T) and saline (SAL) over 2 minutes in a cross over design with a two weeks wash out period. At predetermined time points blood samples were collected, physiological parameters and mechanical nociceptive threshold (NMT) values were recorded. Tramadol and M1 fitted a two compartmental model and a non compartmental model respectively. Pharmacokinetic parameters were similar for T4 and T6. Tramadol and M1 plasma concentrations decreased rapidly. Physiological parameters were not statistically different between groups. No mechanical antinociceptive effects of tramadol were detected, as MNT values did not statistically differ between groups.
In conclusion, these studies showed that there is great scope for improvement in pain assessment and treatment in sheep both in the research than clinical settings. Moreover more experimental and clinical studies regarding the pharmacokinetic and pharmacokinamic effects of analgesic drugs in sheep are advocated in order to improve their welfare.La pecora domestica (Ovis aries) è una delle specie animali più comunemente allevate ed utilizzate nella ricerca biomedica; nonostante questo l’analgesia in questo animale è stata a lungo trascurata. I primi due studi presentati in questa tesi sono stati elaborati allo scopo di valutare la somministrazione di analgesici nell’ambito clinico e sperimentale. Il terzo studio valuta la farmacocinetica e gli effetti antinocicettivi del tramadolo e del suo metabolita O desmethyltramadol (M1). Il primo studio consiste in una meta-analisi sull’ uso di farmaci analgesici riportato nelle pecore utilizzate a fini sperimentali. Studi riguardanti procedure sperimentali in pecore effettuati in anni selezionati (2008-2011-2014) sono stati identificati utilizzando un motore di ricerca. In totale, sono stati selezionati 75 articoli scientifici. Lo studio evidenzia mostra che la terapia antalgica spesso non viene accuratamente riportata. Il secondo studio consiste in un questionario on line redatto allo scopo di valutare l’attuale approccio dei veterinari italiani, che si occupano della specie ovina, alla valutazione ed al trattamento del dolore in questa specie. Il questionario era diviso in cinque sezioni riguardanti i dati demografici, l’uso di farmaci analgesici a tecniche utilizzate per apportare analgesia, e l’approccio utilizzato dai veterinari nella valutazione e trattamento del dolore nella specie ovina, ed, infine, la loro conoscenza riguardo tale argomento. Un numero limitato di veterinari ha completato il questionario. I farmaci più comunemente utilizzati dai veterinari che hanno risposto al questionario sono i farmaci antiinfiammatori non steroidei e gli anestetici locali. Secondo l’opinione dei veterinari, le ragioni principali per cui la terapia analgesica non viene effettuata nella specie ovina erano la mancanza di farmaci registrati, il loro costo, i tempi di sospensione e la regolamentazione riguardante il loro utilizzo. La maggior parte dei veterinari si dimostrava interessata a migliorare le proprie conoscenze riguardo l’analgesia nella specie ovina. Il terzo studio investiga la farmacocinetica e gli effetti antinocicettivi del tramadolo ed M1 dopo somministrazione endovenosa nelle pecore. Due dosi di tramadolo, 4 mg/kg (T4) e 6 mg/kg (T6), e soluzione salina (SAL) sono state somministrate in due minuti a sei pecore adulte e sane in uno studio randomizzato “in cieco” con un periodo di sospensione di due settimane. A tempi predeterminati, sono stati effettuati i prelievi di sangue per l’analisi farmacocinetica, e sono stati registrati i parametri fisiologici e i valori dopo stimolazione nocicettiva meccanica (MNT). Tramadolo ed M1 presentano rispettivamente una cinetica bi-compartimentale e non-compartimentale. I parametri farmacocinetici sono simili per le due dosi T4 e T6. Le concentrazioni plasmatiche di tramadolo ed M1 sono rapidamente diminuite. I parametri fisiologici non sono risultati statisticamente diversi tra i gruppi. Non sono stati evidenziati effetti antinociettivi del tramadolo; infatti i valori di MNT non sono risultati statisticamente diversi tra i gruppi. Concludendo, questi studi hanno dimostrato che ci sono ampi margini di miglioramento nella valutazione e trattamento del dolore nella specie ovina sia in ambito sperimentale sia clinico. Inoltre, sono necessari studi sperimentali e clinici riguardanti la farmacocinetica e farmacodinamica di farmaci analgesici nella specie ovina al fine di migliorarne il benessere.
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Moreira, Alcides. "Analgesia preemptiva versus analgesia preventiva com lumiracoxibe em cirurgias de terceiros molares retidos." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290774.
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Orientador: Eduardo Dias de AndradeTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A analgesia preemptiva consiste na instituição de um regime analgésico previamente ao estímulo nociceptivo, com o objetivo de prevenir a hiperalgesia e a subsequente amplificação da dor. O objetivo deste trabalho foi avaliar a analgesia preemptiva com o lumiracoxibe, inibidor seletivo da cicloxigenase-2 (COX-2), em exodontias bilaterais de terceiros molares mandibulares retidos, comparando-a à analgesia preventiva. Foram selecionados 16 voluntários com bom estado de saúde geral, com indicação para a remoção dos dois terceiros molares mandibulares retidos, em posições simétricas e assintomáticos. O estudo foi delineado de forma duplo-cego e cruzado. Em uma das cirurgias os voluntários foram tratados com lumiracoxibe 400 mg, via oral, em dose única, administrada uma hora antes da cirurgia, seguido da administração de placebo, logo após o término do procedimento. Na cirurgia contralateral, de modo inverso, o tratamento consistiu do uso do placebo antes da intervenção, seguido da administração de lumiracoxibe 400 mg após o término do ato cirúrgico. A eficácia dos regimes analgésicos foi avaliada pelos seguintes parâmetros: tempo decorrido para a tomada do primeiro comprimido de analgésico a partir do final da intervenção; quantidade de comprimidos de analgésico tomada nas primeiras 24 h do pósoperatório; escala visual analógica nos tempos de 4, 8, 12 e 24 h e qualidade do tratamento. Não houve diferenças estatisticamente significantes entre os tratamentos preemptivo e preventivo no que se refere ao tempo requerido para a tomada da primeira dose de analgésico: 241,5 (±322,5) e 137,2 (± 246,48) minutos (p=0,3633); quantidade de comprimidos analgésicos tomados no período pósoperatório: 2,6 (±2,56) e 4,2 (± 5,13) comprimidos (p=0,5471), qualidade do tratamento (p=0,6794) e escala visual analógica (p=0,3916). Concluiu-se que o tratamento com lumiracoxibe, prévio ao estímulo nociceptivo (analgesia preemptiva) ou posterior a ele (analgesia preventiva), promove efeito analgésico efetivo e similar em cirurgias de terceiros molares mandibulares retidos.
Abstract: Preemptive analgesia is defined as an analgesic regimen established before the occurrence of noxious stimulus in order to prevent hyperalgesia and subsequent amplification of pain. The aim of this study was to evaluate the preemptive analgesia with lumiracoxib, a selective cicloxigenase-2 (COX-2) inhibitor, in impacted third molars surgery, compared to the protocol of preventive analgesia. Sixteen subjects who required elective surgical removal of symmetric and asymptomatic impacted mandibular third molars, in an outpatient setting were selected for the study, characterized as double-blind and crossover. In one of the surgeries, the volunteers where treated with lumiracoxib 400 mg orally in a single dose given one hour before surgery, followed by administration of placebo, immediately after the end of the procedure. Conversely, in contralateral surgery, treatment consisted of using placebo before intervention, followed by administration of lumiracoxib 400 mg after surgery. The effectiveness of analgesia was evaluated by the following parameters: time elapsed from the end of the intervention, until the first analgesic intake in the postoperative period; number of analgesic tablets consumed in the first 24 hours after surgery; visual analog scale (VAS) at of 4, 8, 12 and 24 h after the surgery and treatment quality. There were o statistically significant differences between preemptive and preventive treatments in relation to the time required for the first analgesic intake: 241.5 (± 322.5) and 137.2 (± 246.48) minutes (p = 0.3633), number of analgesic tablets taken in the postoperative period: 2.6 (± 2.56) and 4.2 (± 5.13) tablets (p = 0.5471), quality of treatment (p = 0.6794) and visual analog scale (p = 0.3916). It was concluded that treatment with lumiracoxib, prior to noxious stimulation (preemptive analgesia) or after it (preventive analgesia), promotes similar analgesic effect in lower impacted third molars surgery.
Doutorado
Farmacologia, Anestesiologia e Terapeutica
Doutor em Odontologia
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Swanton, Rosie. "Learned analgesic cue association and placebo analgesia in rats: an empirical assessment of an animal model and meta-analysis." Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/24505.
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This thesis focuses on animal models of placebo analgesia. Placebo analgesia is the experience of reduced pain, or pain relief, without the delivery of a pain-relieving drug or actual reduction of the painful stimulus. Research into the underlying neuro-mechanisms of placebo analgesia have been limited by unreliable animal models of the effect and attempts to replicate human placebo testing paradigms in animals have had mixed outcomes. In many cases, a tolerance to analgesic has been observed instead.
The project had two main aims. The first was to replicate a recent model of placebo analgesia. The second aim of the project was to conduct a meta-analysis of the existing published literature and determine the overall effect size of placebo analgesia in rodent models.
Experiment 1 sought to replicate a previous model of rodent placebo analgesia. Results from experiment 1 did not support previous findings and showed no evidence for placebo analgesia in rodents.
Experiment 2 was a second attempt to replicate a previous model of placebo analgesia. The second attempt adjusted the potential limitations from experiment 1 such as cue chamber intensity and re-ran the protocol using rodents of the same sex and strain as the original paper. Results from experiment 2 were similar to experiment 1 and did not support the hypotheses or provide any evidence for placebo analgesia in rodents.
Experiment 3 used a simplified version of the behavioural conditioning methodology from experiments 1 and 2, but was modified to reduce handling stress, to increase the salience of the to-be-conditioned placebo cue, and to reduce stress-induced analgesia. Results from experiment 3 found no evidence for placebo analgesia in rodents was observed.
The results from 45 studies across 21 papers were meta-analysed and showed a moderate effect size for placebo analgesia in rodents, and moderator analysis revealed that cue type was a significant factor in the development of the effect in rodents. Using a context cue box as the cue type was found to be the most effective approach to establishing placebo analgesia in rodents.
The current research has highlighted the replicability problem in pre-clinical research and as such it is recommended that animal studies looking at placebo analgesia aim to include more methodological detail in their reporting, particularly in regard to cue type. A limitation of the current project was the exclusion of drug tolerance literature that results in nocebo responses. Future research should compare and contrast this body of work more closely with research into placebo analgesia in rodents.
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Yat, P. N. "Synthesis and reactions of 2,6-methano-3-benzazocines and arylbicyclo[4.n.1]enones as potential analgesics." Thesis, University of Salford, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.376863.
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Volmanen, P. (Petri). "Intravenous patient controlled analgesia with remifentanil in early labour." Doctoral thesis, University of Oulu, 2010. http://urn.fi/urn:isbn:9789514261176.
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In four prospective clinical trials, 114 parturients used intravenous patient-controlled remifentanil analgesia during the 1st stage of labour. The median effective dose per bolus was ascertained to be 0.4 μg/kg and the pain scores were reduced with this by a median of 2 on a numerical scale (0–10). Compared with nitrous oxide, 15 parturients included in a cross-over study reported a larger reduction in pain scores during remifentanil analgesia (1.5 vs. 0.5, p = 0.001) and better pain relief scores (2.5 vs. 0.5 on a ranked five point scale 0–4, p < 0.001). In a parallel study including 45 parturients, epidural analgesia (EDA, 20 ml bupivacaine 0.625 mg/ml and fentanyl 2 μg/ml) was associated with lower pain scores (5.2 vs. 7.3 with remifentanil, p = 0.004) but variables related to satisfaction with analgesia (pain relief score, proportion of mothers with desire to continue with the given medication and termination of the study due to inadequate pain relief) were similar. A comparison of two methods for timing the remifentanil bolus during the uterine contraction cycle suggested that delaying the bolus does not improve analgesia. A period effect was noted in the cross-over trial with higher pain scores and increased drug consumption during the second study period suggesting acute hyperalgesia.
Side effects of remifentanil analgesia included respiratory depression warranting oxygen supplementation in 33% of parturients. Sedation was experienced by the parturients using remifentanil and this was scored as stronger than sedation during nitrous oxide and EDA. The number of parturients with nausea did not increase during remifentanil analgesia. Other maternal side effects included dizziness, a difficulty in visual focusing and itching. Foetal heart rate tracing abnormalities were noted. The incidence of abnormal tracings and decreased UapH were not different, however, from that observed during nitrous oxide or EDA. Apgar scores at 1 and 5 minute indicated no neonatal depression.
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Marsh, Deborah Frances. "The ontogeny of opioid analgesia." Thesis, University College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286332.
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Watts, Sarah. "Aspects of analgesia in cattle." Thesis, Royal Veterinary College (University of London), 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412147.
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Young, Shawquia Elithia. "Dual Mechanism Analgesia-Enhancing Agents." VCU Scholars Compass, 2005. http://scholarscompass.vcu.edu/etd/1166.
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Currently, there is an increasing need for novel analgesics that are potent but lack undesired side effects. Recent studies have shown that both 5-HT3 receptors and α2B- adrenoceptors play a role in antinociception. MD-354, N-(3-chlorophenyl)guanidine, has a high-affinity both for 5-HT3 and α2B- adrenoceptors and could be viewed as the first example of a rather selective 5-HT3/α2B- adrenoceptor ligand. MD-354, inactive by itself, potentiates the antinociceptive effects of an inactive dose of clonidine in the mouse tail- flick assay. An attempt to determine the underlying mechanism of this potentiating effect was the purpose of the present investigation. The studies focused on an examination of: i) MD-354 in the mouse hot-plate assay, ii) a more lipophilic analog of MD-354 in the tail-flick assay, iii) various analogs of MD-354 with different binding profiles in both mouse tail-flick and hot-plate assays. The present investigation suggests that both 5-HT3 and α2B- adrenoceptors are playing a role in the potentiation of clonidine analgesia by arylguanidines such as MD-354. Arylguanidines might represent a unique class of analgesia-enhancing agents with a dual (5-HT3/α2- adrenoceptor) mechanism of action.
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Van, der Westhuizen Christo. "Analgesia : a prospective audit on patient satisfaction with postoperative analgesia in a South African tertiary hospital." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16932.
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Includes bibliographical referencesBackground: The vast majority of patients will be admitted to general wards after their surgical procedures. Ward staff will provide the prescribed analgesia. The researchers would like to ascertain whether the patient population is satisfied with the analgesia that they receive. Methods: Fifty-two postoperative patients consented to taking part in a prospective audit that enquired about pain using a Numeric Rating Scale (NRS) on discharge from the theatre recovery room as well as on day one postoperatively. Additionally patients were asked to indicate whether the analgesia was 'good', 'fair' or 'poor' and were interviewed about their expectations regarding pain. Results: The mean age was 45 (SD 14) years and median surgical duration was 100 (IQR 75- 150) minutes. Mean NRS score was 3 (SD 3) on discharge from recovery as well as on day one postoperatively. 'Good' analgesia was reported by 69.2% of patients and 71.2% reported that they had less pain than expected. The median time from recovery room discharge to first dose of analgesia was 135 (IQR 65-400) minutes. Conclusion: Sixty seven per cent of patients indicated that they were satisfied with the analgesia provided. There are, however, still problems with long waiting times to first doses of analgesia. The relatively low overall pain scores and high levels of satisfaction are encouraging.
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Almeida, Maria Raquel de [UNESP]. "Efeitos analgésicos pós-operatórios de cetamina e/ou morfina em cadelas submetidas à OSH eletiva." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/95068.
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almeida_mr_me_botfm.pdf: 222592 bytes, checksum: 05b672385b2d5a4637d5ffd83bfcfbc3 (MD5)Avaliaram-se os efeitos analgésicos de morfina e/ou cetamina em 24 cadelas hígidas com peso de 11,01± 8,69 kg e idade de 27±17 meses, submetidas à ovariosalpingohisterectomia (OSH) eletiva. Os animais foram tratados imediatamente após a indução anestésica com: morfina (GM, n=8, 0,5 mg/kg IM), cetamina (GC, n=8, 2,5 mg/kg IM) ou morfina associada à cetamina nas mesmas doses anteriores. Avaliou-se o escore de sedação e a dor de forma encoberta (cega) por meio de escala analógica visual (EAV) e Escala de Glasgow Modificada (EGM), às duas horas antes do procedimento cirúrgico e 1, 2, 4, 8,12 e 24 horas após a extubação. Os resgates analgésicos foram realizados com morfina 1 mg/kg e caso não suficiente, no momento seguinte, com meloxicam 0,2 mg/kg, ambos IM, quando a pontuação da EGM atingisse 33% do valor total. Para as variáveis nãoparamétricas utilizou-se o teste de Friedman seguido de Dunn, para avaliar as diferenças de cada grupo ao longo do tempo, o teste de Kruskal-Wallis seguido de Dunn para avaliar as diferenças entre os grupos em cada momento e o número de resgates analgésicos. Para as variáveis paramétricas, utilizou-se o ANOVA seguido do teste de Tukey, todos com 5% de significância. Exceto para EGM onde os valores em GM foram superiores à GCM à 1h, não houve outras diferenças entre os grupos. O número de resgates analgésicos foi superior em GM, já que todos animais necessitaram resgate em 11 ocasiões. Apenas um animal do GC e dois do GCM necessitaram de dois e três resgates respectivamente. A analgesia oferecida pela administração pré-incisional de cetamina foi mais efetiva do que a oferecida pela morfina e este fármaco pode ser utilizado para analgesia preemptiva em cadelas submetidas à OSH
The aim of this study was to evaluate the analgesic effects of morphine and/or ketamine in 24 healthy bitches, weighing 11.01± 8.69 kg and aging 27±17 months, submitted to elective ovariohysterectomy. The animals were submitted one of the three treatments after the anaesthetic induction: morphine (GM, n=8, 0,5 mg/kg IM), ketamine (GC, n=8, 2.5 mg/kg IM) or ketamine combined to morphine using the same doses described previously. Sedation score and pain assessment was performed blindly before surgery and at 1, 2, 4, 8,12 and 24 hours after extubation, using the visual analogue scale and Glasgow modified pain scale (GMPS). Rescue analgesia was performed with morphine 1 mg/kg and of not sufficient followed by meloxicam 0.2 mg/kg, both IM, when the GMPS reached 33% of the total score. Parametric data were analysed using Friedman´s test followed by Dunn´s test for differences in time. Kruskal-Wallis´ followed by Dunn´s test were performed to investigate differences in number of analgesic rescues and between groups at each time. Paramentric data were evaluated by ANOVA followed by Tukeys´s test, with 5% of statistical significance. Except for GMPS, where the values of GM were greater than for GCM at 1h post-operatively, there wrere no other differences between groups. The number of rescue analgesia was greater in GM, as all animals needed rescue analgesia in 11 occasions, while only one dog from GC and two from GCM needed two and three analgesic rescues respectively. Analgesia provided by pre-incisional ketamine was more effective when compared to morphine. According to that ketamine alone may be used as a preemptive analgesic in bitches undergoing ovariohysterectomy
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Almeida, Maria Raquel de. "Efeitos analgésicos pós-operatórios de cetamina e/ou morfina em cadelas submetidas à OSH eletiva /." Botucatu : [s.n.], 2012. http://hdl.handle.net/11449/95068.
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Orientador: Stelio Pacca Loureiro LunaBanca: Juliana Tabarelli Brondani
Banca: Silvia Renata Gaido Cortopassi
Resumo: Avaliaram-se os efeitos analgésicos de morfina e/ou cetamina em 24 cadelas hígidas com peso de 11,01± 8,69 kg e idade de 27±17 meses, submetidas à ovariosalpingohisterectomia (OSH) eletiva. Os animais foram tratados imediatamente após a indução anestésica com: morfina (GM, n=8, 0,5 mg/kg IM), cetamina (GC, n=8, 2,5 mg/kg IM) ou morfina associada à cetamina nas mesmas doses anteriores. Avaliou-se o escore de sedação e a dor de forma encoberta (cega) por meio de escala analógica visual (EAV) e Escala de Glasgow Modificada (EGM), às duas horas antes do procedimento cirúrgico e 1, 2, 4, 8,12 e 24 horas após a extubação. Os resgates analgésicos foram realizados com morfina 1 mg/kg e caso não suficiente, no momento seguinte, com meloxicam 0,2 mg/kg, ambos IM, quando a pontuação da EGM atingisse 33% do valor total. Para as variáveis nãoparamétricas utilizou-se o teste de Friedman seguido de Dunn, para avaliar as diferenças de cada grupo ao longo do tempo, o teste de Kruskal-Wallis seguido de Dunn para avaliar as diferenças entre os grupos em cada momento e o número de resgates analgésicos. Para as variáveis paramétricas, utilizou-se o ANOVA seguido do teste de Tukey, todos com 5% de significância. Exceto para EGM onde os valores em GM foram superiores à GCM à 1h, não houve outras diferenças entre os grupos. O número de resgates analgésicos foi superior em GM, já que todos animais necessitaram resgate em 11 ocasiões. Apenas um animal do GC e dois do GCM necessitaram de dois e três resgates respectivamente. A analgesia oferecida pela administração pré-incisional de cetamina foi mais efetiva do que a oferecida pela morfina e este fármaco pode ser utilizado para analgesia preemptiva em cadelas submetidas à OSH
Abstract: The aim of this study was to evaluate the analgesic effects of morphine and/or ketamine in 24 healthy bitches, weighing 11.01± 8.69 kg and aging 27±17 months, submitted to elective ovariohysterectomy. The animals were submitted one of the three treatments after the anaesthetic induction: morphine (GM, n=8, 0,5 mg/kg IM), ketamine (GC, n=8, 2.5 mg/kg IM) or ketamine combined to morphine using the same doses described previously. Sedation score and pain assessment was performed blindly before surgery and at 1, 2, 4, 8,12 and 24 hours after extubation, using the visual analogue scale and Glasgow modified pain scale (GMPS). Rescue analgesia was performed with morphine 1 mg/kg and of not sufficient followed by meloxicam 0.2 mg/kg, both IM, when the GMPS reached 33% of the total score. Parametric data were analysed using Friedman's test followed by Dunn's test for differences in time. Kruskal-Wallis' followed by Dunn's test were performed to investigate differences in number of analgesic rescues and between groups at each time. Paramentric data were evaluated by ANOVA followed by Tukeys's test, with 5% of statistical significance. Except for GMPS, where the values of GM were greater than for GCM at 1h post-operatively, there wrere no other differences between groups. The number of rescue analgesia was greater in GM, as all animals needed rescue analgesia in 11 occasions, while only one dog from GC and two from GCM needed two and three analgesic rescues respectively. Analgesia provided by pre-incisional ketamine was more effective when compared to morphine. According to that ketamine alone may be used as a preemptive analgesic in bitches undergoing ovariohysterectomy
Mestre
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Lorena, Sílvia Elaine Rodolfo de Sá. "Estudo demográfico sobre as condutas de avaliação e tratamento da dor dos médicos veterinários brasileiros no período perioperatório de grandes e pequenos animais /." Botucatu : [s.n.], 2010. http://hdl.handle.net/11449/101036.
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Orientador: Stélio Pacca Loureiro LunaBanca: Antonio José de Araújo Aguiar
Banca: Carlos Augusto Araújo Valadão
Banca: Suzane Lilian Beier
Banca: Juliana Tabarelli Brondani
Resumo: O uso de analgésicos em animais é justificado moral e cientificamente. Para tal, é necessário que os profissionais saibam reconhecer e tratar a dor de forma adequada em animais. Objetivou-se correlacionar diversos dados demográficos para obter o perfil do médico veterinário brasileiro de grandes e pequenos animais. O questionário da pesquisa foi composto por: dados pessoais, utilização de fármacos analgésicos, analgesia, conduta no alívio da dor, uso de analgésicos em diversos procedimentos de grandes e pequenos animais, avaliação da dor e atualizações. A estatística foi realizada pelo programa SAS for Windows versão 9.1.3 com estatística descritiva com análise de frequência. Para as comparações simples foi utilizado o teste de qui-quadrado (x2). Foram obtidos 1.298 questionários de pequenos animais e 713 de grandes. Mulheres e profissionais graduados havia menos de dez anos conferiram maiores escores de dor que homens e profissionais formados havia mais de dez anos, porém a duração do tratamento não diferiu entre os gêneros. Os opioides mais utilizados para a analgesia foram tramadol (79%) e morfina (50,5%), em cães e gatos, e butorfanol (43,4%) e tramadol (39%) em grandes animais. Os efeitos adversos mais reportados dos opioides em gatos foram depressão respiratória e excitação. Em cães os principais efeitos adversos assinalados foram depressão respiratória e êmese. Para grandes animais, as preocupações com o uso desses fármacos foram: risco de excitação e síndrome cólica equina. Mais de 50% dos veterinários não utilizava opioides em bovinos. Os anti-inflamatórios não esteroidais (AINEs) mais escolhidos para pequenos animais foram meloxicam (81%) e cetoprofeno (70,4%), e flunixin meglumine (83,2%) e cetoprofeno (67,6%) em grandes animais. Os efeitos... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The use of analgesics in animals is morally and scientifically justified. According to that, the professionals should know how to recognize and treat pain in animals. The aim of this study was to correlate the demographic data of the Brazilian veterinarians, with the use of analgesics, the factors that affected the decision on the use of analgesia, attitudes, knowledge and methods of obtaining information on the evaluation and treatment of pain in animals. The questionnaire was composed of demographics, personal data, use of analgesics in general and specific procedures, analgesia, attitudes in the assessment and relief of pain and types of information in the area. The descriptive statistics with frequency analysis was performed using SAS for Windows 9.1.3. Chi-square (x2) for simple comparisons test was used. Questionnaires were obtained from 1298 small and 713 large animal veterinarians. Women and veterinarians graduated for less than ten years attributed higher pain scores than men, and veterinarians graduated for over ten years, but the frequency and duration of analgesic treatment did not differ between gender. The most commonly used opioid for analgesia of small animals were tramadol (79%) and morphine (50.5%) for dogs and cats, and butorphanol (43.4%) and tramadol (39%) for large animals. The most important side effects of opioids in small animals were respiratory depression and excitement, for cats and emesis in dogs and excitement and colic syndrome in 4 horses. NSAIDs of choice for small animals were meloxicam (81%) and ketoprofen (70.4%) and for large animals, flunixin meglumine (83.2%) and ketoprofen (67.6%). Side effects of NSAIDs most frequently reported for all species were gastric changes and nephrotoxicity. The most important limiting factors for the use of NSAIDs and opiods were the side effects for horses and the cost for cattles. The cats received lower pain... (Complete abstract click electronic access below)
Doutor
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Hurwitz, Emily. "Stress induced analgesia in competitive athletes." Diss., Connect to the thesis, 2006. http://hdl.handle.net/10066/736.
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Björnsson, Marcus. "Pharmacometric Models in Anesthesia and Analgesia." Doctoral thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-205580.
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Modeling is a valuable tool in drug development, to support decision making, improving study design, and aid in regulatory approval and labeling. This thesis describes the development of pharmacometric models for drugs used in anesthesia and analgesia. Models describing the effects on anesthetic depth, measured by the bispectral index (BIS), for a commonly used anesthetic, propofol, and for a novel anesthetic, AZD3043, were developed. The propofol model consisted of two effect-site compartments, and could describe the effects of propofol when the rate of infusion is changed during treatment. AZD3043 had a high clearance and a low volume of distribution, leading to a short half-life. The distribution to the effect site was fast, and together with the short plasma half-life leading to a fast onset and offset of effects. It was also shown that BIS after AZD3043 treatment is related to the probability of unconsciousness similar to propofol. In analgesia studies dropout due to lack of efficacy is common. This dropout is not at random and needs to be taken into consideration in order to avoid bias. A model was developed describing the PK, pain intensity and dropout hazard for placebo, naproxen and a novel analgesic compound, naproxcinod, after removal of a wisdom tooth. The model provides an opportunity to describe the effects of other doses or formulations. Visual predictive checks created by simultaneous simulations of PI and dropout provided a good way of assessing the goodness of fit when there is informative dropout. The performance of non-linear mixed effects models in the presence of informative dropout, with and without including models that describe such informative dropout was investigated by simulations and re-estimations. When a dropout model was not included there was in general more bias. The bias increased with decreasing number of observations per subject, increasing placebo effect and increasing dropout rate. Bias was relatively unaffected by the number of subjects in the study. The bias had, in general, little effect on simulations of the underlying efficacy score, but a dropout model would still be needed in order to make realistic simulations.
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Watson, Alison. "The neurophysiology of human placebo analgesia." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499914.
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Milligan, Kevin Robert. "Spinal analgesia after reconstructive hip surgery." Thesis, Queen's University Belfast, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337112.
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Habib, Neda Adly. "Ventilatory pattern and post-operative analgesia." Thesis, University of Bristol, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260272.
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Essving, Per. "Local infiltration analgesia in knee arthroplasty." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-21412.
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Local infiltration analgesia (LIA) is a new technique for postoperative pain management following knee arthroplasty. LIA involves a long-acting local anesthetic (ropivacaine), a non-steroid anti-inflammatory drug (ketorolac) and epinephrine infiltrated into the knee joint during surgery and injected postoperatively via a catheter. In the first two studies, LIA was compared with placebo in unicompartmental (I) and total (II) knee arthroplasty. Postoperative pain levels, morphine consumption and the incidence of side effects were lower in the LIA groups. In addition, we found a shorter length of hospital stay in the LIA group following unicompartmental knee arthroplasty compared with placebo (I), while the time to home readiness was shorter in the LIA group following total knee arthroplasty (II). In this study, we found that the unbound venous blood concentration of ropivacaine was below systemic toxic blood concentrations in a sub-group of patients. In the third study, LIA was compared with intrathecal morphine for postoperative pain relief following total knee arthroplasty (III). Pain scores and morphine consumption were lower, length of hospital stay was shorter and patient satisfaction was higher in the LIA group. In the final study, we investigated the effect of minimally invasive surgery (MIS) compared with conventional surgery in unicompartmental knee arthroplasty (IV). Both groups received LIA. We found no statistically significant differences in postoperative pain, morphine consumption, knee function, home readiness, hospital stay or patient satisfaction. In conclusion, LIA provided better postoperative pain relief and earlier mobilization than placebo, both in unicompartmental and total knee arthroplasty. When compared to intrathecal morphine, LIA also resulted in improved postoperative pain relief and earlier mobilization. Minimally invasive surgery did not improve outcomes after unicompartmental knee arthroplasty, when both groups received LIA.
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Tresierra, Paz José Gabriel. "Sedación y analgesia postoperatoria con dexmedetomidina." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2005. https://hdl.handle.net/20.500.12672/1812.
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Objetivo: Determinar la eficacia analgésica y sedativa de la dexmedetomidina así como la seguridad de la administración de la misma en pacientes postoperados
Metodología: Se diseño un estudio descriptivo, serie de casos, longitudinal, prospectivo a simple ciego, la muestra incluyo 25 pacientes (relacionado al costo de la droga y la dificultad para su obtención) que cumplieron con los criterios de inclusión:
a.- Edad: 18 a 65 años.
b.- Pacientes ASA I – II
c.- Pacientes sometidos a anestesia general operados de colecistectomía laparoscópica
d.- Pacientes que no presenten alergia conocida a cualquiera de los medicamentos usados dentro del protocolo del estudio
Un observador vigilo el cumplimiento del protocolo intraoperatorio y otro monitorizo y registro los valores relacionados a cambios hemodinámicos y ventilatorios, así como los valores de EVA para el dolor y Ramsay para sedación en la Unidad de Recuperación post-Anestésica. Los datos obtenidos fueron ingresados a una hoja de cálculo en Excel y procesados y analizados con el programa SPSS
Resultados: Un 92% de los pacientes estaban comprendidos entre los 40 y 65 años, la mitad de ellos comprendidos en cada sexo 52% masculino y 48% femenino. En relación a la eficacia analgésica se observó una disminución progresiva de los valores de EVA a medida que se desarrollaba la infusión, sin embargo un 40% de los pacientes fue necesario un complemento analgésico con opioide para alcanzar el objetivo analgésico (EVA menor de 4). En relación a la eficacia sedativa se observó una progresiva profundidad en los niveles de sedación destacándose sin embargo la cualidad de “sedación activa” descrita para la droga. En relación a la seguridad de la administración se evidencian cambios predecibles de la frecuencia cardiaca: bradicardia en un 80% de los pacientes, que responden fácilmente a la administración de atropina. Se observó además hipotensión en 20% de los casos, no siendo necesario en ningún caso el uso de vasopresores. No se evidencia depresión ventilatoria en ningún caso.
Conclusiones: La infusión de dexmedetomidina por sí misma no evidencia ser suficiente para aliviar el dolor de los pacientes sometidos al estudio probablemente disminuya los requerimientos de analgésicos opioides. La eficacia sedativa ha sido demostrada. Así mismo se demuestra que la droga es segura con la dosis administrada en el presente estudio.Tesis de segunda especialidad
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Morton, Debbie L. "Cognitive changes due to placebo analgesia." Thesis, University of Manchester, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.511238.
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Morana, Rosario. "Analgesia non farmacologica del dolore postoperatorio." Doctoral thesis, Università di Catania, 2012. http://hdl.handle.net/10761/1243.
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Dati della letteratura riportano che Il trattamento del dolore postoperatorio risulta essere una prassi poco diffusa e di applicazione spesso non adeguata. Con il presente lavoro si è inteso studiare, in un reparto di Chirurgia Generale il trattamento del dolore postoperatorio, valutando l utilizzo di farmaci antidolorifici in soggetti trattati con metodiche analgesiche non farmacologiche (nella fattispecie, mediante utilizzo di patches elettromagnetici), confrontandolo l utilizzo di farmaci antidolorifici in soggetti senza trattamento non farmacologico del dolore postoperatorio. Tale studio, svolto su una popolazione di 108 pazienti (60 uomini e 48 donne) si è concentrato su due tipologie di intervento chirurgico, diffuse nel territorio: colecistectomia in VLS ed ernia inguinale. A questi pazienti, è stato somministrato, quando richiesto dal soggetto, il trattamento non farmacologico, riservando l intervento farmacologico in caso di inefficacia del primo trattamento. Allo stesso tempo, è stato effettuato un confronto con un gruppo di controllo di 72 pazienti (36 uomini e 36 donne) nei quali il dolore postoperatorio è stato trattato, quando richiesto, in modo esclusivamente farmacologico. I risultati ottenuti mostrano una netta diminuzione di ricorso alla terapia antidolorifica in coloro che sono stati trattati con i patches elettromagnetici, che, nella grande maggioranza dei casi, si sono dimostrati in grado di agire sul dolore in modo adeguato e con tempi rapidissimi, suggerendo una nuova metodica di trattamento del dolore postoperatorio.
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Saavedra, Díaz Paola Sofía. "Analgesia con acupuntura comparada con la analgesia con lidocaína al 2% en el tratamiento de pulpitis reversible sintomática." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2011. https://hdl.handle.net/20.500.12672/11702.
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Publicación a texto completo no autorizada por el autorCon el objetivo de evaluar el efecto analgésico de la acupuntura en el tratamiento de pulpitis reversible sintomática, se realizó un estudio descriptivo, transversal, comparativo en el Centro de Salud Condevilla perteneciente a la Red de Salud Rímac – SMP- LO de la Dirección de Salud V Lima – ciudad; comparando el efecto analgésico de la lidocaína al 2% con el efecto analgésico de la acupuntura conectando las agujas a un electroestimulador. Se incluyeron 40 pacientes de ambos géneros cuyas edades se encontraban entre los 18 y 55 años que aceptaron participar en el estudio mediante consentimiento informado. En un grupo de 20 pacientes se colocaron las agujas de acupuntura en los resonadores 4IG bilateral y el 44E bilateral estimulando las agujas de acupuntura con un electroestimulador hasta que el paciente manifestó según la Escala Visual Análoga (EVA) la disminución del dolor a dolor leve, en los 20 pacientes restantes se administró lidocaína al 2% hasta que los pacientes manifestaron la disminución del dolor a no dolor antes de iniciar el tratamiento de operatoria dental. Se pudo observar que ambas técnicas presentaron diferente efectividad; siendo la técnica analgésica con lidocaína estadísticamente de mayor efecto analgésico, el tiempo de acción en la analgesia con lidocaína es estadísticamente mayor; el tiempo de latencia en la analgesia con acupuntura es estadísticamente mayor y en la analgesia con lidocaína se produjeron estadísticamente mayor cantidad de complicaciones.
Tesis
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Escudero, Lara Alejandra 1992. "Targeting endogenous analgesia systems for endometriosis treatment." Doctoral thesis, TDX (Tesis Doctorals en Xarxa), 2021. http://hdl.handle.net/10803/671695.
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Endometriosis is a chronic inflammatory disease that affects 1 in 10 women of childbearing age. It is characterized by the growth of endometrium in extrauterine locations and is associated with chronic pelvic pain, infertility, emotional distress and loss of working ability. Current clinical management provides unsatisfactory outcomes. Thus, the development of more effective therapeutic strategies is still an unmet clinical need, and their development relies on the establishment of animal models that recapitulate the features of endometriosis. The present Thesis has characterized a surgical model of endometriosis that shows nociceptive, affective-like behaviors and impaired cognition, reproducing the symptoms observed in endometriosis patients. In this model of endometriosis, natural cannabinoids alleviate nociceptive behaviors, restore cognitive function and inhibit the development of endometriotic growths. A kappa opioid receptor agonist also shows pain-relieving properties in this model, although affective and cognitive disturbances persist regardless of the pain alleviation. A minimally invasive model of endometriosis that also mimics the symptoms of human endometriosis revealed that minimal endometriosis leads to neuroinflammation in the central nervous system.La endometriosis es una enfermedad inflamatoria crónica que afecta a 1 de cada 10 mujeres en edad fértil. Se caracteriza por el crecimiento de tejido endometrial fuera del útero y se asocia con dolor pélvico crónico, infertilidad, alteraciones emocionales y disminución de la capacidad de trabajo. Los tratamientos actuales proporcionan resultados insatisfactorios. Por lo tanto, se necesitan estrategias terapéuticas más eficaces y su desarrollo depende de la disponibilidad de modelos animales que recapitulen las características de esta enfermedad. La presente Tesis ha caracterizado un modelo quirúrgico de endometriosis que muestra alteraciones nociceptivas, afectivas y cognitivas, reproduciendo los síntomas de la endometriosis. En este modelo, el tratamiento con fitocannabinoides alivia las manifestaciones nociceptivas, restaura la función cognitiva e inhibe el desarrollo del tejido endometrial ectópico. El tratamiento con un agonista del receptor opioide kappa también reduce las manifestaciones nociceptivas de este modelo, aunque no modifica las alteraciones afectivas y cognitivas. Se ha utilizado un modelo mínimamente invasivo, que también reproduce los síntomas de la endometriosis, para explorar los cambios neuroinflamatorios inducidos por la presencia de células endometriales ectópicas. En este modelo, la endometriosis mínima-leve provoca neuroinflamación en el sistema nervioso central.
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Ocvirk, Rok. "Quantifying formalin-induced behaviours and morphine analgesia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0016/MQ55083.pdf.
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Lammer, Peter. "Applications of mathematical modelling in demand analgesia." Thesis, University of Oxford, 1986. http://ora.ox.ac.uk/objects/uuid:781c3d6b-9c17-4fca-a8df-93b0bd18d93e.
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This thesis describes applications of mathematical modelling to systems of demand analgesia for the relief of acute postoperative pain. It builds upon work described in the D.Phil. thesis of M.P. Reasbeck. Following major surgery, patients are given a hand-held button which they press when in need of pain relief. The relief is afforded by automatic intravenous infusion of opiates. New clinical demand analgesia hardware, PRODAC, has been developed and data have been collected with it in two major trials involving a total of 80 patients. Patients' drug requirements have been found not to be correlated with body weight, contrary to conventional teaching. The type of operation was also found to have no significant influence upon drug requirements. The performance of transcutaneous nerve stimulation (TNS) as a method of analgesia for acute postoperative pain has been studied and found to be poor. Reasbeck's mathematical model of patients in pain has been corrected and extended. The representation of pharmacokinetics has been enhanced by modelling the transfer of drug between blood plasma and analgesic receptor sites as a first-order process. The time constant of this process has been calculated for morphine using a novel method and found to be 12 minutes. On line estimation of 2nd order pharmacokinetic time constants has been found in simulation not to be feasible. New software has been used to tune the revised model to the clinical data collected with PRODAC. Model behaviour is now demonstrably life-like, which was not previously the case. Blood samples taken during demand analgesia have permitted a comparison between measured and estimated drug concentrations, with good results.
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Lee, Franklin. "The Effects of Rhes on Opioid Analgesia." ScholarWorks@UNO, 2010. http://scholarworks.uno.edu/td/1254.
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Rhes (Ras homolog enriched in striatum) has been identified as a novel monomeric G-protein involved in dopaminergic and other signaling in the striatum. Given the many effects of opioids that involve striatal circuitry, genetically engineered mice that are incapable of making Rhes (rhes-/-) and their control littermates (rhes+/+) were subjected to behavioral tests to determine if any differences existed in opioid analgesia, tolerance, withdrawal, reward, and locomotion. Rhes-/- mice showed an increased opioid mediated analgesia, along with an absence of tolerance and decrease in withdrawal when compared with rhes+/+ littermates. However, no significant changes were seen in opioid induced locomotor activation or conditioned place preference. These results provide strong evidence for the implication of Rhes in opioid signaling.
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Robinson, Susan. "Patient-controlled analgesia in the postoperative period." Thesis, University of Leicester, 1995. http://hdl.handle.net/2381/34214.
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Patient-controlled delivery systems deliver drugs at a rate which is controlled by the patient in order to achieve plasma concentrations consistent with acceptable efficacy and minimal side-effects. They can be used therapeutically to provide pain relief after surgery and as a research tool to measure the efficacy of other analgesic techniques. Patient-controlled analgesia (PCA) was investigated in the postoperative period. Comparative studies of PCA devices revealed little difference in terms of clinician and patient satisfaction. As a research tool, PCA proved useful in evaluating alternative methods of providing postoperative analgesia. Ambulatory PCA devices were more portable (p=0.01) on the first postoperative day with less nausea (p=0.02) on the second. Mean (SEM) postoperative morphine requirements were 82.9 (9.8) mg and 120.6 (17.5) mg for the ambulatory and bedside PCAS respectively (p=0.06). Mean (SEM) postoperative morphine consumption between the electronic 35.1 (8.5) mg and nonelectronic devices 35.7 (6.6) mg were similar (p=0.77). In evaluating other methods of analgesia, there was no significant difference between active and placebo TCENS. Mean (SEM) postoperative opioid requirements were 35.6 (5.3) mg and 31.6 (3.5) mg for the active and placebo groups respectively (p=0.5). Subcutaneous wound infiltration with bupivacaine 0.5% also failed to decrease mean (SEM) opioid requirements for the first postoperative day, which were 56.7 (6.1) mg and 67.3 (6.4) mg for the bupivacaine and saline groups respectively (p=0.89). When diamorphine and morphine were compared for dose and effect, the postoperative mean (SEM) requirements were 20.2 (2.4) mg and 44 (6.8) mg respectively (p=0.004). No significant differences were found in side-effects. After PCA and i.m. morphine no differences were detected in mean (SEM) postoperative consumption - 34.8 (5.0) mg and 30.2 (6.7) mg in the PCA and i.m. groups respectively (p=0.17). Overall requirements for antiemetics were not significant (p=0.69). In the PCA group, 53% patients did not vomit, were not nauseated and did not require antiemetics compared with 27% patients in the i.m. group (p=0.14).
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BERRINI, ANTONIO. "La sedo-analgesia nell'esecuzione della biopsia osteomidollare." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2012. http://hdl.handle.net/2108/209759.
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Barros, Guilherme Antonio Moreira de [UNESP]. "Considerações sobre analgesia controlada pelo paciente (PCA) em hospital universitário." Universidade Estadual Paulista (UNESP), 2001. http://hdl.handle.net/11449/86638.
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barros_gam_me_botfm.pdf: 228323 bytes, checksum: 6466d10f0d4eb9a3ff79e8f785fea941 (MD5)Com o rápido avanço que foi observado nos últimos anos nas técnicas cirúrgicas e anestésicas, os procedimentos se tornaram cada vez mais invasivos. Como houve progressivo envelhecimento da população, o período mais delicado de recuperação, ou seja, o pós-operatório, passou a receber maior atenção. O surgimento de novas técnicas de analgesia, como a Analgesia Controlada pelo Paciente (PCA), vem preencher as necessidades da comunidade médica, cada vez mais atenta à qualidade dos serviços prestados. O Hospital de Clínicas da Faculdade de Medicina da UNESP, Botucatu, atento a essa nova realidade constituiu o Serviço de Dor Aguda (SEDA) para que esta lacuna fosse também preenchida em nosso meio. No intuito de identificar a atuação do SEDA, realizou-se levantamento, de fevereiro de 1995 a dezembro de 1997, com a pesquisa das evoluções de 679 pacientes seguidos pelo SEDA e que fizeram uso do método PCA de analgesia. Observou-se que os resultados obtidos pelo Serviço estavam acima da média relatada pela literatura internacional, com excelentes níveis de analgesia atingidos, baixa ocorrência de efeitos colaterais, e nenhuma complicação fatal no período do estudo.
In the past years a fast developing has been observed in the surgery and anesthetic technique, with more invasive procedures being performed. As the general population has becoming older, the critical recovery period, it means the post surgery period, became focus of attention. The developing of new analgesia techniques, such as Patient Controlled Analgesia (PCA), has the intention of fulfill the needs of the medical community, day by day more aware about the quality of the services. The Hospital of the Sao Paulo State Medical School, Botucatu, aware of this new reality had decided to form the Acute Pain Management Service (SEDA). With the goal of identify the way the SEDA acts this research was realized in period between February, 1995, to December, 1997. Data of 679 patients who used the PCA device were evaluated. The results in this study were as good as the international literature shows, with high quality analgesia, low side effects and no fatal complications on the period observed.
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Mattuschka, Lisanne [Verfasser]. "Korrelationen und Übereinstimmungen zwischen Surgical Pleth Index, Analgesia Nociception Index und klinischen Zeichen mangelnder Analgesie während Allgemeinanästhesien / Lisanne Mattuschka." Kiel : Universitätsbibliothek Kiel, 2017. http://d-nb.info/1128731541/34.
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Tucker, Adam Paul 1965. "An evaluation of the spinal and supraspinal actions of analgesic drugs." Monash University, Dept. of Anaesthesia, 2002. http://arrow.monash.edu.au/hdl/1959.1/8492.
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Rane, Lindgren Kerstin. "Intrathecal adenosine for treatment of acute pain : safety assessments and evaluation in experimental, surgical and labour pain /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-750-9.
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Barros, Guilherme Antonio Moreira de. "Considerações sobre analgesia controlada pelo paciente (PCA) em hospital universitário /." Botucatu : [s.n.], 2001. http://hdl.handle.net/11449/86638.
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Orientador: Lino LemonicaResumo: Com o rápido avanço que foi observado nos últimos anos nas técnicas cirúrgicas e anestésicas, os procedimentos se tornaram cada vez mais invasivos. Como houve progressivo envelhecimento da população, o período mais delicado de recuperação, ou seja, o pós-operatório, passou a receber maior atenção. O surgimento de novas técnicas de analgesia, como a Analgesia Controlada pelo Paciente (PCA), vem preencher as necessidades da comunidade médica, cada vez mais atenta à qualidade dos serviços prestados. O Hospital de Clínicas da Faculdade de Medicina da UNESP, Botucatu, atento a essa nova realidade constituiu o Serviço de Dor Aguda (SEDA) para que esta lacuna fosse também preenchida em nosso meio. No intuito de identificar a atuação do SEDA, realizou-se levantamento, de fevereiro de 1995 a dezembro de 1997, com a pesquisa das evoluções de 679 pacientes seguidos pelo SEDA e que fizeram uso do método PCA de analgesia. Observou-se que os resultados obtidos pelo Serviço estavam acima da média relatada pela literatura internacional, com excelentes níveis de analgesia atingidos, baixa ocorrência de efeitos colaterais, e nenhuma complicação fatal no período do estudo.
Abstract: In the past years a fast developing has been observed in the surgery and anesthetic technique, with more invasive procedures being performed. As the general population has becoming older, the critical recovery period, it means the post surgery period, became focus of attention. The developing of new analgesia techniques, such as Patient Controlled Analgesia (PCA), has the intention of fulfill the needs of the medical community, day by day more aware about the quality of the services. The Hospital of the Sao Paulo State Medical School, Botucatu, aware of this new reality had decided to form the Acute Pain Management Service (SEDA). With the goal of identify the way the SEDA acts this research was realized in period between February, 1995, to December, 1997. Data of 679 patients who used the PCA device were evaluated. The results in this study were as good as the international literature shows, with high quality analgesia, low side effects and no fatal complications on the period observed.
Mestre
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Niu, Katelyn Y. "Sex differences in cannabinoid and opioid mediated analgesia." Thesis, University of Maryland, Baltimore, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3563358.
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Orofacial musculoskeletal pain conditions, such as temporomandibular disorder (TMD), are debilitating and often difficult to treat. As with many chronic pain conditions, TMD occurs more frequently in women. Thus, understanding mechanisms underlying sex differences in pain and analgesia is essential for effective pain management in both sexes. This study introduces the potential therapeutic advantage of targeting cannabinoid 1 receptor (CB1) localized in primary afferent neurons under myositis conditions. Although sex differences in CB1 responses are recognized in the CNS, it is not known whether such sex differences exist in the periphery. Therefore, I investigated whether peripheral cannabinoid treatment leads to sex differences in anti-hyperalgesic effects, and whether the effects are mediated by sex differences in CB1 level in trigeminal ganglia (TG) under a rodent orofacial myositis model. Peripherally administered ACPA, a specific CB1 agonist, significantly attenuated inflammation-induced mechanical hypersensitivity in the masseter of male rats. In female rats, a 30-fold higher dose of ACPA was required to produce a reduction in mechanical hypersensitivity. CFA injected in masseter muscle significantly up-regulated CB1 mRNA expression in TG from males, but not from females, and CB1 mRNA levels in TG were positively correlated with the anti-hyperalgesic effect of ACPA. IL-1β and IL-6, elevated in the muscle tissue following inflammation, induced a significant up-regulation of CB1 mRNA expression in TG cultures from male rats. The up-regulation of CB1 was prevented in TG cultures from orchidectomized males, and was restored by testosterone treatment. The cytokines did not alter the CB1 mRNA level in TG from intact or ovariectomized female rats. Neither estradiol nor estrogen receptor blockade had any effect on CB1 expression. Similar results were obtained regarding cytokine-induced regulation of μ-opioid receptor (MOR) in TG, another important peripheral target for pain management. These data indicate that testosterone, but not estradiol, is required for the regulation of CB1 and MOR in TG under inflammatory conditions, which explains the sex differences in the anti-hyperalgesic effects of peripherally administered agonists. These data offer important new insights for the development of mechanism-based sex-specific pharmacological treatment alternatives that can be directed at the peripheral anti-nociceptive systems to ameliorate persistent pain.
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Chumbley, Gillian Mary. "Patients' evaluation of patient controlled analgesia after surgery." Thesis, St George's, University of London, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249438.
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Gorham, Louise. "The role of somatostatin 4 receptors in analgesia." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/the-role-of-somatostatin-4-receptors-in-analgesia(ad132ebf-00e6-4157-948c-46da793abdf5).html.
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Pain is an unpleasant sensory or emotional experience associated with potential or actual tissue damage; presenting a worldwide debilitating problem. Somatostatin is a regulatory cyclic neuropeptide with inhibitory roles in the central nervous system (CNS) via activation of the five somatostatin receptor subtypes belonging to the family of G protein-coupled receptors (GPCRs). Somatostatin is known to exert analgesic effects, which are in part achieved by activation of the somatostatin 4 (sst4) receptor subtype. This research aimed to gain a greater understanding of the role of sst4 receptors in analgesia, with a particular interest in elucidating molecular mechanisms. Using the synthetic sst4 receptor selective agonist, J-2156, the behavioural analgesic profile was established in four analgesic models: the inflammatory Complete Freund ́s Adjuvant (CFA) and monosodium iodacetate (MIA) models; and the neuropathic partial nerve ligation (PNL) and streptozotocin-induced diabetes (STZ) models. Following this mode of action studies were conducted on dissociated dorsal root ganglion (DRG) neurons. J-2156 has a potent analgesic profile. Maximal analgesic effects were seen at 1 mg/kg in all pain models except the MIA model, which required a dose of 10 mg/kg. Analgesia was long-lasting in inflammatory pain models, where significant improvements were present at 24 hours post compound administration. J-2156 modulated the activity of a variety of ion channels within DRG neurons. Activation of sst4 receptors induced a G-protein gated inwardly rectifying potassium channel (GIRK) current and inhibited voltage sensitive calcium channel (Cav), transient receptor potential vanilloid channel (TRPV1) and transient receptor potential ankyrin channel (TRPA1) currents. For all ion channels a concentration-dependent effect was observed, with significant effects first being produced at 10 nM and maximal effects reached at 100 nM. J-2156 caused a significant reduction in paw volume, however this was only seen at doses 10-times that required for analgesia in the CFA model, at 10 mg/kg. This was independent of paw neutrophil and cytokine levels. A significant reduction in inflammatory mediator release from stimulated DRG neurons was observed following incubation with J-2156. The inhibition produced was bell-shaped, where maximal effects were observed at 30 nM. J-2156 modulated the expression of a number of previously characterised pain, inflammatory and immune genes in both DRG neurons and paw tissue, suggesting that the analgesia is in part due to gene normalisation. Overall, this work provides a novel insight into the role of sst4 receptor activation in nociception in chronic pain conditions, indicating contributory molecular mechanisms to the analgesia. From these results it can be concluded that the sst4 receptor presents an appropriate target for novel broad treatment analgesia.
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Riedel, Bernard J. C. J. "Epidural analgesia for coronary artery bypass graft surgery." Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/25890.
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On reviewing the medical literature, there is a clear resurgence of interest in the use of TEA (thoracic epidural analgesic) in cardiac anaesthesia. This resurgence was brought about by laboratory-based evidence that TEA-induced sympatholysis may be cardioprotective through the promotion of myocardial blood flow to areas at-risk and subsequent early, small clinical studies suggesting that TEA was feasible, and possibly also beneficial in CABG surgery [Joachimsson et. al, 1989; Liem (1-3) et. al, 1992; Stenseth et. al, 1994]. Despite the positive results of these early studies and suggestions that TEA may be the preferred anaesthetic/analgesic technique in select groups of patients (promoting early extubation and fast-tracking) undergoing cardiac surgery, many anaesthetists are still reluctant, however, to use this technique because of the theoretical increased risk of the patient suffering a spinal haematoma and subsequent paraplegia. In order to outweigh this theoretical risk it is important that we show that added benefit, in addition to the provision of analgesia and expedited postoperative convalescence, can be obtained by using TEA. It is therefore our duty as anaesthetists and perioperative physicians to determine whether TEA may also affect the pathophysiology of the disease process, especially in the perioperative period - and thereby influencing the subsequent long term outcome and quality of life of the patient. An example of this latter point would be the potential role of TEA in; • reducing the incidence of perioperative myocardial infarction (P-MI), through the suggested cardioprotective effects of TEA, • reducing the incidence of early postoperative graft failure, through either; * reduction of native coronary artery and/or graft (conduit) spasm, or * reduction of postoperative hypercoagulability.
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Laurila, née Kostamovaara P. (Päivi). "Pain relief after joint surgery:a clinical study." Doctoral thesis, University of Oulu, 2002. http://urn.fi/urn:isbn:9514267958.
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Abstract
Excessive pain after surgery causes many kinds of endocrine, metabolic and inflammatory responses, which may increase postoperative morbidity and mortality - especially among elderly patients. This study evaluated the effect of peripheral and central pain relief techniques after joint surgery.
Intravenously administered doses of 100 mg, 200 mg and 300 mg of ketoprofen decreased the requirement for opioid (fentanyl) in a dose-dependent manner by 38%, 45% and 53%, respectively, compared with a placebo, without any noticeable ceiling-effect, when administered after hip and knee arthroplasty. Patients receiving a 300 mg dose of ketoprofen had significantly lower postoperative pain scores than those receiving a placebo. There were no significant differences in incidences of nausea and vomiting, or in the amount of bleeding between the ketoprofen and placebo groups.
Intravenous doses of 200 mg of ketoprofen, 150 mg of diclofenac, and 120 mg of ketorolac produced similar postoperative pain scores and requirement for opioid (fentanyl) with no intergroup differences in the incidence of nausea and vomiting and in the amount of bleeding, when administered after hip arthroplasty.
The addition of ropivacaine, 1 mg·ml-1, did not decrease the requirement for epidural fentanyl administered via a patient-controlled analgesia device for postoperative pain relief after hip arthroplasty. Both drug infusions provided effective pain relief. The most common adverse effect was pruritus, which occurred in a similar number of patients in both groups.
An interscalene brachial plexus block with ropivacaine decreased the dose of PCA-delivered oxycodone by 78% after arthroscopic shoulder surgery while subacromial bursa blockade with ropivacaine decreased it by only 11 % compared to a placebo during the 20 hour study period. Postoperative pain scores were significantly lowest with a interscalene brachial plexus block.
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Martinez, Flores Francisco E. "Evaluación Analgésica Post Quirúrgica con Quetorolaco Vs. Diclofenaco Vs. Metamizol." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2002. https://hdl.handle.net/20.500.12672/2097.
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Evalúa la eficacia del ketorolaco como analgésico postquirúrgico versus el diclofenaco versus metamizol. Determina si el uso del ketorolaco brinda mayor analgesia que los medicamentos ya mencionados. Identifica las ventajas de los tres analgésisos mediante la escala análoga visual.Tesis de segunda especialidad
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Pinheiro, Marcos Luciano Pimenta. "Infiltração submucosa intrabucal de betametasona na previsão ou controle da dor em endodontia." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290791.
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Orientador: Eduardo Dias de AndradeTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A dor pós-operatória decorrente de procedimentos endodônticos ainda se constitui numa grande preocupação do cirurgião-dentista.O objetivo desta pesquisa foi avaliar os efeitos da betametasona na prevenção ou controle da dor pós-operatória, em duas situações distintas: na primeira etapa ('E IND. 1¿), a prevenção da dor decorrente de tratamentos endodônticos eletivos, em sujeitos previamente assintomáticos;na segunda fase ('E IND. 2¿), o controle da dor já estabelecida,no caso das urgências endodônticas. Foram selecionados 102 voluntários em bom estado de saúde geral para a 'E IND. 1¿ e 120 sujeitos para a 'E IND. 2¿, que receberam os seguintes tratamentos: injeção infiltrativa de uma solução de betametasona (0,05 mg/Kg de peso corporal) ou placebo (solução salina, num volume equivalente), administrada pela via submucosa, na face vestibular da região apical do dente envolvido, imediatamente após o final da intervenção, de forma aleatória e duplo-cega. A intensidade de dor foi avaliada por meio de escalas verbais descritivas, nos tempos de 4, 24 e 48 horas após o tratamento, por contato telefônico. Os dados foram tratados estatisticamente pelos testes Exato de Fischer, Mann-Whitney e Qui-quadrado ('alfa¿=5%), demonstrando que na primeira etapa, a intensidade de dor pós-operatória foi significativamente menor nos pacientes tratados com a betametasona, em relação ao placebo, nos 3 tempos de estudo (4 horas: p = 0,0007, 24 horas: p = 0,0022, 48 horas: p = 0,0126). Na segunda etapa, o controle da dor também foi mais eficaz no grupo tratado com a betametasonanos tempos de 4 horas (p = 0,0177) e 24 horas (p = 0,0012), se comparado ao placebo. Com base no conceito de que a dor decorrente da instrumentação em endodontia é, de forma geral, de maior intensidade nas primeiras 24 horas após o procedimento, conclui-se que a betametasona pode ser indicada como terapia adjuvante aos procedimentos clínicos de ordem local, tanto nos tratamentos eletivos quanto nas urgências endodônticas
Abstract: Posttreatment endodontic pain is still a significant problem in dentistry. The aim of this randomized double-blind study was to evaluate, in two stages, the effect of betamethasone on the control of postoperative pain in patients submitted to endodontic treatment. In the first stage, patients were asymptomatic, whereas in the second, pain was already present before the treatment. Volunteers (n=102), both genders, were submucosally injected with a single dose of a betamethasone solution (0.05 mg/body weight) or a sterile saline solution (placebo) after endodontic treatment completion. All volunteers received a vestibular injection periapically to the tooth treated. To assess pain intensity, verbal descriptive scales were given to all volunteers. Answers were given from their homes by telephone at 4, 24, and 48 hours afier endodontic treatment. The Chi-square, Mann-Whitney and Fischer's exact tests were used for statistical analysis. In the first stage, pain intensity was significantly lower for patients treated with betamethasone in the three periods tested (4 hours: p=0.0007;24 hours: p=0.0022; 48 hours: p=0.0126), when compared to placebo. In the second stage, pain was also better controlled by betamethasone at periods of 4 hours (p=0.0177) and 24 hours (p=0.0012) for patients treated with betamethasone, when compared to placebo. In conclusion, once the pain caused by endodontic instrumentation is in general more intense at the first 24 hours after treatment, betamethasone might be used as an adjuvant therapy to pain control in endodontic procedures
Doutorado
Farmacologia, Anestesiologia e Terapeutica
Doutor em Odontologia
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Spindola, Humberto Moreira. "Atividade antinociceptiva e antitumoral de compostos isolados da Pterodon pubescens Benth. (Leguminosae- papilionoidea)." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288226.
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Orientadores: Mary Ann Foglio, João Ernesto de CarvalhoTese (doutorado) - Universidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba
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Resumo: A espécie vegetal Pterodon pubescens Benth tem seu uso amplamente difundido na medicina popular. Neste trabalho, demonstramos de forma específica a atividade antinociceptiva (analgésica) e antitumoral de compostos isolados da espécie. Os resultados mais expressivos foram: 1) fracionamento, isolamento e identificação de compostos biomonitorados por ensaios experimentais in vitro e in vivo; 2) identificação dos compostos 6?-acetoxi-7?-hidroxivouacapano (inédito), éster 6?,7?-diidroxivouacapano-17?-oato de metila e 6?,7?-diidroxivouacapano- 17?-metilenol com atividade antitumoral in vitro específica para uma linhagem celular de próstata (PC-3); 3) biodisponibilidade dos compostos geranilgeraniol e ?ter 6?,7?-diidroxivouacapano-17?-oato de metila com atividade antitumoral através de ensaios in vivo; 4) mecanismos de modulação analgésica dos compostos geranilgeraniol e éster 6?,7?-diidroxivouacapano-17?-oato de metila atribuídos a dor inflamatória, dor neurogênica, receptores gluatamatérgicos, receptores vanilóides, e possível exclusão de receptores opióides; 5) ação antialodínica e anti-hiperalgésica dos compostos geranilgeraniol e éster 6?,7?- diidroxivouacapano-17?-oato de metila, que demonstraram atividade medular e central; 6) mecanismos da ação antinociceptiva relacionados síntese e/ou liberação de serotonina (5-HT) para o composto éster 6?,7?-diidroxivouacapano- 17?-oato de metila e especificidade por receptores serotonérgicos 5-HT3 e imidazólicos I1 para o composto geranilgeraniol. Os resultados apresentados no presente trabalho permitiram determinar a eficácia dos compostos relacionada à atividades analgésica e antitumoral.
Abstract: Pterodon pubescens Benth. species is widespread used in folk medicine. In this study, we demonstrated the antinociceptive (analgesic) and anti-tumor activity of compounds isolated from species. The most relevant results were: 1) bioactivityguided fractionation, isolation and identification of compounds using in vitro and in vivo assays; 2) identification of compounds 6?-acetoxy-7?-hydroxyvouacapan; 6?,7?-dihydroxyvouacapan-17?-oate methyl ester and 6?,7?-dihydroxyvouacapan-17?-metilenol with selectivity for prostate cell line (PC-3); 3) bioavailability of compounds geranylgeraniol and 6?,7?-dihydroxyvouacapan-17?-oate methyl ester with antitumor activity confirmed by in vivo assays; 4) analgesic modulation mechanisms of compounds geranylgeraniol and 6?,7?-dihydroxyvouacapan-17?-oate methyl ester related to inflammatory pain, neurogenic pain, glutamate receptors, vanilloid receptors, and possible exclusion of opioid receptors, 5) antiallodynic and anti-hyperalgesic activities of compounds geranylgeraniol and 6?,7?-dihydroxyvouacapan-17?-oate methyl ester demonstrating spinal and central activity; 6) the antinociceptive mechanisms related to the synthesis and / or release of serotonin (5-HT) for compound 6?,7?-dihydroxyvouacapan-17?-oate methyl ester, and specificity for serotonergic 5-HT3 and imidazoline I1 receptors for geranylgeraniol . The results presented in this study allowed us to determine the efficacy of compounds related to analgesic and anti-tumor activities, with potential for development as drugs.
Doutorado
Farmacologia, Anestesiologia e Terapeutica
Doutor em Odontologia
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Torres, Chavez Karla Elena 1978. "Mecanismos envolvidos na ação anti-hiperalgésica do agonista opióide mu no tecido periférico." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290420.
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Orientador: Carlos Amilcar ParadaTexto em português e inglês
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Os objetivos deste estudo foram: (1) Verificar se a administração local de prostaglandina E2 (PGE2) no tecido periférico aumenta o efeito anti-hiperalgésico da ativação do receptor opióide mu e se este efeito é mediado por um aumento da expressão de receptor opióide mu (2) Testar se o efeito anti-hiperalgésico da ativação do receptor opióide mu no tecido periférico está associada com a diminuição da excitabilidade das fibras-C. De acordo com o objetivo (1)... Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital
Abstract: The aims of this study were:(1) To verify whether local administration of E2 prostaglandin (PGE2) in peripheral tissue increases the anti-hyperalgesic effect of mu opioid receptor activation and whether this effect is mediated by an increased expression of mu opioid receptor (2) To test if the anti-hyperalgesic effect of the activation of mu opioid receptor in peripheral tissue is associated with the decrease of C-fibers excitability. According to the objective(1)... Note: The complete abstract is available with the full electronic document
Doutorado
Fisiologia Oral
Doutor em Odontologia
47
Sousa, Rejane dos Santos. "Avaliação de anti-inflamatórios não esteróidais no tratamento da laminite asséptica aguda decorrente de acidose ruminal por oligofrutose em bovinos." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/10/10136/tde-27072017-164410/.
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Objetivou-se avaliar as alterações ruminais e sistêmicas da indução de acidose ruminal e laminite em zebuínos por meio do oferecimento de oligofrutose bem como caracterizar o quadro de laminite, comparar métodos diagnósticos e avaliar a eficácia entre tratamentos com três anti-inflamatórios não esteróidais (AINEs). Foram utilizadas 29 novilhas Nelore, providas de cânula ruminal e pesando 474,5±58,5 kg. A indução iniciou-se com a administração intraruminal de 0,765 g/kg de oligofrutose duas vezes ao dia por três dias consecutivos, seguida de dose única de 10,71g/kg de oligofrutose administrada 72 horas após o início da indução. Durante o período de indução os animais foram submetidos a exame clinico e coleta de sangue e fluido ruminal diariamente e após a dose maior foram avaliados a cada seis horas (durante as 24 horas iniciais) e a cada 12 horas (até 72 horas pós-indução). Duas novilhas não apresentaram quadro de laminite e foram descartadas. Quase metade dos animais (48,1%) teve que ser tratada com bicarbonato e solução salina para correção da acidose metabólica e desidratação. Devido a este tratamento os animais foram analisados em grupos medicado (n=13) e não medicado (n=14). Durante o período de avaliação pós-indução o diagnóstico da laminite foi confirmado após duas respostas positivas ao teste de sensibilidade dolorosa e escore de locomoção. As novilhas com laminite foram alocadas aleatoriamente em quatro grupos que receberam por três dias consecutivos dose diária (endovenosa) dos seguintes medicamentos: Controle (8 mL solução salina isotônica; n=6); Flunixin meglunine (1,1 mg/kg; n=7); Cetoprofeno (3 mg/kg; n=7) e Meloxican (0,5 mg/kg; n=7). Após o início do tratamento com AINEs os animais foram avaliados a cada 12 horas durante 96 horas. A fermentação máxima da oligofrutose ocorreu entre a 6ª e a 12ª h pós-indução com destacado acúmulo de ácido láctico, intensa diminuição da anaerobiose e aumento temporário na osmolaridade ruminal. No grupo medicado existiu uma correlação positiva entre o pH ruminal e o pH sanguíneo (r = 0,90; P = 0,0040), e uma correlação negativa entre o pH sanguíneo e a osmolaridade sanguínea (r =-0,69; P =0,0090) no auge da fermentação ruminal. Ambos os grupos tiveram uma febrícula efêmera e compensação respiratória frente à acidose sistêmica. A maioria dos animais desenvolveu laminite da 24ª h a 72ª h em dígitos de dois membros e uma pequena porcentagem (29,6%) polisinovite nas articulações tarsocrurais. Empregando-se a sensibilidade dolorosa como padrão ouro no diagnóstico o melhor método foi o de escore de locomoção, seguido da plataforma de força e termografia infravermelha. Porém, a plataforma de força não foi sensível para analisar a evolução do tratamento com AINEs dos animais laminíticos. Os três AINEs reduziram semelhantemente o cortisol em relação ao grupo controle (Plt;0,05) e não provocaram danos na mucosa abomasal. O meloxican foi bastante eficaz na diminuição de sensibilidade podal, melhorando da mesma forma que o cetoprofeno o escore de locomoção. Estes dois medicamentos estimularam o retorno do apetite e a melhora da atitude. Deve-se incluir no tratamento da laminite asséptica algum AINE, dando-se preferência ao meloxicam, seguido do cetoprofeno.This study aimed to evaluate ruminal and systemic alterations of laminitis and ruminal acidosis oligofructose-induced in Zebu cattle; characterize laminitis clinical picture and compare methods of diagnostic; and to evaluate the treatment efficacy between three non-steroidal anti-inflammatory drugs (NSAIDs). Twenty-nine rumen-canulated Nelore heifers weighing 474.5 ± 58.5 kg were used. Induction was initiated with intraruminal administration of 0.765 g/kg oligofructose twice a day for three consecutive days, followed by single dose of 10.71 g/kg oligofructose administered 72 hours after beginning of induction. During the induction period the animals underwent clinical examination, blood and ruminal fluid collection daily and after induction were evaluated every 6 hours (during the initial 24 hours) and every 12 hours (up to 72 hours post-induction). Two heifers that did not present laminitis were discarded. Almost half of the animals (48.1%) had to be treated with bicarbonate and saline for correction of metabolic acidosis and dehydration. Due to this treatment the animals were analyzed in groups medicated (n=13) and unmedicated (n =14). After induction, the diagnosis of laminitis was confirmed after two positive responses to the pain sensitivity and locomotion score tests. Heifers with laminitis were randomly assigned to four groups that received, for three consecutive days, daily doses (intravenous) of the following medications: Control (8 mL isotonic saline; n=6); Flunixin meglunine (1.1 mg/kg; n=7); Ketoprofen (3 mg/kg; n=7) and Meloxican (0.5 mg/kg; n=7). After NSAIDs treatment the animals were evaluated every 12 hours up to 96 hours. The maximum fermentation of oligofructose occurred between the 6th and 12th hour post-induction with marked accumulation of lactic acid, intense decrease of anaerobiosis and temporary increase in ruminal osmolarity. In the medicated group, there was a positive correlation between ruminal and blood pH (r =0,90; P= 0,0040), and a negative correlation between blood pH and blood osmolarity (r =-0,69; P=0,0090) at the peak of ruminal fermentation. Both groups had a mild fever and respiratory compensation due systemic acidosis. Most animals developed laminitis 24 to 72 hours after induction in digits of two limbs and a small percentage (29.6%) had polysinovite in the tarsocrural joints. Using the pain sensitivity as gold standard, the best diagnostic method was the locomotion score, followed by the force platform and infrared thermography. Notwithstanding, the force platform was not sensitive to evaluate animals during the treatment of laminitis with NSAIDs. The three NSAIDs similarly reduced cortisol in relation to control group (P<0.05) and did not cause damage to the abomasal mucosa. Meloxicam was very effective in reducing hoof sensibility, improving in the same way as ketoprofen the locomotion score. These two drugs stimulated the return of appetite and improved attitude. For the treatment protocol of aseptic laminitis a NSAID should be included, with preference to meloxicam followed by ketoprofen.
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Nunes, Talyta Lins. "Tramadol em caprinos: efeitos clínicos, farmacocinética e biodisponibilidade." Universidade Federal Rural do Semi-Árido, 2017. http://bdtd.ufersa.edu.br:80/tede/handle/tede/724.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Tramadol is an atypical opioid analgesic widely used in humans and in the routine of the small animal clinic. Due to the lack of studies that determine its pharmacokinetic and pharmacodynamic characteristics, its use in production animals is restricted. The objective of this research was to evaluate the clinical, familial and bioavailability effects of tramadol in goats. The study was divided into two phases: the first one evaluated the clinical effects of tramadol at doses of 2 and 4 mg / kg intravenously; In the second stage, the bioavailability and pharmacokinetic parameters of tramadol and O-desmethyltramadol were evaluated after intravenous and intramuscular administration at a dose of 4 mg / kg. Opioid has been shown to be safe and effective in the control of orchiectomy pain and should be given every 6 and 8 hours at doses of 2 and 4 mg / kg. The intramuscular opioid has bioavailability of 62%. The data from this research provide information on tramadol and its metabolites, and serve as the basis for future studies involving the drug and the plasm
O tramadol é um analgésico opioide atípico amplamente utilizado em humanos e na rotina da clínica de pequenos animais. Devido ausência de estudos que determinam as características farmacocinéticas e farmacodinâmicas, sua utilização em animais de produção é restrita. Objetivou-se com esta pesquisa avaliar os efeitos clínicos, farmacocinética e biodisponibilidade do tramadol em caprinos. O estudo foi dividido em duas fases: na primeira, realizou-se avaliação dos efeitos clínicos do tramadol nas doses de 2 e 4 mg/kg intravenoso em caprinos submetidos a orquiectomia e na segunda etapa, realizou-se avaliação da biodisponibilidade e dos parâmetros farmacocinéticos do tramadol e O-desmetiltramadol após administração intravenosa e intramuscular em caprinos, na dose de 4 mg/kg. O opioide mostrou-se seguro e eficaz no controle da dor da orquiectomia, devendo ser administrado a cada 6 e 8 horas, nas doses de 2 e 4 mg/kg. O opioide intramuscular tem biodisponibilidade de 62%. Os dados desta pesquisa fornecem informações relevantes a respeito do tramadol e seus metabólitos e servem de base para estudos futuros envolvendo o fármaco e a matriz biológica
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Bailey, Alexis. "Interactions between the opioid and adenosine systems in CNS." Thesis, University of Surrey, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.252360.
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Teixeira, Justijanio Cacio Leal. "Efeito do uso da dipirona sódica e da sssociação codeína mais paracetamol na analgesia pós-artroscópica do ombro." reponame:Repositório Institucional da UFC, 2015. http://www.repositorio.ufc.br/handle/riufc/15368.
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TEIXEIRA, Justijanio Cacio Leal. Efeito do uso da dipirona sódica e da sssociação codeína mais paracetamol na analgesia pós-artroscópica do ombro. 2015. 60 f. Dissertação (Mestrado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2015.Submitted by denise santos (denise.santos@ufc.br) on 2016-03-08T11:26:43Z No. of bitstreams: 1 2015_dis_jclteixeira.pdf: 567896 bytes, checksum: 9b62d078a0bc20e711b06d82cdb19867 (MD5)
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The inflammatory process is a reaction of the body's defense against aggression triggered by physical, chemical or biological factors. Is present in almost all the lesions produced in the human body, thus being a usefu l and necessary process. This study aimed to compare the analges ic effect of dipyrone sodium (1 g) and Tylex (30mg) in controlling postoperative pain shoulder arthroscopy . Methodology: The sample consisted of 50 patients who underwent arthroscopy of the sho ulder needed, divided into two groups of 25 patients, in which one of the groups was given Dipyrone Sodium postoperatively and in the other the Tylex. Postoperative evaluation occurred immediately after surgery and during the 72 hours after surgery by debi litating Functional Scale (EDF). Results: Both dipyrone as Tylex were effective in controlling postoperative pain. Conclusions: analysis of the immediate postoperative period, the Dipyrone was more effective in combating postoperative pain, signaling the a nalgesic effects, but Tylex presented a longer effect.
O processo inflamatório é uma reação de defesa do organismo contra agressão desencadeada por fatores de natureza física, química ou biológica. Está presente em quase todas as lesões produzidas no organismo humano, sendo, portanto, um processo útil e necessário. Esse estudo teve por objetivo comparar a ação analgésica da Dipirona Sódica (1g) e do Tylex (30mg), no controle da dor pós- operatória em cirurgia de videoartroscopia do ombro. Metodologia: A amostra foi composta por 50 pacientes, que necessitavam realizar a videoartroscopia do ombro, dividindo-se em dois grupos de 25 pacientes, em que em um dos grupos foi administrada Dipirona Sódica no pós-operatório e no outro Tylex. A avaliação pós- operatória ocorreu imediatamente após a cirurgia e ao longo das 72 horas do pós- cirúrgico através da Escala Desabilitante Funcional (EDF). Resultados: Tanto a dipirona quanto o Tylex foram eficazes no controle da dor pós-operatória. Conclusões: na análise do pós-operatório imediato, a Dipirona foi mais eficaz no combate da dor pós-operatória, sinalizando o efeito analgésico preemptivo, mas o tylex apresentou efeito mais longo.