The Clinical journal of pain
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Randomized Controlled Trial Comparative Study Clinical Trial
Ketorolac versus fentanyl for postoperative pain management in outpatients.
The purpose of this study was to compare the efficacy and safety of i.v. ketorolac and fentanyl for moderate to severe postoperative pain in patients undergoing elective surgery in an ambulatory surgery unit. ⋯ Ketorolac appears not be as effective as fentanyl in treating early postoperative pain. Although fentanyl still appears to be the drug of choice in the early postoperative period, the parenteral use of ketorolac was more effective during the later postoperative period in providing longer lasting analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of morphine and ketorolac for intravenous patient-controlled analgesia in postoperative cancer patients.
To compare the effectiveness of intravenous patient-controlled (i.v.-PCA) ketorolac to i.v.-PCA morphine in the treatment of postoperative pain in cancer patients. ⋯ These results indicate that ketorolac supplemented with small doses of morphine is associated with a lower incidence of nausea, vomiting, and pruritus compared to morphine alone. This combination should be considered where immunosuppression from operation and administration of morphine is undesirable.
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Randomized Controlled Trial Clinical Trial
Epidural morphine pretreatment for postepisiotomy pain.
A randomized double-blind controlled study was conducted on two groups of 45 parturients to evaluate the importance of the timing of epidural morphine administration for the relief of postepisiotomy pain. Both groups had preemptive analgesia by continuous lumbar epidural bupivacaine blockade. Upon completion of the episiotomy repair and before the onset of pain, the patients received epidural injections of 3 ml saline with or without 2 mg morphine in groups A and B respectively. When pain appeared, group A patients received an epidural injection of 3 ml saline while group B patients received 2 mg morphine in 3 ml saline. Postepisiotomy pain level was evaluated by a visual analogue scale. ⋯ Epidural morphine for postepisiotomy pain is much more effective if administered before the onset of pain.
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Randomized Controlled Trial Clinical Trial
False-positive rates of cervical zygapophysial joint blocks.
To determine the false-positive rate of anesthetic blocks of the medial branches of the cervical dorsal rami in the diagnosis of cervical zygapophysial joint pain. ⋯ Uncontrolled diagnostic blocks are compromised by a significant false-positive rate that seriously detracts from the specificity of the test.
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Randomized Controlled Trial Clinical Trial
Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled analgesia.
We designed a clinical study to determine: a) the safety and efficacy of patient-controlled analgesia (PCA) therapy in children and adolescents undergoing major operations, b) if the use of a concurrent opioid infusion improved the efficacy of conventional PCA therapy, and c) if nurse control of the PCA device was a useful alternative in the intensive care unit (ICU) setting. ⋯ Both PCA and NCA were safe and efficient methods of analgesic administration in the pediatric ICU setting. However, use of a concurrent opioid infusion with PCA therapy did not provide any clinically significant advantages over intermittent bolus doses of the analgesic medication after scoliosis surgery. For patients unable to use a conventional PCA device, NCA is an acceptable alternative for the management of acute pain in the ICU setting.