Search

Background: Acute pain management enhances the overall quality of life for individuals having cesarean sections. Although it is a basic human right, pain treatment following a cesarean section lacks a gold standard. Multimodal analgesia is now recommended to aid recovery and mitigate the adverse effects of strong pain-relieving medications like opioids. Multimodal analgesic therapy, with the goal of obtaining synergistic or additive analgesia with fewer side effects, is by combining lesser amounts of each drug with different mechanisms of action. Aims and Objectives: The objective of the study was to compare the efficacy and safety of the combination of piroxicam with tramadol versus pentazocine in postcesarean pain management. Materials and Methods: Following cesarean section after skin closure, cases were randomly assigned into two groups of thirty cases each. Group A was administered tramadol 100 mg+piroxicam 20 mg and Group B received pentazocine 30 mg+piroxicam 20 mg by intramuscular injection. Diclofenac 75 mg served as the rescue pain relief medication. The main focus was pain control, evaluated using the Visual Analog Scale (VAS). Secondary outcomes included sedation levels and the duration until additional pain relief was required. The safety profile of the medications was assessed by monitoring adverse drug reactions. Statistical analysis involved methods such as student's t-test, analysis of variance, and post hoc testing. Results: Both the groups were comparable and statistically significant in VAS, time to rescue analgesia, and mean sedation score. Conclusion: The combination of piroxicam with tramadol versus pentazocine is effective and considered as an acceptable method of pain relief after cesarean delivery. [ABSTRACT FROM AUTHOR]

Goats respond to pain and often require chemical restraints for veterinary procedures. Information regarding the cardiopulmonary, haematological and biochemical effects of chlorpromazine (CPZ) or chlorpromazine-pentazocine (CPZ-PTZ) in West African Dwarf (WAD) goats has not been fully established. The study aimed to evaluate the cardiopulmonary, haematological and biochemical responses of WAD goats following sedation with either CPZ alone or a combination of CPZ-PTZ. Six healthy adult WAD bucks were randomly selected for two separate experiments using CPZ or CPZ-PTZ in a prospective crossover trial. Anaesthetic indices were taken. Blood samples were collected before the experiment (0 minutes), 45 minutes, 90 minutes and 24 hours for haematology and serum biochemistry assay. Heart rate (HR), respiratory rate (RR) and rectal temperature (°C) were measured at intervals of 10 minutes for 90 minutes. In between clinical trials, the bucks were given a 14-day break. The duration of recumbency for CPZ (43.00 ± 12.95 minutes) was significantly lower compared to the CPZ-PTZ protocol (46.50 ± 27.32 minutes). Analgesia was recorded in only the CPZ-PTZ group for 41.67 ± 1.75 minutes. The HR was significantly higher (p<0.05) in the CPZ-PTZ group than in the CPZ group from 0 to 70 minutes. The CPZ-PTZ protocol was a better one as it did not exert a negative effect on the red blood cells or serum protein compared with CPZ alone in the goats. Haematological, biochemical and cardiopulmonary changes were also evident in the goats. Further research may determine the risk-benefit profile of this anaesthetic regimen. [ABSTRACT FROM AUTHOR]

Pentazocine is an opioid analgesic used to treat moderate to severe pains. The real analysis for the pharmaceutical products containing pentazocine is basically to ensure the correct dose and patient safety. This study developed and validated an improved high-performance liquid chromatography (HPLC) method in the selective and accurate quantification of pentazocine. Two-dimensional (2D) HPLC technique is employed to enhance the resolution and selectivity compared to conventional HPLC methods. The 2D-HPLC instrumentation consists of two C18 columns coupling with a switching valve to capture fractions from the first column, which is analyzed in the second column. The mobile phase was optimized to 45% acetonitrile and 55% water with 0.1% phosphoric acid. The method was validated in the International Conference on Harmonization guidelines and shows excellent linearity (R2=0.998), limit of detection of 1.58 μg/L, accuracy of 97.70–102.50%, and precision by relative standard deviation (RSD) of 1.02–4.20%. Selectivity was verified in resolving pentazocine from paracetamol, caffeine, ibuprofen, and oxycodone in laboratory mixtures. The utility of the 2D-HPLC method was demonstrated by accurate quantification of pentazocine in pharmaceutical injections and tablets unaffected in excipients. This research provides a rich validating technique to enhance the quality control testing of pharmaceuticals containing pentazocine.

Background:Pain is a product of Man's highly complex nervous system, which integrates all parts of his body, making each closely interrelated with every other part. Pain has become the price man has to pay for his superiority in the evolutionary scale. Objective:To compare the analgesic effects of Diclofenac sodium, pentazocine and Ketoralac administered by intramuscular route in post-operative conditions. Methods:This study was undertaken at Government General Hospital and Basaveshwara Teaching and General Hospital, Gulbarga which are attached to M.R. Medical College. Gulbarga. The study included 150 patients who had come to the hospital for surgery below the umbilicus either abdominal or non-abdominal. Results:Onset of analgesia was faster in case of ketorolac when compared with diclofenac sodium and pentazocine. Duration of analgesia was longer in case of diclofenac sodium when compared to pentazocine and ketorolac. The vital parameters blood pressure and heart rate increased mildly in case of pentazocine. The PRST scale did not reveal any change in autonomic function. The scale was not of much utility. In case of ketorolac side effects were very minimal. Conclusions:It is concluded that ketorolac is preferable in immediate post-operative period to bring about relief of pain. [ABSTRACT FROM AUTHOR]

Background: Postoperative nausea and vomiting (PONV) following atrial fibrillation (AF) ablation can cause considerable distress. Aim: Continuous intravenous propofol sedation with adaptive servo-ventilation (ASV) with or without an analgesic, pentazocine, during AF ablation was studied in 272 consecutive patients with paroxysmal, persistent, and long-standing persistent AF. The study objectives were to determine the incidence of PONV after AF ablation and to assess the predictive value of factors for PONV using the area under the receiver operating characteristic curve (AUC). Results: The present sedation maneuver was successfully accomplished with a low incidence of hypotension and without discontinuation of ablation or switching to general anesthesia, while maintaining an acceptable procedural time (102 ± 32 min). The incidence of PONV was 5.5% (15/272). Nausea occurred in nine patients after an average of 4.6 ± 3.5 h (range: 2-12 h) postablation, and vomiting with nausea occurred in six patients after an average of 4.5 ± 3.1 h (range: 1-9 h) postablation. The postablation interval did not differ significantly between the occurrence of nausea and nausea accompanied by vomiting. AUCs based on various factors, including the Apfel score, ranged from 0.55 to 0.67, indicating low accuracy in predicting PONV occurrence. Conclusions: The incidence of PONV after propofol sedation with ASV was the lowest (5.5%) reported to date. Scoring systems, which included the Apfel score, were ineffective in predicting PONV. The low PONV incidence in addition to the efficacy of propofol sedation with ASV revealed the adequacy of this regimen for AF ablation. [ABSTRACT FROM AUTHOR]

Objective: To determine if opioid-free analgesia is as effective and safe as opioid-based analgesia for post-cesarean section pain. Material and Methods: Non-inferiority, assessor-blinded randomized controlled trial. One hundred cesarean section patients were randomized into 2 arms. Opioid-free analgesia arm had 1 gram intravenous paracetamol infusion and bolus 4 grams intravenous 20% magnesium sulfate preoperatively, then 1 gram/hour infusion of 20% magnesium sulfate intraoperatively until 2 hours post-operation. Postoperatively, they had 100 milligrams of rectal diclofenac 12-hourly and continued paracetamol 6-hourly for 24 hours. Opioid-based analgesia arm had 100 milligrams of rectal diclofenac 12-hourly, 30 milligrams of intramuscular pentazocine 6-hourly, and 1 gram of intravenous paracetamol 6-hourly, postoperatively for 24 hours. Both arms were allowed rescue analgesia with intramuscular pentazocine. Primary outcomes were pain intensity at 4, 8, and 24 hours post-operation and postoperative pentazocine use. Non-inferiority limit was a mean difference in pain score <1.3. Results: Postoperative pain scores at 4, 8, and 24 hours were lower in the opioid-free analgesia arm; mean difference -0.18; 95% confidence interval (CI): -0.70-0.34; p=0.499, -0.10; 95% CI: -0.78-0.59; p=0.782 and -0.31; 95% CI: -0.89-0.29; p=0.308 respectively. Mean pentazocine use was lower in the opioid-free analgesia arm (52.83±21.85 mg/164.40±28.59 mg; p=0.001). Serious adverse event occurred in one (2.0%) participant in the opioid-free analgesia arm and none in the opioid-based analgesia arm, p=0.315. There was no significant difference in the 5th-minute Apgar score (p=0.315). Conclusion: Opioid-free analgesia using perioperative intravenous magnesium sulfate, intravenous paracetamol, and postoperative rectal diclofenac is non-inferior to and as safe as the opioid-based analgesia and it reduced pentazocine consumption. [ABSTRACT FROM AUTHOR]

BACKGROUND Tympanoplasty is usually done under local anesthesia with sedation under monitored anesthesia care (MAC) or general anesthesia. This randomized, double-blind study compares dexmedetomidine as an adjuvant to local anaesthetic vs a combination of intravenous midazolam-pentazocine in patients undergoing tympanoplasty Under Monitored Anesthesia Care with respect to-VAS (Visual Assessment Score) and Time required for rescue analgesia in a tertiary hospital in India. MATERIALS AND METHODS This was a prospective, randomized, double blinded, comparative study. All the patients were well informed about study & each one of them gave written informed & valid consent to participate in the study. Total number of patients in the study was 82, with 41 patients in each of the two groups. Grouping done as follows Group Dexmed 10 ml of Bupivacaine + 10 ml of Lignocaine-adrenaline+ Dexmedetomidine 50mcg Group MPInj Midazolam 1.5 mg+ Inj Pentazocine 30mg IV RESULTS The demographic data were comparable in both the groups. Of 41 cases in Group Dexmed, 25 cases (61.0%) had Right CSOM and 16 cases (39.0%) had Left CSOM. Of 28 cases in Group MP, 25 cases (61.0%) had Right CSOM and 16 cases (39.0%) had Left CSOM. Distribution of mean pain score (VAS) at 30 min, 40 min, 50 min, 60 min and 80 min among the cases studied is significantly lower in Group Dexmed compared to Group MP (P-value<0.05 for all). Distribution of no. of rescue sedation injections required among the cases studied is significantly higher in Group Dexmed compared to Group MP (P-value<0.05). Distribution of mean time until the need for rescue analgesia is significantly higher in Group Dexmed compared to Group MP (P-value<0.05 CONCLUSION We found that Dexmedetomidine is more effective as an adjuvant to Local Anaesthetic Versus Combination of Intravenous Midazolam And Pentazocine In Tympanoplasty Surgeries. [ABSTRACT FROM AUTHOR]

Pentazocine abuse is relatively uncommon and even rarely seen in Indian females. It is often associated with multiple dermatological sequelae due to the repetitive local trauma at the injection site and the local effects of the drug. While managing opioid dependence, pathways of care vary a lot, thus deeming the multilevel screening at the level of general practitioners, pharmacists, mental health professionals, and other specialties, rather crucial. This one step can lead to a significant reduction in the treatment gap of opioid dependence. Here, we present a case of a female who started self‑injecting a combination of pentazocine and promethazine (Phenergan) posttubercular meningitis recovery for her persistent postmeningitic headache. [ABSTRACT FROM AUTHOR]

Background: Opioids are useful in the management of vaso-occlusive crisis among Sickle Cell Disease patients; however, there is a need to search for drugs that can ameliorate the withdrawal symptoms without causing further dependence. Case presentations: Three patients living with Sickle cell disease abusing Pentazocine were managed with Tab Chlorpromazine 100mg twice daily for three weeks and had a significant reduction in the level of craving and also experienced improved sleep. Chlorpromazine demonstrates a high affinity for dopamine (DA) receptors and acts as a receptor antagonist by inhibiting adenylate cyclase activity. Conclusion: Chlorpromazine was found to be useful in the management of cravings associated with Pentazocine addiction.

Sigma 1 receptor (Sig1R), a pluripotent modulator of cell survival, is neuroprotective in models of retinal degeneration when activated by the high-affinity, high-specificity ligand (+)-pentazocine ((+)-PTZ). The molecular mechanisms of Sig1R-mediated retinal neuroprotection are under investigation. We previously reported that the antioxidant regulatory transcription factor Nrf2 may be involved in Sig1R-mediated retinal photoreceptor cell (PRC) rescue. Cullin 3 (Cul3) is a component of the Nrf2-Keap1 antioxidant pathway and facilitates Nrf2 ubiquitination. Our earlier transcriptome analysis revealed decreased Cul3 in retinas lacking Sig1R. Here, we asked whether Sig1R activation can modulate Cul3 expression in 661 W cone PRCs. Proximity ligation and co-immunoprecipitation (co-IP) showed that Cul3 resides closely to and co-IPs with Sig1R. Activation of Sig1R using (+)-PTZ significantly increased Cul3 at the gene/protein level; silencing Sig1R decreased Cul3 gene/protein levels. Experiments in which Cul3 was silenced in cells exposed to tBHP resulted in increased oxidative stress, which was not attenuated with Sig1R activation by (+)-PTZ, whereas cells transfected with scrambled siRNA (and incubated with tBHP) responded to (+)-PTZ treatment by decreasing levels of oxidative stress. Assessment of mitochondrial respiration and glycolysis revealed significantly improved maximal respiration, spare capacity and glycolytic capacity in oxidatively-stressed cells transfected with scrambled siRNA and treated with (+)-PTZ, but not in (+)-PTZ treated, oxidatively-stressed cells in which Cul3 had been silenced. The data provide the first evidence that Sig1R co-localizes/interacts with Cul3, a key player in the Nrf2-Keap1 antioxidant pathway. The data suggest that the preservation of mitochondrial respiration/glycolytic function and reduction of oxidative stress observed upon activation of Sig1R occur in part in a Cul3-dependent manner. [Display omitted] • Sig1R activation and its relationship to Cul3 were assessed in photoreceptor cells. • Sig1R co-localizes/interacts with Cul3, a player in the Nrf2-Keap1 antioxidant pathway. • Sig1R activation increased, while silencing Sig1R decreased, Cul3 gene/protein levels. • Sig1R activation preserved mitochondrial/glycolytic function in a Cul3-dependent manner. • Activation of Sig1R reduced oxidative stress, which was Cul3 dependent. [ABSTRACT FROM AUTHOR]

Pentazocine is a synthetic, narcotic analgesic, indicated for various moderate-to-severe pain conditions. Its use and dependence on health care personnel pose unique challenges that make them difficult in seeking help. Complications due to parenteral pentazocine injection resulted in significant impairment for day-to-day functioning and contribute to disability. Hence, we present a case series on pentazocine dependence in health care personnel along with chronic nonhealing ulcers, myofibrosis, inflammatory compartmental syndromes like puffy hand syndrome and highlighting the integrative management of it. [ABSTRACT FROM AUTHOR]

Pentazocine abuse is relatively uncommon and even rarely seen in Indian females. It is often associated with multiple dermatological sequelae due to the repetitive local trauma at the injection site and the local effects of the drug. While managing opioid dependence, pathways of care vary a lot, thus deeming the multilevel screening at the level of general practitioners, pharmacists, mental health professionals, and other specialties, rather crucial. This one step can lead to a significant reduction in the treatment gap of opioid dependence. Here, we present a case of a female who started self-injecting a combination of pentazocine and promethazine (Phenergan) posttubercular meningitis recovery for her persistent postmeningitic headache.

Pentazocine is a synthetic, narcotic analgesic, indicated for various moderate-to-severe pain conditions. Its use and dependence on health care personnel pose unique challenges that make them difficult in seeking help. Complications due to parenteral pentazocine injection resulted in significant impairment for day-to-day functioning and contribute to disability. Hence, we present a case series on pentazocine dependence in health care personnel along with chronic nonhealing ulcers, myofibrosis, inflammatory compartmental syndromes like puffy hand syndrome and highlighting the integrative management of it.

In upper limb surgery supraclavicular brachial plexus (SCBP) block with 0.5% bupivacaine is commonly used for anesthesia. To increase the duration of sensory block opioids are used along with bupivacaine, but data on the effect of pentazocine as adjuvant with bupivacaine in SCBP block is still lacking. The study aimed to compare the duration of postoperative analgesia, sensory and motor block between 0.5% bupivacaine and 0.5% bupivacaine with pentazocine as an adjuvant in SCBP. Methods: The study was conducted on 60 consenting patients, posted for upper limb orthopedic surgery involving the forearm under SCBP block. Patients were randomly divided into two groups. Group B received 19 ml of 0.5 % bupivacaine with 1 ml of normal saline; Group BP received 19 ml of 0.5 % bupivacaine with 1 ml pentazocine (30 mg). Block characteristics, duration of postoperative analgesia, and side effects if any were recorded. Statistical analysis was done using the student t-test and Chi-square test for continuous and categorical variables respectively. Results: The onset of sensory (11.47 ± 1.57 vs. 16.8 ± 2.23 min) and motor (8.17 ± 1.14 vs. 13.9 ± 2.44 min) block was significantly faster in the BP group. Duration of sensory (392.33 ± 9.92 vs. 357.2 ± 8.76 min) and motor (379.27 ± 9.28 vs. 347.27 ± 9.13 min) block was also prolonged in group BP (p < 0.0001). Duration of postoperative analgesia was more (p < 0.0001) in the BP group (407.43 ± 10.46 vs 367.3 ± 8.74min). Conclusion: Pentazocine as an adjuvant with bupivacaine in SCBP block provides faster onset, prolonged duration of the block, and postoperative analgesia.

Background: A middle ear surgery (tympanoplasty), is done under various modes of anaesthesia such as local anaesthesia (LA), general anaesthesia (GA) or sedation with local anaesthesia (MAC). It is usually performed under MAC providing advantages of rapid onset, allowing hearing test intraoperatively and early mobilization of the patient. Aims and Objectives: The aim of this study was to compare effectiveness of nalbuphine and propofol with pentazocine and promethazine combination for intraoperative sedation under monitored anesthesia care for tympanoplasty under local anesthesia (LA). Materials and Methods: A total 60 patients undergoing tympanoplasty under LA divided in to two groups randomly to receive either IV nalbuphine (50 mcg/kg) and propofol 750 mcgs/kg in 10 min followed by a maintenance infusion at the rate of 25 mcg/kg/min. Group N or pentazocine 0.6 mg/Kg and Inj. Promethazine 0.5 mg/kg IV diluted in 10 ml normal saline over 10 min followed by 25 mcg/kg/min infusion of normal saline (Group P). Sedation was titrated to Ramsay Sedation Score (RSS) of 3. Vital parameters such as HR, BP, SpO2, RSS, visual analog scale score (VAS), requirement of rescue analgesics, mean bleeding score, and surgeon satisfaction score (Likert Scale) were recorded and analyzed. Results: RSS was higher and VAS score was lower in Group N at 30, 60, 90, and 120 min (P

Abstract Background and Aim Radiofrequency ablation (RFA) therapy is frequently used as first‐line treatment for small hepatocellular carcinoma (HCC). RFA is often associated with pain; however, no definitive solution has been established for its relief. We retrospectively analyzed the safety and efficacy of the combination of pentazocine and midazolam to relieve pain experienced by HCC patients undergoing RFA. Methods We studied 77 patients with 98 HCCs treated with RFA between January 2015 and August 2019. Patients were divided into two groups: the sedative‐free group, which included those who received pentazocine alone, and the pentazocine–midazolam group, which included those who received a combination of pentazocine and midazolam. The degrees of analgesia and sedation were evaluated using the numerical rating scale (NRS) and the Richmond Agitation‐Sedation Scale (RASS), respectively. Other parameters such as treatment time, awakening time, midazolam dosage, vital signs, local recurrence rate, and time to recurrence were also examined. Results The median NRS score and RASS score were significantly lower in the pentazocine–midazolam group. Ninety‐five percent of patients in the pentazocine–midazolam group had no memory of the RFA session. The treatment time and awakening time were prolonged for the pentazocine–midazolam group. No significant differences in oxygen saturation, recurrence rates, and time to local recurrence were observed between groups. Conclusion A combination of pentazocine and midazolam is safe and effective for pain and anxiety relief experienced by patients undergoing RFA for local treatment of HCC.

Background: Nonmedical use of prescription drugs for recreational purposes is a major health problem that raises high concerns for public health. Recently, several laboratory studies have reported the misuse of pentazocine, an agonist-antagonist opioid in combination with antihistamines in opioid addicts. Illicit self administration of prescription drugs has been increasingly reported in India. Urinalysis as an adjunct to self report plays a key role in providing additional information in the treatment of drug users. This paper aims to discuss a simple, convenient, and rapid capillary column gas-liquid chromatography method for simultaneous detection of pentazocine, pheniramine, and cotinine in urine.Methods: The sample was extracted with chloroform and isopropanol (3:1,v/v) and evaporated to dryness. After reconstitution with methanol, it was directly subjected to gas chromatography analysis. Method performance was evaluated and validated in terms of sensitivity, precision, the limit of detection (LOD), and the limit of quantification (LOQ).Findings: The linearity obtained was in the range of 50–1000 ng/ml with a correlation coefficient (r) above 0.999 for each drug. Good LOQ (50ng/ml) was obtained with each drug. Also, the developed method was effective in analyzing samples from patients with suspected abuse of these drugs.Conclusion: The technique was found to be simple, robust, sensitive, and precise in the simultaneous analysis of drugs (pentazocine, pheniramine, and cotinine). This method was proved to be useful and cost-effective in treating and monitoring patients seeking help for addiction in clinical settings.

Background: A middle ear surgery (tympanoplasty), is done under various modes of anaesthesia such as local anaesthesia (LA), general anaesthesia (GA) or sedation with local anaesthesia (MAC). It is usually performed under MAC providing advantages of rapid onset, allowing hearing test intraoperatively and early mobilization of the patient. Aims and Objectives: The aim of this study was to compare effectiveness of nalbuphine and propofol with pentazocine and promethazine combination for intraoperative sedation under monitored anesthesia care for tympanoplasty under local anesthesia (LA). Materials and Methods: A total 60 patients undergoing tympanoplasty under LA divided in to two groups randomly to receive either IV nalbuphine (50 mcg/kg) and propofol 750 mcgs/kg in 10 min followed by a maintenance infusion at the rate of 25 mcg/kg/min. Group N or pentazocine 0.6 mg/Kg and Inj. Promethazine 0.5 mg/kg IV diluted in 10 ml normal saline over 10 min followed by 25 mcg/kg/min infusion of normal saline (Group P). Sedation was titrated to Ramsay Sedation Score (RSS) of 3. Vital parameters such as HR, BP, SpO2, RSS, visual analog scale score (VAS), requirement of rescue analgesics, mean bleeding score, and surgeon satisfaction score (Likert Scale) were recorded and analyzed. Results: RSS was higher and VAS score was lower in Group N at 30, 60, 90, and 120 min (P<0.05) that mean bleeding score was lower in Group N as compare to Group P which was statistically significant. Conclusion: Nalbuphine and propofol combination are superior to pentazocine and promethazine combination in terms of producing better analgesia, sedation with batter surgical field. [ABSTRACT FROM AUTHOR]

An 80‐year‐old man underwent catheter ablation for atrial tachycardia (AT), which developed after catheter ablation for atrial fibrillation. The AT was diagnosed as dual‐loop tachycardia, which included peri‐mitral and roof‐dependent ATs. An ethanol infusion into the vein of Marshall resulted in left phrenic nerve paralysis. During the procedure, the phrenic nerve paralysis was completely relieved. [ABSTRACT FROM AUTHOR]

Background and Aim: Radiofrequency ablation (RFA) therapy is frequently used as first‐line treatment for small hepatocellular carcinoma (HCC). RFA is often associated with pain; however, no definitive solution has been established for its relief. We retrospectively analyzed the safety and efficacy of the combination of pentazocine and midazolam to relieve pain experienced by HCC patients undergoing RFA. Methods: We studied 77 patients with 98 HCCs treated with RFA between January 2015 and August 2019. Patients were divided into two groups: the sedative‐free group, which included those who received pentazocine alone, and the pentazocine–midazolam group, which included those who received a combination of pentazocine and midazolam. The degrees of analgesia and sedation were evaluated using the numerical rating scale (NRS) and the Richmond Agitation‐Sedation Scale (RASS), respectively. Other parameters such as treatment time, awakening time, midazolam dosage, vital signs, local recurrence rate, and time to recurrence were also examined. Results: The median NRS score and RASS score were significantly lower in the pentazocine–midazolam group. Ninety‐five percent of patients in the pentazocine–midazolam group had no memory of the RFA session. The treatment time and awakening time were prolonged for the pentazocine–midazolam group. No significant differences in oxygen saturation, recurrence rates, and time to local recurrence were observed between groups. Conclusion: A combination of pentazocine and midazolam is safe and effective for pain and anxiety relief experienced by patients undergoing RFA for local treatment of HCC. [ABSTRACT FROM AUTHOR]

Background: Nonmedical use of prescription drugs for recreational purposes is a major health problem that raises high concerns for public health. Recently, several laboratory studies have reported the misuse of pentazocine, an agonist-antagonist opioid in combination with antihistamines in opioid addicts. Illicit self- administration of prescription drugs has been increasingly reported in India. Urinalysis as an adjunct to self- report plays a key role in providing additional information in the treatment of drug users. This paper aims to discuss a simple, convenient, and rapid capillary column gas-liquid chromatography method for simultaneous detection of pentazocine, pheniramine, and cotinine in urine. Methods: The sample was extracted with chloroform and isopropanol (3:1,v/v) and evaporated to dryness. After reconstitution with methanol, it was directly subjected to gas chromatography analysis. Method performance was evaluated and validated in terms of sensitivity, precision, the limit of detection (LOD), and the limit of quantification (LOQ). Findings: The linearity obtained was in the range of 50-1000 ng/ml with a correlation coefficient (r) above 0.999 for each drug. Good LOQ (50ng/ml) was obtained with each drug. Also, the developed method was effective in analyzing samples from patients with suspected abuse of these drugs. Conclusion: The technique was found to be simple, robust, sensitive, and precise in the simultaneous analysis of drugs (pentazocine, pheniramine, and cotinine). This method was proved to be useful and cost-effective in treating and monitoring patients seeking help for addiction in clinical settings. [ABSTRACT FROM AUTHOR]

Background: The most common major obstetric procedure is caesarean section (CS) and one of the greatest concerns for women after CS is to have optimal pain relief. Aim: This study aims to compare the efficacy of pentazocine + diclofenac and paracetamol + diclofenac on post-operative analgesia after CS. Methodology: This was a single-blind, randomised trial. Pregnant women that had CS were randomized into two groups. Group A received intramuscular pentazocine + rectal diclofenac postoperatively. Group B received intramuscular paracetamol + rectal diclofenac postoperatively. Post-operative pain was assessed by numeric rating scale at 1 h after the surgery, at 6 h, 12 h and 24 h. The result obtained was analysed using SPSS Version 22 and P < 0.05 was considered statistically significant. Results: The median pain scores in both groups ranged from 2 to 3 across all periods of assessment. The pain relief was slightly better in the pentazocine + diclofenac group with no significant difference in the pain score between the two groups at all periods of assessment. The satisfaction level was good in 66.3% and 69.5% of the participants in the pentazocine + diclofenac and paracetamol + diclofenac group respectively but the difference was not statistically significant (χ2 = 4.14, P = 0. 12). Nausea, vomiting and drowsiness were significantly more in the pentazocine + diclofenac combination (P < 0.001). Conclusion: Both combination of analgesics provided adequate analgesia but pentazocine + diclofenac combination had better pain relief but was more associated with side effects.

A 33-year-old man came with nausea, vomiting and abdominal pain due to hypercalcaemia and renal dysfunction following two doses of intramuscular vitamin D injections. Levels of vitamin D were repeatedly above 300 ng/ml over a period of 10 months. Whole-body PET CT scan revealed a thin-walled collection in the right gluteal region. The patient refused a surgical intervention for the same. After 7 months of follow-up, the abscess ruptured spontaneously and was then surgically debrided. At this point, a history of pentazocine addiction was uncovered. One month later, vitamin D levels began to fall along with improvement in serum calcium and creatinine. This case unravels a diagnostic odyssey which ended with a simple surgical debridement. We aim to highlight that vitamin D supplementation in 'megadoses' in the presence of active infection can have an exaggerated response and may take months to resolve. [ABSTRACT FROM AUTHOR]

Objective. To observe and compare the analgesic effects of oxycodone, pentazocine, and ketorolac tromethamine pre-emptive analgesia on gynecological laparoscopic patients after operation and the effects on oxidative stress and inflammatory reaction. Methods. A total of 64 patients who underwent elective gynecological laparoscopic surgery in Yiwu Central Hospital from June 2019 to December 2020 were randomly divided into four groups (n = 16). Before anesthesia induction, oxycodone (group A), pentazocine (group B), ketorolac tromethamine (group C), and normal saline (group D) were, respectively, administered. Patients' mean arterial pressure (MAP) and heart rate (HR) changes, visual analogue scale (VAS), Bruggemann comfort scale (BCS), serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), blood glucose (CLU), serum cortisol level, postoperative adverse reactions, and additional analgesia were recorded at each time point. Results. The MAP levels of T2 (immediate intubation), T3 (immediate catheter removal), and T4 (5 min after catheter removal) in the four groups were higher than those of T1 (quiescent state), and the HR levels T2, T3, and T4 were lower than those of T1 P < 0.05 . The MAP and HR levels of T2, T3, and T4 in patients of groups A, B, and C were lower than those of group D in the same period P < 0.05 . The VAS and BCS scores of groups A, B, and C at 1, 6, 12, and 24 h after operation were better than those of group D at the same time, and the scores of group A at 1 h and 6 h after operation were better than those of groups B and C at the same time P < 0.05 . The levels of serum TNF-α, IL-6, and CRP in the four groups of patients at 6, 12, and 24 h after operation were higher than those before operation, but those in groups A, B, and C were lower than those in group D, and those in group A were higher than those in groups B and C at 12 h and 24 h after operation P < 0.05 . The CLU and serum cortisol levels in the four groups were significantly higher at 6, 12, and 24 h after operation, but those in groups A, B, and C were lower than those in group D, and those in group A were lower than those in groups B and C at 6 and 12 h after operation P < 0.05 . There was no significant difference in the incidence of adverse reactions within 24 h between the four groups P > 0.05 . The incidence of additional analgesia in groups A, B, and C was lower than that in group D P < 0.05 . Conclusion. Oxycodone, pentazocine, and ketorolac tromethamine are effective and safe in inhibiting postoperative pain and the generation of inflammatory factors and relieving inflammatory state in gynecological laparoscopic pre-emptive analgesia. Oxycodone has better postoperative analgesic effect because it can effectively alleviate stress reaction. [ABSTRACT FROM AUTHOR]

Background: There is no definitive conclusion on relationship between insulin and pain threshold through opioid mechanism in experimental animal model. The present study investigated the role of endogenous insulin in the modulation of pain using opioid drugs through opioid mechanism and their relationship in experimental animal model. Methods: Eight animal groups were used, each group consisting of six mice (Swiss albino). Group 1-treated saline ip; Group 2-administered pentazocine ip; Group 3-treated naloxone in low dose (0.005 mg/kg, ip) 15 min prior to pentazocine treatment; Group 4-administered naloxone in high dose (5 mg/kg, ip)15 min prior to pentazocine treatment. Another four groups of animals (Group 5, 6, 7 and 8) treated saline, pentazocine, low dose and high dose naloxone both administered 15 min prior to pentazocine treatment respectively. Group 1,2,3 and 4 subjected to acetic acid challenge and Group 5,6, 7 and 8 subjected to formalin test. Blood samples were collected and serum insulin was estimated by ELISA and blood glucose was measured by using Ames glucometer. Results: Pentazocine significantly increased both serum insulin and antinociceptive response to nociceptive stimuli to acetic acid as well as formalin challenge without significantly affecting plasma glucose in both pain models as compared to saline control. Conclusion: The study concluded that possible association between endogenous insulin and pain threshold which is independent of the glycemic status in both the chemically induced nociceptive tests. The relationship between endogenous insulin and pain threshold involves an interaction with opioid system possibly by binding with kappa receptor. [ABSTRACT FROM AUTHOR]

The study evaluated the effect of constant rate infusion of tramadol-xylazine and pentazocine-xylazine on pain in dogs undergoing digital amputation. Twelve mongrel used for the study were randomly assigned to four groups (n=3). Group 1 received loading dose (LD) Xylazine (1mg/kg IV) and Pentobarbitone sodium (Na) (30mg/kg IV) [LD-XP] prior to digital amputation (DA).Group 2 received LD-XP andXylazine (1mg/kg/hr) by constant rate infusion (CRI IV) prior to DA. Group 3 received LD Xylazine (1mg/kg IV), Pentobarbitone Na (30mg/kg IV), CRI Xylazine (1mg/kg/hr) and Tramadol (1mg/kg/hr) prior to DA. Group 4 received LD-XP, CRI Xylazine (1mg/kg/hr) and CRI Pentazocine (1mg/kg/hr) prior to DA. Results of the pain score evaluation showed that at 1, 3, 6 and 24 hours post-surgery (PS), group 4 had the lowest (p<0.05) pain score followed by group 3. Group 4 animals had a significantly (p<0.05) higher heart rate and pulse rate values at 3 and 120 hours. The respiratory rate of group 4 was significantly higher (p<0.05) when compared with the other groups at 3 and 24 hours. It was concluded that CRI pentazocine-xylazine provided better analgesia in the dog DA model. [ABSTRACT FROM AUTHOR]

Background: The most common major obstetric procedure is caesarean section (CS) and one of the greatest concerns for women after CS is to have optimal pain relief. Aim: This study aims to compare the efficacy of pentazocine + diclofenac and paracetamol + diclofenac on post-operative analgesia after CS. Methodology: This was a single-blind, randomised trial. Pregnant women that had CS were randomized into two groups. Group A received intramuscular pentazocine + rectal diclofenac postoperatively. Group B received intramuscular paracetamol + rectal diclofenac postoperatively. Post-operative pain was assessed by numeric rating scale at 1 h after the surgery, at 6 h, 12 h and 24 h. The result obtained was analysed using SPSS Version 22 and P < 0.05 was considered statistically significant. Results: The median pain scores in both groups ranged from 2 to 3 across all periods of assessment. The pain relief was slightly better in the pentazocine + diclofenac group with no significant difference in the pain score between the two groups at all periods of assessment. The satisfaction level was good in 66.3% and 69.5% of the participants in the pentazocine + diclofenac and paracetamol + diclofenac group respectively but the difference was not statistically significant (X² = 4.14, P = 0. 12). Nausea, vomiting and drowsiness were significantly more in the pentazocine + diclofenac combination (P < 0.001). Conclusion: Both combination of analgesics provided adequate analgesia but pentazocine + diclofenac combination had better pain relief but was more associated with side effects. [ABSTRACT FROM AUTHOR]

Pentazocine, a synthetic, prescription opioid analgesic, can now be obtained from the Nigerian illicit market. This development is not without concomitant medical and psychosocial complications. This is a case of psychosocial and cutaneous complications of 8-year history of pentazocine dependence in a 44-year-old married male health worker with features of severe depression, multiple cutaneous abscesses, and punched-out, deep, painless ulcers surrounded by hypopigmented halos. There were associated fibrosis of the skin, strained relationship with wife, and imminent dismissal from work. This report underscores the need for standard prescription procedure adherence by health workers, especially for medications that are potential drugs of dependence for patients with physical conditions.

The present research work was carried out the High Performance Thin Layer Chromatography (HPTLC) and Gas Chromatography-Mass Spectrometry (GC-MS) analysis and assessment of pharmacological activities of Phoenix loureiroi Kunth (Arecaceae) ethanolic leaves extract at doses of 200, 400 and 600 mg/kg, body weight, per os. Preliminary phytochemical screening, HPTLC and GC-MS studies were carried out according to the standard methods. The acute toxicity studies were conducted on Swiss albino mice as per Organization for Economic Cooperation and Development (OECD) guidelines 420. For the screening of analgesic activity, writhing test was conducted for peripheral analgesic activity whereas tail immersion test was conducted for central analgesic activity. Antipyretic activity was performed by using the yeast induced hyperpyrexia method and for the screening of anti-inflammatory activity carrageenan-induced rat paw edema method was used. Preliminary phytochemical screening of the ethanol extract of Phoenix loureiroi leaves (EEPLL) contains sterols, flavonoids, saponins, proteins, reducing sugar, tannins, and phenolic compounds. The HPTLC analysis method employed in this work resulted in good peak shape and enabled good resolution of quercetin present in the extract and GC-MS analysis showed a total of 25 peaks and led to the identification of 22 different phytoconstituents in the ethanolic extract. Lethal Dose 50 (LD50) was above 2,000 mg/kg and no death was recorded. The prevailing study demonstrated that EEPLL possesses widespread analgesic, antipyretic and anti-inflammatory effects in dose dependent manner. It can be concluded that the ethanolic extract from Phoenix loureiroi leaves possesses promising analgesic, antipyretic and anti-inflammatory activities. [ABSTRACT FROM AUTHOR]