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Background@#In the past musculoskeletal complaints were treated with topical preparations from medicinal plants until the advent of NSAIDs. However, because of the side effects of NSAIDs, interest has increased on going back to the use of topical traditional herbal medicines in patients with musculoskeletal pain.@*Objective@#This review was conducted to identify the active substance, its mechanism of action, pre-clinical and clinical studies and propose a topical herbal formulation balancing its analgesic and anti-inflammatory effect with skin care effect among patients with various somatic pain conditions.@*Methods@#This is a qualitative review of both local and international published medical literature to identify and summarize information on the use of topical herbal preparation for the treatment of musculo-skeletal pain.@*Results@#After the initial review, the authors identified six herbal preparations that have been investigated for its analgesic and anti-inflammatory properties in clinical trials. They eventually arrived at a consensus to consider the final combination of ginger, capsaicin, peppermint and virgin coconut oil. Gingerol, a naturally occurring plant phenol, is one of the major components of ginger known to have diverse pharmacologic effects including anti-oxidant, anti-apoptotic, and anti-inflammatory activities in vitro and in vivo. Capsaicin is a highly selective agonist for the transient receptor potential vanilloid 1 receptor expressed in nociceptive sensory nerves. The mechanisms underlying capsaicin-induced analgesia likely involve reversible ablation of nociceptor terminals. Local application of peppermint oil generates a long-lasting cooling effect on the skin and result to muscle relaxation. Ginger, capsicum and peppermint have been shown in clinical trials to relieve musculoskeletal pain and inflammation. Virgin coconut oil on the other hand has no analgesic effect but has been shown in some studies to be favorable for skin conditions and facilitate skin penetration of some substances. @*Conclusion@#Using combined preparation may have the advantage of complementation of its effect i.e. analgesic and anti-inflammatory effect of ginger, warm sensation of capsicum and the cold sensation of peppermint.
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Musculoskeletal Pain , Anti-Inflammatory Agents, Non-Steroidal , Plant PreparationsABSTRACT
Objective To assess the efficacy and safety of multimodal analgesia with different doses of nalbuphine combined with flurbiprofen on patients who received intravenous patient -controlled analgesia(PCIA) after thoracotomy.Methods Sixty patients underwent thoracotomy,ASA Ⅰ -Ⅱ,18 -65 years old,who underwent postoperative PCIA,were randomly divideded into three groups according to the digital table,nalbuphine 60 mg group (N60 group),nalbuphine 80 mg group(N80 group)and nalbuphine 100 mg group (N100 group),20 cases in each group.All patients were given 150mg flurbiprofen,a total of 100mL.PCIA solution:the background dose was 2mL/h, PCIA dose of 0.5mL,locking time of 15min.10min before surgery,each patient was intravenously given flurbiprofen 50mg,given a loading dose of 0.1mL/kg when closed chest.All patients were followed up for 48h.The incidence of adverse reactions such as vital signs,number of times,visual analog scale(VAS)score,sedation score,nausea and vomiting were recorded.Results There were no significant differences in the age,gender,body mass index and surgery duration among the three groups(all P >0.05).The vital signs were stable within 48h after operation.The VAS scores of N60 group were higher than the other two groups(N80 group:t =7.94,6.35,6.49,5.21,5.63,all P =0.00;N100 group:t =8.41,9.10,5.80,8.07,8.18,all P =0.00)at 4,6,8,24 and 48h after operation(all P 0.05).The effective /actual compression ratio of PCIA of N80 group and N100 group were significantly higher than that of N60 group (t =7.30,8.35,all P 0.05;group N100:χ2 =3.14,0.23,1.03,all P >0.05).Conclusion Postoperative PCIA with nalbu-phine (80 mg)combined with flurbiprofen(150 mg)has significant analgesic effect and lower costs.
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Objective:To discuss the significance of standardized treatment for cancer pain, according to the Cancer Pain Treat-ment Specification (2011 Edition) issued by the Ministry of Health, PR China. Methods:Clinical data of 126 patients with cancer pain, who were admitted to the Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, were collected to com-pare the improvement of the Numeric Rating Scale (NRS) score, number of breakthrough pain, and quality of life score after treatment. The relationships between different pain grades, disease entities, and treatment effect were analyzed. The influence factors of pain relief were also analyzed by using Logistic regression analysis. Results:1). Following standardized treatment, the improvement rate of NRS score has shown significant differences in pain grading (P=0.001) and gender (P=0.000). However, no significant differences were ob-served between different diseases (P=0.112). The improvement rate of the life quality score and the number of breakthrough pain had no significant difference after standardized treatment. 2). The grading of cancer pain and the disease entities had little effect on cancer pain relief. 3). The anti-tumor treatment and“no distant metastasis”were the independent factors that brought about the decrease in NRS and quality of life scores.“No distant metastasis”(P=0.046) was the independent factor that reduced the number of pain out-breaks. Conclusion: The standardized treatment positively affects the NRS score, number of breakthrough pain, and quality of life score. Patients who received anti-neoplastic therapy and who had no distant metastasis showed significant treatment effectiveness in pain management.
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Objective:To analyze the analgesic effectiveness of dezocine after laparoscopic cholecystectomy. Methods: Totally 80 patients with laparoscopic cholecystectomy were randomly divided into the observation group and the control group. The control group was given tramadol 0. 2 mg·kg-1 for anesthetize, the observation group was given dezocine 0. 1 mg·kg-1 analgesia. Conducted according to a simgle drug additional pain status of the patient. After the surgery, the time of surgery, VAS and BCS pain condition score of the pa-tients were analyzed and compared, and the incidence of adverse reactions of the two groups were recorded. Results:After the surgery, the operation time, opening eyes, awaking time and extubation time showed no significant difference in the two groups (P>0. 05). VAS scores of the observation group in 30min, 1h, 2h and 6h after the surgery were significantly lower than those of the control group, and BCS score was significantly higher than that of the control group (P<0. 05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (χ2 =4. 020 5,P=0. 045 0). Conclusion:The analgesic effect of dezocine after lap-aroscopic cholecystectomy is promising, which can significantly alleviate the pain after the operation and is worthy of wider application.
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Objective To explore dezocine preemptive analgesia in laparoscopic operation on serum interleukin-6(IL-6) and substance P.Methods 82 cases of laparoscopic operation were randomly divided into two groups,41 cases in the observation group,41 cases in the control group.Observation group was treated with routine anesthesia and analgesia with dezocine,the control group with routine anesthesia.Using visual analogue score (VAS) of pain scores,measured in the two groups of serum IL-6 and P material.Results The observation group after 2h,12h,24h VAS scores were (1.02 ±0.42),(2.19 ±0.87),(1.69 ±0.96) points,which were less than the control group (1.39 ±0.77)%,(3.08 ± 1.15)%,(2.27 ± 1.21)points (t =5.536 2,2.064 4,3.756 4,all P ＜0.05).The observation group before and after operation,serum IL-6,P material were (117.4 ± 17.2) mg/L,(204.4 ± 23.6) mg/L,(4.21 ± 0.96) mg/L,(4.33 ± 1.03) mg/L,the control group were (115.3 ± 14.7) mg/L,(276.5 ± 29.1) mg/L,(4.19 ± 0.94) mg/L,(6.92 ± 1.37) mg/L,two groups of postoperative serum IL-6,substance P (t =3.754 4,7.643 0,all P ＜ 0.05).Increased significantly,compared with the control group,the patients in the observation group the extent of small elevated(t =3.7544,7.6430,all P ＜ 0.05).Conclusion Dezocine extended analgesia in patients undergoing laparoscopic surgery can significantly reduce serum IL-6 and substance P expression.
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Objective:To research and compare the therapeutic effect of oxycodone hydrochloride controlled—release tablets and morphine sulfate controlled—release tablets on the visceral cancer pain.Methods:Total of 72 patients with visceral cancer pain were randomly assigned into two groups:OO group was treaded by oxycodone hydrochloride controlled—release tablets,MO Group was given morphine sulfate controlled—release tablets.According to the principle of NCCN(2008),the two groups were titrated by morphine,and then diverted to controlled-release agent.The visual analogue scale(VAS)was kept smaller than 4.The side effects of two groups'and the rescue analgesic doses were recorded after the application of the controlled-release agent for 15 days,and the cost-effectiveness was analysed.Results:The rescue analgesic doses of the OO group were smaller than that of the MO group (P0.05).Conclusion:The two drugs have notable analgesic effect in the visceral cancer pain.Considered gastrointestinal tract side effects and the rescue analgesic dose,Oxycodone hydrochloride controlled—release tablets surpass the Morphine sulfate controlled-release tablets.Oxycodone hydrochloride controlled-release tablets may be a potential regimen for visceral cancer pain.
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OBJECTIVE:To investigate the analgesic and hypnotic effects of oral isoflurane(Iso)and sevoflurane(Sev). METHODS:180 mice were randomly divided into 18 groups(n=10). It included in hot-plate test(n=60),writhing test(n= 60),i.e. NS group,Iso1 group(1 mL?kg-1),Iso2 group(2 mL?kg-1),Iso3 group(3 mL?kg-1),Sev1 group(5 mL?kg-1),Sev2 group(10 mL?kg-1). Another six groups were included in sleeping test,i.e. NS group,Iso1 group(6 mL?kg-1),Iso2 group(8 mL?kg-1),Iso3 group(10 mL?kg-1),Sev1 group(20 mL?kg-1),Sev2 group(40 mL?kg-1). Hot-plate test,writhing test,sleeping test were employed to evaluate the hot- plate pain threshold(HPPT),writhing times(WT)and sleeping time(ST)respectively after i.g. administration of Iso and Sev to evaluate analgesic and hypnosis effect. RESULTS:As compared with NS group,Iso(1～3 mL?kg-1)and Sev(5,10 mL?kg-1)with intragastric administration could increase the HPPT and decrease the WT(P
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Objective To study the effect of morphine used in epidural anesthesia on puerpera after cesarean section and the safety of morphine to neonate. Method One hundred puerpera undergone cesarean section were randomly divided into test group and control group with continuous 2% lidocaine epidural anesthesia, as soon as the operation were finished, 2 mg morphine was injected into vacum epidurale for test group, nothing for control group. Colostrum and plasma, urine samples of puerpera and neonate were collected, morphine and metabolite level were tested by GC-MS and FPIA. Result Morphine concentrations ranged from 0.05). Conclusion As the epidural analgesia medicine after cesarean section, morphine has no side-effect to neonate and is safe to neonate.