Anesthesia and analgesia
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Anesthesia and analgesia · Feb 1990
Randomized Controlled Trial Clinical TrialEffects of oral caffeine on postdural puncture headache. A double-blind, placebo-controlled trial.
Forty postpartum patients with postdural puncture headache (PDPH) were randomly assigned to receive oral caffeine (300 mg) or a placebo. Intensity of headache, quantitated using a visual analogue pain scale (VAS), was assessed immediately before drug administration and 4 and 24 h later. ⋯ Six patients (30%) whose PDPH was relieved by caffeine at 4 h had recurrence of symptoms the following day. Our study demonstrates that caffeine administered orally provides relief, albeit if sometimes transient, from PDPH with minimal side effects.
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Anesthesia and analgesia · Feb 1990
Intrathecal morphine dose-response data for pain relief after cholecystectomy.
We studied the effect of low-dose intrathecal morphine (0.00-0.20 mg) on pain relief and the incidence of side effects after cholecystectomy in 139 patients divided into eight groups according to intrathecal morphine dose: groups 1 (0.00 mg), 2 (0.04 mg), 3 (0.06 mg), 4 (0.08 mg), 5 (0.10 mg), 6 (0.12 mg), 7 (0.15 mg), and 8 (0.20 mg). Preservative-free morphine hydrochloride mixed in hyperbaric tetracaine solution was administered at the time of induction of spinal anesthesia just before surgery. Pain relief was significantly greater for the first 24 h in groups 3, 4, 5, 6, 7, and 8 than in group 1. ⋯ Vomiting occurred significantly more often in group 1 than in groups 2, 3, 4, and 5. Intraoperative cholangiography and the postoperative clinical course indicated no increase in tone of the sphincter of Oddi in any patient. We conclude that 0.06-0.12-mg intrathecal morphine is the best dose range for pain relief after cholecystectomy without respiratory depression and with the lowest incidence of vomiting or pruritus, or both.