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Text
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URL Address
<a href="http://doi.org/10.1093/bja/aeh222" target="_blank" rel="noreferrer">http://doi.org/10.1093/bja/aeh222</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia
Publisher
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British Journal Of Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Female; Humans; Male; Adult; Analgesics; Aged; Middle Aged; Drug Therapy; Double-Blind Method; Biomarkers of Pain; Injections; Dose-Response Relationship; Drug; Opioid/administration & dosage; Receptors; Arthroscopy; Intra-Articular; Morphine/administration & dosage; Pain Measurement/methods; Combination; Knee Joint/metabolism/surgery; Opioid/metabolism; Pirinitramide/administration & dosage; Synovitis/metabolism/pathology
Creator
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Likar R; Mousa SA; Philippitsch G; Steinkellner H; Koppert W; Stein C; Schafer M
Description
An account of the resource
BACKGROUND: Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing arthroscopic knee surgery might shift the analgesic dose-response curve of intra-articular (i.a.) morphine. METHODS: Following IRB approval and informed consent, patients were randomly assigned to the following i.a. treatments at the end of surgery: group I (n=39), isotonic saline; group II (n=40), 1 mg morphine hydrochloride; group III (n=48), 2 mg morphine hydrochloride; group IV (n=39), 4 mg morphine hydrochloride. Postoperative pain intensity was assessed by the visual analogue scale (VAS), by the time to first analgesic request and by the supplemental piritramide consumption. Synovial specimens from each patient were stained for the presence of inflammatory cells and END and were discriminated into groups with low versus high numbers of these cells. Differences between groups were statistically analyzed by chi(2), anova and mancova where appropiate. RESULTS: Patient characteristics and VAS scores did not differ between groups. Total postoperative piritramide consumption decreased and the time to first analgesic request increased significantly with increasing doses of i.a. morphine (P0.05, mancova). CONCLUSIONS: The dose-response relationship of i.a. morphine analgesia is not shifted by enhanced inflammation and END expression within synovial tissue. Thus, the presence of END within inflamed synovial tissue does not seem to interfere with i.a. morphine analgesia.
2004
Identifier
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<a href="http://doi.org/10.1093/bja/aeh222" target="_blank" rel="noreferrer">10.1093/bja/aeh222</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Adult
Aged
Analgesics
Arthroscopy
Backlog
Biomarkers of Pain
British Journal Of Anaesthesia
Combination
Dose-Response Relationship
Double-Blind Method
Drug
Drug Therapy
Female
Humans
Injections
Intra-Articular
Journal Article
Knee Joint/metabolism/surgery
Koppert W
Likar R
Male
Middle Aged
Morphine/administration & dosage
Mousa SA
Opioid/administration & dosage
Opioid/metabolism
Pain Measurement/methods
Philippitsch G
Pirinitramide/administration & dosage
Receptors
Schafer M
Stein C
Steinkellner H
Synovitis/metabolism/pathology
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12453926" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12453926</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability
Publisher
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British Journal Of Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Child; Female; Male; Analgesics; Double-Blind Method; Phenotype; Urban Population; Preschool; Non-U.S. Gov't; Anti-Inflammatory Agents; Human; Support; Vomiting/chemically induced; Genotype; Analgesia; Tonsillectomy; Non-Steroidal/administration & dosage; Morphine Derivatives/blood; Central Nervous System Stimulants/blood; Codeine/genetics/metabolism; Diclofenac/administration & dosage; Morphine/metabolism; Opioid/metabolism
Creator
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Williams DG; Patel A; Howard RF
Description
An account of the resource
BACKGROUND: Codeine analgesia is wholly or mostly due to its metabolism to morphine by the cytochrome P450 enzyme CYP2D6, which shows significant genetic variation in activity. The aims of this study were to investigate genotype, phenotype and morphine production from codeine in children undergoing adenotonsillectomy, and to compare analgesia from codeine or morphine combined with diclofenac. METHODS: Ninety-six children received either codeine 1.5 mg kg(-1) or morphine 0.15 mg kg(-1) in a randomized, double-blind design. Genetic analysis was performed and plasma morphine concentrations at 1 h were determined. Postoperative analgesia and side-effects were recorded. RESULTS: Forty-seven per cent of children had genotypes associated with reduced enzyme activity. Mean (SD) morphine concentrations were significantly lower (P<0.001) after codeine [4.5 (0.3) ng ml(-1)] than after morphine [24.7 (1.5) ng ml(-1)], and morphine and its metabolites were not detected in 36% of children given codeine. There was a significant relationship between phenotype and plasma morphine (P=0.02). More children required rescue analgesia after codeine at both 2 (P<0.05) and 4 h after administration (P<0.01). Fifty-six per cent of children vomited after morphine and 29% after codeine (P<0.01). Neither phenotype nor morphine concentration was correlated with either pain score or the need for rescue analgesia (r=-0.21, 95% confidence interval -0.4, -0.01). CONCLUSIONS: Reduced ability for codeine metabolism may be more common than previously reported. Plasma morphine concentration 1 h after codeine is very low, and related to phenotype. Codeine analgesia is less reliable than morphine, but was not well correlated with either phenotype or plasma morphine in this study.
2002
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2002
Analgesia
Analgesics
Anti-Inflammatory Agents
Backlog
British Journal Of Anaesthesia
Central Nervous System Stimulants/blood
Child
Codeine/genetics/metabolism
Diclofenac/administration & dosage
Double-Blind Method
Female
Genotype
Howard RF
Human
Journal Article
Male
Morphine Derivatives/blood
Morphine/metabolism
Non-Steroidal/administration & dosage
Non-U.S. Gov't
Opioid/metabolism
Patel A
Phenotype
Preschool
Support
Tonsillectomy
Urban Population
Vomiting/chemically induced
Williams DG