European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Tramadol in the management of post-operative pain: a double-blind, placebo- and active drug-controlled study.
A double-blind, randomized, placebo- and drug-controlled study in which the analgesic efficacy and safety of intravenous (i.v.) tramadol in patients with post-operative pain is reported. One hundred and eighty patients recovering from gynaecological or abdominal surgery were assigned to one of three treatment groups. After titration of an individual loading dose, patients could self-administer tramadol 20 mg, morphine 2 mg or placebo using a patient-controlled analgesia (PCA) device throughout a 48-h period. ⋯ VAS after the initial bolus were 39.2 +/- 22.1, 35.9 +/- 21.6 and 50.0 +/- 24.2 (P = 0.002), the initial loading dose amounted to tramadol 144.9 +/- 51.2 mg, morphine 12.3 +/- 5.1 mg and placebo 17.2 +/- 4.9 mL. No serious opioid-related adverse events occurred in the patients given tramadol while two patients given morphine developed an impaired respiratory rate and a decreased oxygen saturation to 80% or less. Tramadol proved to be efficacious for PCA treatment of post-operative pain following gynaecological and abdominal surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal sufentanil compared with epidural bupivacaine analgesia in labour.
Epidural analgesia for pain relief during labour has certain disadvantages including slow onset. However, intrathecal sufentanil provides rapid onset and well-controlled analgesia lasting 1-4 h. The aim of this study was to compare the analgesia and the side effects of intrathecal sufentanil with epidural bupivacaine during labour. ⋯ Pain scores were significantly lower between 5 and 90 min after injection in patients receiving intrathecal sufentanil. Pruritus was significantly more frequent among those receiving intrathecal sufentanil. The rapid onset and effective analgesia of intrathecal sufentanil may in certain situations be advantageous.
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Randomized Controlled Trial Comparative Study Clinical Trial
Is an alkalinized lignocaine solution a better topical anaesthetic for intratracheal application?
Topical anaesthesia of the trachea is used to avoid coughing during emergence from anaesthesia. This study was designed to compare the effects of an alkalinized lignocaine and plain lignocaine solution given intratracheally. After institutional approval and written informed consent, 30 patients were randomized into three groups and received in a double-blind fashion: lignocaine, alkalinized lignocaine and normal saline for control. ⋯ Noradrenaline levels were significantly diminished in the lignocaine groups (P < 0.05). Plain and alkalinized lignocaine solutions for topical anaesthesia significantly improved tolerance to the tracheal tube during emergence from anaesthesia. Plain and alkalinized lignocaine given directly before intubation reduced the sympathomimetic stress response resulting in a lower noradrenaline concentration and a reduced heart rate.
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Randomized Controlled Trial Clinical Trial
The influence of timing of ketorolac administration on post-operative analgesic requirements following total abdominal hysterectomy.
One hundred and thirty-seven patients were studied to assess whether the timing of a dose of ketorolac affected cumulative morphine requirements during the first 12 post-operative hours. Pain, sedation and nausea scores, respiratory rate and degree of operative blood loss were also recorded. Thirty-six patients (group A) were given placebo injections pre- and intra-operatively. ⋯ Thus, the timing of ketorolac administration made no difference to overall morphine consumption. Pain, nausea, sedation and respiratory rate scores were similar in all four groups. There was a significantly greater blood loss in patients receiving ketorolac (groups B, C and D) compared with those receiving placebo alone (group A).
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Randomized Controlled Trial Clinical Trial
Analgesic effect of intra-articular bupivacaine or diamorphine after arthroscopic surgery of the knee joint in day-case patients.
A prospective, randomized, double-blind, controlled study was conducted to assess the efficacy of intra-articular bupivacaine and diamorphine. Ninety-six day-case patients were allocated randomly to receive intra-articular injections of either 20 mL 0.9% saline (control, n = 35), 20 mL 0.5% plain bupivacaine (n = 31), or 20 mL 0.9% saline with 5 mg diamorphine (n = 30) prior to tourniquet release. ⋯ Intra-articular analgesics conferred a noticeable improvement in patient comfort. First, the quantity of supplementary analgesia required prior to discharge was significantly reduced (P = 0.016); second, patients reported a less disturbed night's sleep (P = 0.034).