Anesthesiology and pain medicine
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Addicted patients present difficulties for pain management because they have another problem besides their pain. Adding adjuvants to opioid pumps to intensify quality, control other problems, lengthen analgesia, and reduce side effects has been considered in the field. ⋯ This study showed that, compared to simply increasing the dose of morphine, adding chloropromazine, promethazine, midazolam, and clinidine to morphine significantly controlled pain scores and increased treatment satisfaction in addicted patients without notable side effects.
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Opioid analgesics are commonly added to epidural local anesthetics to improve analgesia during surgery. ⋯ The addition of tramadol to epidural 2% lidocaine offers advantages in cesarean section.
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Intentional lowering of blood pressure helps to produce a desirably clean surgical field. Many drugs can be used to induce a hypotensive state, but due to their high potency and rapid effect, drugs that more easily and safely control the induction of hypotension are desirable. ⋯ Premedication with oral clonidine can improve the hemodynamic management of cesarean cases.