Articles: analgesics.
-
Erroneous presumptions about children's reactions to pain have misguided professionals' management of this issue. Recent recognition and understanding of the pain experience in children have prompted research and clinical advances in treatment and care. Considerable study is still needed to further comprehend the difference between the perception and reaction to pain in the pediatric population.
-
Nonsteroidal anti-inflammatory drugs (NSAIDs) are very effective for the management of acute postoperative pain. These agents can be used in combination with opioid analgesics and local anaesthetics for the relief of severe postoperative pain, when the combination results in reduced narcotic requirements and improved analgesia compared with opioids and/or local anaesthetics. ⋯ By adding the NSAIDs to a routine analgesic armamentarium the goal of preventing or eliminating postoperative pain, rather than treating or reducing postoperative pain, is achieved. To use these agents more effectively, further research is required to distinguish the differences between the various NSAIDs, the optimal dosage schedules and route of administration, and, finally, the cost-effectiveness and impact on the quality and speed of postoperative recovery of NSAIDs.
-
Eur. J. Clin. Pharmacol. · Jan 1992
Clinical Trial Controlled Clinical TrialPharmacokinetic-pharmacodynamic modeling of the effects of clonidine on pain threshold, blood pressure, and salivary flow.
Although clonidine analgesia appears to be mediated by the same central alpha 2-adrenoceptors that mediate its hypotensive effect, it is short-lasting when compared to the fall in blood pressure. This has been investigated by combined pharmacokinetic-pharmacodynamic analysis in 10 healthy volunteers who received (double-blind and crossover) clonidine 200 micrograms orally + placebo i.v. and clonidine orally + naloxone i.v. (2.8 mg/5 h). Analgesia was assessed by measuring the subjective (VAS) and objective (RIII) pain thresholds after transcutaneous electrical stimulations of the sural nerve; the mean arterial blood pressure (MAP), salivary flow (SF), and plasma clonidine concentrations were also monitored. ⋯ The concentration-effect curves for RIII had the same shape as MAP but the starting hysteresis suddenly collapsed, suggesting acute tolerance. The best fit was obtained with a model where the linear relationship between concentration in the effect compartment and analgesia changed acutely after the third hour. The short-lived analgesia was probably related to an acute change in pain sensitivity induced by food, suggesting that it is not mediated solely by the alpha 2-adrenoceptors responsible for hypotension.