American journal of hospital pharmacy
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled analgesia versus intramuscular analgesic therapy.
The pharmacy and nursing time requirements, quality of postoperative pain control, and cost of patient-controlled analgesia (PCA) and intramuscular (i.m.) analgesic therapy were studied. All timings were conducted with a stopwatch on a single nursing unit that primarily receives gynecologic surgery patients. The various work elements involved in each type of therapy were timed individually. ⋯ The median pain scores were moderate for i.m. patients and mild for PCA patients. Scores tended to be lower for PCA patients at 16 and 20 hours. Although equal numbers of patients in the two groups experienced nausea, i.m. patients needed more doses of antiemetics than PCA patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Effect of telephone follow-up on medication compliance.
This study compared the effectiveness, in improving patient compliance with a 10-14 day course of antibiotic therapy, of the following two strategies: (1) a follow-up telephone call and (2) written instructions and oral consultation by a pharmacist. The 82 study patients were randomly assigned to four groups: 1--control; 2--call-back; 3--written and oral consultation; and 4--written and oral consultation plus a call-back. The follow-up telephone call was made on the fourth or fifth day of the prescription course. ⋯ The compliance in the control group was significantly less than for each of the study groups (p = 0.0295), but the three study groups were not significantly different (p less than 0.05). Patients receiving written and oral consultation had significantly greater knowledge about side effects and what to do if they missed doses (p less than 0.002). After follow-up telephone call was equal to, but did not enhance, written and oral consultation in improving patient compliance.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lidocaine anesthesia: comparison of iontophoresis, injection, and swabbing.
The duration and depth of anesthesia produced by lidocaine with three methods of administration were studied. To test duration of anesthesia, either lidocaine or placebo was administered by iontophoresis, subcutaneous infiltration, or swabbing to each of three sites 3 cm apart on the flexor surface of each forearm of 27 subjects. ⋯ Lidocaine iontophoresis produced local anesthesia of significantly longer duration (p less than 0.001) than topical application of lidocaine or placebo by any route of administration, but of significatnly shorter duration (p less tahn 0.001) than lidocaine infiltration. The results showed that lidocaine iontophoresis is an effective method of producing local anesthesia for about five minutes without requiring the use of a hypodermic needle and syringe.
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Randomized Controlled Trial Clinical Trial
Effect of filtration on complications of postoperative intravenous therapy.
The incidence of intravenous complications (phlebitis) and the length of hospital stay in postoperative patients whose infusions were filtered through inline final filters were compared with those in patients whose infusions were not filtered. Identical i.v. solutions were administered to 150 postoperative orthopedic patients randomly assigned to three study groups: control (no filter), 5-micrometers membrane filter and 0.45-micrometers membrane filter. ⋯ In a subgroup of 104 patients undergoing total hip replacement, the mean reduction in length of postoperative hospital stay compared with the control group (13.6 days) was: 5-micrometers filter group--3.4 days (p less than 0.01); and 0.45-micrometer filter group--3.3 days (p less than 0.01). The results suggest that final filters can be used to reduce the incidence of phlebitis-related i.v. complications and thereby reduce the length of hospital stay.
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Randomized Controlled Trial Clinical Trial
Filtration and infusion phlebitis: a double-blind prospective clinical study.
The effect of final filtration on the incidence of infusion phlebitis was studied in a prospective, double-blind investigation involving 146 postoperative patients. The incidence of infusion phlebitis was found to be significantly reduced when an inline, 0.45-mum membrane filter was used. The greatest reduction of infusion phlebitis was in the filter groups receiving unbuffered solutions and no set change over the 72 hours of therapy. ⋯ Antibiotic therapy appeared to have a slightly beneficial effect only when inline filters were employed. A significant rise in white blood cell count and an increase in sedimentation rate were observed in the patients receiving unfiltered fluids. It is recommended that inline final filters should be a part of routine intravenous therapy.