Articles: pain.
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In 150 patients buprenorphine was given as postoperative analgesic in a dose of 4 microgram/kg. Pain suppression was judged very good (71%), fairly good (24%) and insufficient (5%). Analgesic activity lasted at least 325 +/- 15 min. Side effects were few.
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Randomized Controlled Trial Comparative Study Clinical Trial
Controlled clinical trial of oral and parenteral nefopam hydrochloride. A novel and potent analgesic drug.
The results of a controlled, double-blind clinical trial are reported demonstrating the potency of analgesia produced by orally and parenterally administered nefopam HCl in hospitalized patients with pain principally of skeletal and neuromuscular origin. The drug is an analogue of orphenadrine, consisting of a cyclization of the diphenhydramine molecule. A double-blind, crossover study was made of the analgesic effects of intramuscular doses of 20 mg nefopam HCl, 50 mg pethidine, and saline placebo in 20 patients. ⋯ A double-blind, randomized study was made of orally administered nefopam HCl, 60 mg t.i.d., for three days and of placebo t.i.d. for three days in 80 patients. Nefopam was distinctly superior to placebo in analgesic effectiveness, both in the initial single dose and in maintaining therapeutic benefit for the duration of the three-day trial. It was concluded that nefopam is a potent analgesic of novel structure and unique physiologic properties.
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A case of chronic prostatitis where conventional chemotherapy and repeated transurethral resections failed to relieve pain is described. A cutaneous uretero-entero anastomosis was performed for troublesome pain and incontinence and only a permanent sympathetic block with phenol at the level of L4 achieved complete pain relief.
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Twenty-eight male patients referred to work ECG due to chest pain, all with a positive oesophageal symptom questionnaire believed to detect oesophageal dysfunction (OD), have been subjected to a graded work test and an oesophageal manometry test and answered a questionnaire believed to detect effort angina. Ischaemic heart disease (IHD) was defined as earlier infarction on ECG at rest or a pathological effort ECG. OD was defined as a positive acid perfusion test, hernia or a clear dysmotility in combination with a lower sphincter incompetence. ⋯ Five of the 20 patients had signs of both IHD and OD. Eight patients had a negative effort angina questionnaire; OD was found in 7 and IHD in 1 of these patients. It is concluded that in cases with angina-like chest pain OD should be considered.