Subject(s)
Acquired Immunodeficiency Syndrome/complications , Anesthesia , Critical Care , Resuscitation , Acquired Immunodeficiency Syndrome/therapy , Brain Diseases/therapy , Gastrointestinal Diseases/therapy , Humans , Pneumonia/therapy , Pneumonia, Pneumocystis/therapy , Respiratory Insufficiency/therapyABSTRACT
The effectiveness of intrathecal morphine (500 micrograms), intrathecal dermorphine (20 micrograms) and routine intramuscular pentazocine (30 mg) in the relief of postoperative pain, was compared in 150 consecutive patients after elective surgery, in a prospective randomized double blind study. The analgesic effect of intrathecal dermorphine was found to be profound and to last significantly longer (43.41 +/- 1.64 hr) than intrathecal morphine (34.45 +/- 2.35 hr) or the routine pentazocine therapy (10.79 +/- 2.23 hr). The mean postoperative hospital stay in the intrathecal dermorphine (5.6 +/- 4) and morphine groups (6.3 +/- 45) was significantly shorter than in the control group (8.7 +/- 42). Side-effects, as urinary retention, vomiting and headache, were not significantly different in the three groups of patients.
Subject(s)
Analgesics , Oligopeptides/therapeutic use , Adult , Aged , Double-Blind Method , Female , Humans , Male , Middle Aged , Morphine/therapeutic use , Opioid Peptides , Pentazocine/therapeutic use , Postoperative Complications/epidemiology , Postoperative PeriodABSTRACT
In order to clarify the mechanism of the analgesic effect of ceruletide (CRL), the peptides B-endorphin (BE), ACTH, prolactin (PRL), growth hormone (GH) and substance P were determined in the basal state and following IV CRL administration in 11 patients. CRL, at the dose of 2 ng/kg/min, significantly augmented BE levels in the plasma, and in CSF. Substance P levels were significantly augmented by CRL in the plasma, while ACTH levels were significantly augmented in CSF. GH and PRL levels were not affected by CRL. Placebo had no effect on any of the measured peptides. The effect of CRL on mood and anxiety, known to be affected by opioids, was studied in 14 patients with psychogenic headache. The effect of histamine induced headache on State trait anxiety inventory and on Mood adjective check list was studied before and after administration of placebo or CRL. CRL significantly diminished anxiety when compared to placebo. Elation, surgency and egotism were significantly augmented while skepticism was significantly diminished by CRL. The CRL effect on mood and pain may be mediated by augmented levels of neurohormones both in the plasma and in CSF.
