British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Epidural oxycodone or morphine following gynaecological surgery.
The analgesic action of oxycodone is of rapid onset, in contrast to morphine, and is mediated by kappa-opioid receptors of the spinal cord. We compared analgesia and side-effects of epidural oxycodone with those of morphine after gynaecological surgery. ⋯ Epidural oxycodone was as effective as morphine at the doses investigated, with fewer side-effects.
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Randomized Controlled Trial Clinical Trial
Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia.
Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing arthroscopic knee surgery might shift the analgesic dose-response curve of intra-articular (i.a.) morphine. ⋯ The dose-response relationship of i.a. morphine analgesia is not shifted by enhanced inflammation and END expression within synovial tissue. Thus, the presence of END within inflamed synovial tissue does not seem to interfere with i.a. morphine analgesia.
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Randomized Controlled Trial Clinical Trial
Epidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia for knee arthroplasty.
Peripheral neural blockade appears to provide effective analgesia with potentially less morbidity than central neuraxial techniques. We compared the relative benefits of combined femoral (3-in-1) and sciatic nerve block with epidural blockade for postoperative knee arthroplasty analgesia. ⋯ Combined femoral (3-in-1) and sciatic blocks offer a practical alternative to epidural analgesia for unilateral knee replacements.
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Randomized Controlled Trial Clinical Trial
Effect of pre-emptive ketamine on sensory changes and postoperative pain after thoracotomy: comparison of epidural and intramuscular routes.
In this study we have evaluated the efficacy of ketamine via i.m. and epidural routes for the control of post-thoracotomy pain. ⋯ The results of the present study demonstrate that pre-emptive epidural ketamine is effective in reducing intra- and postoperative analgesic requirements, hyperalgesia and touch allodynia.
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Randomized Controlled Trial Clinical Trial
Enhanced visual memory effect for negative versus positive emotional content is potentiated at sub-anaesthetic concentrations of thiopental.
Emotional information has the ability to alter the formation and strength of a memory ('memory modulation'). Memory modulation by negative emotion is mediated by the amygdala. It is not known how gamma aminobutyric acid (GABA)ergic drugs affect the processes involved in memory modulation. This study investigates whether memory for negative emotional stimuli is more refractory to the effects of GABAergic drugs. ⋯ Over a specific dose range of thiopental (target serum concentration 2-7 micro g ml(-1)), impairment of explicit memory for images with negative emotional valence is less than that for images with positive emotional valence. There is a strong possibility that propofol (target serum concentration 0.3-2.4 micro g ml(-1)) causes a similar effect. Modulation of visual memory by negative emotional content continues at sub-anaesthetic concentrations of GABAergic drugs associated with explicit memory impairment.