Articles: analgesics.
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Anesthesia and analgesia · Sep 1996
Randomized Controlled Trial Clinical TrialSpinal anesthesia with bupivacaine and fentanyl in geriatric patients.
We assessed the risks and benefits of the administration of fentanyl during spinal anesthesia in the elderly. Forty patients (70-83 yr) undergoing knee or hip replacement were studied. Preoperatively, cognitive function (minimental state examination [MMSE]), associated pathology, medications, and treatment were evaluated. ⋯ MMSE at hospital discharge was no different from preoperative values. Our results show that 25 micrograms of spinal fentanyl do not modify spinal anesthesia in the elderly, but induces pruritus and O2 desaturation. The decrease in postoperative pain intensity and the preservation of cognitive function would justify the use of spinal fentanyl in the elderly.
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Anesthesia and analgesia · Sep 1996
Randomized Controlled Trial Clinical TrialMode and site of analgesic action of epidural buprenorphine in humans.
This study was designed to clarify the site of analgesic action of epidural buprenorphine and its spinal segmental analgesia. Fifty patients undergoing gastrectomy were randomly assigned to five groups according to the dose of buprenorphine and route of administration: epidural saline group, epidural buprenorphine 2- and 4-micrograms/kg groups, and intravenous buprenorphine 2- and 4-micrograms/kg groups. The changes in pressure pain threshold (PPT) and visual analog scale (VAS) were compared within groups of patients receiving either buprenorphine, 2 or 4 micrograms/kg epidurally, and between groups of patients receiving buprenorphine 2 or 4 micrograms/kg either epidurally or intravenously. ⋯ VAS value significantly (P < 0.01) decreased in the larger dose buprenorphine epidural group compared with that in the smaller dose group during the middle period. The larger dose of epidural buprenorphine provided better analgesia than the smaller dose. We conclude that epidural buprenorphine acts predominantly at the supraspinal region and produces spinal segmental analgesia in a dose-related manner.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 1996
Randomized Controlled Trial Clinical TrialAlfentanil as procedural pain relief in newborn infants.
To assess the need for, and the suitability of, alfentanil for pain relief during tracheal suction used in assisted ventilation in newborn infants. ⋯ Tracheal suction is a painful procedure. The dose of alfentanil required for pain relief (20 micrograms/kg) causes a high incidence of rigidity and thus should be used only with muscle relaxant.
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Acta Anaesthesiol Scand · Sep 1996
Randomized Controlled Trial Clinical TrialPreoperative ketorolac administration has no preemptive analgesic effect for minor orthopaedic surgery.
The utility of preoperative ketorolac administration to reduce the intensity and duration of postoperative pain was compared with placebo in a randomized double-blind design of 60 ASA 1-2 patients scheduled for minor orthopaedic surgery. No opioids nor local anaesthetic blocks were used during surgery. The patients received either 30 mg ketorolac IV before surgery followed by a placebo injection after surgery or the reverse. ⋯ No differences in pain intensity were observed between the two groups except for the initial 15-min postoperative assessments in the ketorolac group. The time to first rescue morphine administration and the total morphine consumption during the 6-h observation period were similar. It is concluded that the preoperative administration of ketorolac did not provide a significant preemptive analgesic benefit with regard to postoperative pain relief and opioid dose-sparing effect.
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Br J Clin Pharmacol · Sep 1996
Randomized Controlled Trial Comparative Study Clinical TrialA randomized, double-blind, placebo-controlled trial comparing pethidine to metamizol for treatment of post-anaesthetic shivering.
1. Shivering is frequent during the post-anaesthetic recovery period, and there is no clear consensus about the best strategy for its treatment. We tested the efficacy of two commonly used analgesic drugs, pethidine and metamizol. 2. ⋯ Both drugs were well tolerated. 4. The persistence of shivering at 45 min in two thirds of placebo-treated patients indicates that drug treatment is worthwhile; metamizol produces a better postanaesthetic shivering response than placebo, especially 15 and 45 min after drug administration; the efficacy of pethidine was the highest and the response to it appeared more quickly; however, at 45 min it was similar to that observed with metamizol. 5. Both metamizol and pethidine suppress postanaesthetic shivering, but the latter induces a quicker and more reliable response.