ABSTRACT
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. Nefopam and pethidine were found to be equally effective and statistically superior to placebo. 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.
Subject(s)
Nefopam/therapeutic use , Oxazocines/therapeutic use , Pain/drug therapy , Adult , Aged , Clinical Trials as Topic , Female , Humans , Male , Meperidine/adverse effects , Meperidine/therapeutic use , Middle Aged , Nefopam/adverse effects , Placebos , Time FactorsABSTRACT
A single-shock stimulus to the skin of widespread and distant parts of the body such as the face, sites in the upper limb, trunk, buttock, and feet produced changes in amplitude of the ankle jerk. A regulated and stabilized system was used for eliciting the ankle jerk and for delivering an unvarying single-shock conditioning stimulus; 35 normal subjects were studied. The characteristics of the recovery curve of the monosynaptic reflex after stimulation at these cutaneous sites are described.
Subject(s)
Motor Neurons/physiology , Reflex, Monosynaptic , Skin/innervation , Back/innervation , Buttocks/innervation , Electric Stimulation , Electromyography , Extremities/innervation , Face/innervation , Hand/innervation , Humans , Shoulder/innervationABSTRACT
It is the thesis of this review that the origin of the intercurrent facilitation at 50 to 400 msec in the standard recovery curve of the H reflex, evoked with paired stimuli, is a complex. It is composed importantly of central feedback effects from the conditioning reflex contraction, influences mediated by cutaneous group III afferent nerve fibres excited by the percutaneous stimulus, and with a possible additional modest contribution by long-loop, spino-bulbo-spinal influences.
