Current medical research and opinion
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural block with ropivacaine and bupivacaine for elective caesarean section: maternal cardiovascular parameters, comfort and neonatal well-being.
To determine cardiovascular effects and neonatal outcome of ropivacaine 0.75% and bupivacaine 0.5% for elective epidural caesarean section. ⋯ Both drugs produced equally satisfactory epidural block. Although ropivacaine 0.75% resulted in a greater decrease of maternal heart rate, this effect did not influence neonatal well-being. Both ropivacaine 0.75% and bupivacaine 0.5% can therefore be recommended for epidural anaesthesia in elective caesarean section.
-
Randomized Controlled Trial Clinical Trial
Clinical efficacy of controlled-release oxycodone 20 mg administered on a 12-h dosing schedule on the management of postoperative pain after breast surgery for cancer.
To assess clinical efficacy of controlled-release oxycodone (CRO) 20 mg on a 12-h dosing schedule in this prospective, randomised, placebo-controlled, double-blinded study of 40 ASA physical status I-III women undergoing breast surgery for cancer. ⋯ The administration of CRO 20 mg on a 12-h dosing schedule halves postoperative IV PCA opioid consumption. CRO 20mg is effective in preventing pain after breast surgery for cancer with only mild side-effects.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Impact of tranexamic acid vs. aprotinin on blood loss and transfusion requirements after cardiopulmonary bypass: a prospective, randomised, double-blind trial.
Aprotinin (AP) reduces blood loss and transfusions after cardiopulmonary bypass (CPB), but may sensitise patients and is expensive. Tranexamic acid (TA) has less side-effects, but data regarding its efficacy are controversial. The aim of our prospective, randomised, double-blind study was to compare the impact of AP vs. TA on drainage blood loss and transfusion requirements in patients undergoing first time CABG on CPB. ⋯ Our data show a difference in blood loss between TA and high-dose AP. Although statistically significant, it has little clinical relevance, because perioperative transfusion requirements were similar for both groups. Thus, TA appears to be a cost-effective alternative to AP in primary CABG patients.
-
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Radiotherapy plus either transdermal fentanyl or paracetamol and codeine for painful bone metastases: a randomised study of pain relief and quality of life.
To compare the effects of providing analgesia with either transdermal fentanyl (TTS-fentanyl) or paracetamol and codeine (P/C) in addition to radiotherapy in patients with metastatic bone pain. ⋯ Transdermal fentanyl combined with R/T was more effective in reducing metastatic bone pain and resulted in greater improvements in quality of life than paracetamol and codeine.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of rofecoxib and nimesulide in controlling postextraction pain in oral surgery: a randomised comparative study.
Rofecoxib 50 mg/day for 6 days provided better postoperative analgesia than nimesulide 200 mg/day in a randomised trial in patients (n = 130) undergoing surgical extraction of third molars. The superiority of rofecoxib over nimesulide was especially marked during the first 2-3 postoperative days and in patients with fully impacted molars. The drugs had similar effects on clinical signs of local postoperative inflammation. The effectiveness of rofecoxib in this study, plus considerations of the toxicity profile of nimesulide, support the conclusion that rofecoxib is preferable to nimesulide for relief of post-operative pain in patients undergoing surgical extraction of molars.