Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

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3 result(s) for: Artroplastia do Joelho; Analgesia; Lidocaina

Antinociceptive effects of saccharose and aqueous extract of <i>Cordyline dracaenoides kunth</i> (uvarana) in experimental models after induction of hyperalgesia using capsaicin

Larissa Gulogurski Ribeiro; Ivo Ilvan Kerppers; Isabel de Almeida Paz; Marcos Paulo Polowei Rolão; Thais Barbosa de Oliveira; Camila da Luz Eltchechem; Mário César da Silva Pereira


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OBJECTIVE: There is evidence that sweet substances such as saccharose can enhance the analgesic properties of endogenous opioids, leading to pain relief; it is also known that Cordyline dracaenoides Kunt, commonly known as uvarana, is used in folk medicine as an anti-inflammatory and analgesic agent. The aim of the present study was to compare the antinociceptive effects of uvarana aqueous extracts vs. saccharose in rats.
METHOD: Twenty-four Wistar rats were used, divided into two groups of twelve, namely a uvarana and a saccharose group. Capsaicin was used to induce hyperalgesia and the nociceptive threshold was assessed every five minutes for a total of 50 minutes Baseline values were obtained and this was followed by administration of uvarana or saccharose at threedifferent concentrations (100, 250 and 300 g/L) The nociceptive threshold was assessed using the tail flick test.
RESULT: In comparison to baseline values, uvarana and saccharose provoked significant and comparable antinociceptive effects at concentrations of 250 g/L and 300 g/L, respectively.
CONCLUSION: Both substances caused similar antinociceptive effects in comparison to baseline values.

Keywords: analgesia; saccharose; uvarana.

Clinical pharmacology of analgesics in infants and the pharmacologic management of pain in neonates

Gian Maria Pacifici

MEDICALEXPRESS 2014;1(3):105-115 - REVIEW

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OBJECTIVES: The objectives of this study are to describe (1) the clinical pharmacology of analgesics in infants and (2) the pharmacologic management of pain in neonates.
METHODS: The bibliographic search was performed using PubMed and EMBASE databases as search engines.
RESULTS: Opioid analgesics are the most commonly used analgesics for acute pain and they include intravenous morphine (50 to 200 µg/kg), oral methadone (50 to 200 µg/kg), intravenous fentanyl (0.5 to 4 µg/kg), alfentanyl (10 to 20 µg/kg), sufentanil (10 to 15 µg/kg), and remifentanil (5 µg/kg). Fentanyl, alfentanyl, sufentanil and remifentanil are short-action opioid analgesics. Non-opioid analgesics can be used for moderate pain; they include oral paracetamol (acetaminophen, 12 to 15 mg/kg), the intravenous benzodiazepine midazolam (50 to 150 µg/kg) which is not recommended in neonates, intravenous propofol (2.5 mg/kg) which is used for induction of general anaesthesia, and ketamine, (2 mg/kg intravenously or 4 mg/kg intramuscularly) which produces a short-lasting, trance-like state with profound analgesia and amnesia.
CONCLUSION: The use of non-opioid analgesics has increased in the last years for the management of non-acute pain. If prevention or elimination of pain is not possible, a more realistic goal may be to aggressively intervene to minimize pain and its effects.

Keywords: analgesia; analgesics; management of pain; neonate; pain; pharmacokinetics.

Effectiveness of lidocaine patches for pain treatment after total knee arthroplasty

David Sadigursky; Mariana de Castro Oliveira; João Gilberto Gomes Macedo; Francisco Roque Paim Costa Junior; Matheus Lemos Azi; Daniel Figueiredo Alencar


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BACKGROUND: Effective analgesic therapy in the postoperative period of total knee arthroplasty is essential for good surgical outcomes. The current trend is to use multimodal treatment, in which the use of patches with lidocaine as adjuvant therapy has an increasingly relevant role.
OBJECTIVE: To investigate the potential benefits of lidocaine patch association with the basic analgesia regimen for pain relief during the postoperative period of total knee arthroplasty.
METHOD: A retrospective cohort study was performed , with a total of 24 patients in each group, who underwent total knee arthroplasty. Pain levels using a visual analogue scale and opioid intake were controlled from the immediate postoperative to the end of a 28-day interval.
RESULTS: During the postoperative period, pain was less intense in patients who used lidocaine patches. In these same patients, the doses of opioids needed to control pain were lower in 15 of the 28 days analyzed. The relative frequency of nausea was higher in the group that did not use adjuvant therapy. Patients older than 70 years and females predominated.
CONCLUSION: Adjuvant treatment after total knee arthroplasty using lidocaine patches was effective in reducing pain and decreasing the use of opioids in the period analyzed, and represents a good addition to multimodal analgesic therapy.

Keywords: Knee Arthroplasty; Analgesia; Lidocaine.