Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Preoperative flurbiprofen provides pain relief after laparoscopic cholecystectomy].
In a single-blind randomized prospective study, postoperative pain was assessed in 60 patients undergoing elective laparoscopic cholecystectomy with three types of anesthesia: standardized general anesthesia (control group), preoperative 50 mg flurbiprofen as an addition to the same method of general anesthesia (flurbiprofen group), and conventional combined epidural and general anesthesia with epidural administration of 0.25% bupivacaine 5-8 ml and 0.1-0.2 mg buprenorphine after surgery (epidural group). After the operation we found that the average time from the end of surgery to the first request for an analgesic was 3.9 h, 22.7 h and 43.7 h in the control, flurbiprofen and epidural group, respectively. ⋯ Patients in the control group requested analgesics for a longer period of time after the initial request compared with patients in the other groups. Our results indicate that postoperative pain can be reduced when flurbiprofen is added to general anesthesia before surgery, although use of flurbiprofen was not as effective as the conventional combined epidural and general anesthesia used for treating pain after laparoscopic cholecystectomy.
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Randomized Controlled Trial Clinical Trial
[Postoperative epidural fentanyl administration in patients for hysterectomy with para-aortic lymph node resection].
In our experience, continuous epidural administration of fentanyl in doses of 12.5 micrograms.h-1, has not been sufficient to relieve postoperative pain in patients after hysterectomy with para-aortic lymph node resection. Thus, a prospective, randomized, single-blind study was performed to compare the analgesic efficacy of fentanyl 25 micrograms.h-1 with 12.5 micrograms.h-1 in these patients for 48 hours after surgery. Twenty-one women undergoing hysterectomy with para-aortic lymph node resection were allocated into three groups; Group C (control, n = 7): fentanyl 12.5 micrograms.h-1, infusion rate 2 ml.h-1, Group S2 (double speed, n = 7): fentanyl 25 micrograms.h-1, infusion rate 4 ml.h-1, and Group C2 (double concentration, n = 7): fentanyl 25 micrograms.h-1, infusion rate 2 ml.h-1. ⋯ At movement, the analgesic efficacy was not sufficient in any groups, but, at rest, groups S2 and C2 experienced significantly less pain than the group C. The degree of pain relief was not different between groups S2 and C2. In conclusion, epidural fentanyl 25 micrograms.h-1 provided significantly superior analgesia compared with epidural fentanyl 12.5 micrograms.h-1.