British journal of anaesthesia
-
Review Meta Analysis
Nefopam for the prevention of postoperative pain: quantitative systematic review.
Nefopam, a centrally acting analgesic, has been used in the surgical setting in many countries since the mid-1970s. However, clinical trials provide contflicting results for its analgesic potency. We performed a systematic search (multiple databases, bibliographies, any language, to January 2008) for randomized, placebo-controlled trials of nefopam for the prevention of postoperative pain. ⋯ The analgesic potency seems to be similar to non-steroidal anti-inflammatory drugs. However, dose responsiveness and adverse effect profile remain unclear, and the role of nefopam as part of multimodal analgesia needs to be established. Data in children are lacking.
-
Randomized Controlled Trial
Prophylactic mirtazapine reduces intrathecal morphine-induced pruritus.
Activation of the serotonergic system is an important factor in the pathogenesis of intrathecal morphine-induced pruritus. Mirtazapine is a new antidepressant that selectively blocks 5-HT(2) and 5-HT(3) receptors. We therefore tested the hypothesis that preoperative mirtazapine would reduce the incidence of intrathecal morphine-induced pruritus. ⋯ Mirtazapine premedication prevents pruritus induced by intrathecal morphine in patients undergoing lower limb surgery with spinal anaesthesia.
-
Randomized Controlled Trial
Pre-incisional epidural magnesium provides pre-emptive and preventive analgesia in patients undergoing abdominal hysterectomy.
This prospective, randomized, double-blind study was designed to evaluate the preemptive and preventive analgesic efficacy of adding magnesium to a multimodal regimen of patient-controlled epidural analgesia (PCEA) in patients undergoing abdominal hysterectomy. ⋯ Continuous epidural magnesium started before anaesthesia provided preemptive, preventive analgesia, and an analgesic-sparing effect that improved postoperative analgesia without increasing the incidence of side-effects.