Articles: analgesics.
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Anesthesia and analgesia · Dec 1995
Randomized Controlled Trial Clinical TrialEpidural clonidine or sufentanil for intraoperative and postoperative analgesia.
This study contrasts the efficacy and side effects of epidural clonidine and sufentanil in the perioperative period. Using a randomized, prospective, double-blind study design, 40 patients undergoing abdominal surgery under propofol/nitrous oxide anesthesia were enrolled. Before anesthesia, an epidural catheter was inserted at the L1-L2 interspace. ⋯ Plasma clonidine and sufentanil concentrations were measured after 20 min and 6, 12, and 24 h. The number of reinjections of propofol (n = 1.6 +/- 1.6 in Group 1 vs 6.5 +/- 4.0 in Group 2) and of IV sufentanil (n = 0.6 +/- 0.8 in Group 1 vs 3.8 +/- 3.7 in Group 2) was significantly reduced (P < 0.001) in the epidural clonidine group. In the early postoperative period, pain scores and rescue analgesic requirements were very low in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Dec 1995
Randomized Controlled Trial Clinical TrialContinuous intravenous administration of ketorolac reduces pain and morphine consumption after total hip or knee arthroplasty.
The purpose of this study was to determine the analgesic efficacy, opioid-sparing effect, and tolerability of ketorolac administered as an intravenous (i.v.) bolus followed by a continuous infusion after total hip or knee arthroplasty. After general anesthesia, patients received either placebo or ketorolac 30 mg i.v. as a bolus over 15-30 s followed by a continuous i.v. infusion of ketorolac 5 mg/h for 24 h. All patients received patient-controlled i.v. morphine with no background infusion. ⋯ Patients receiving ketorolac reported were less sedated and required fewer antiemetics. There was no difference in blood loss. Patients receiving ketorolac reported better analgesia and used less morphine (35% for hips and 44% for knees) than those receiving placebo.
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Acta Anaesthesiol. Sin. · Dec 1995
Randomized Controlled Trial Clinical TrialOpioid in peripheral analgesia: intra-articular morphine for pain control after arthroscopic knee surgery.
Some authors reported that a small dose of intra-articular morphine (1-5 mg) injection provided a potent and long-acting analgesic effect on pain after arthroscopic knee surgery. However, many in other reports did not agree to this result. Therefore, the characteristic of the analgesic effect of intra-articular morphine is worth evaluation. In order to rule out the systemic action of intra-articular morphine, we designed a study to compare the efficacy of 3 mg intra-articular morphine with that of 3 mg intravenous morphine in providing analgesia after arthroscopic knee surgery. ⋯ Intra-articular morphine (3 mg) provided long-lasting analgesia from 6 to 36 h postoperatively and this effect was not due to systemic absorption of morphine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intraarticular bupivacaine with the addition of morphine or fentanyl for analgesia after arthroscopic surgery.
A randomized study on 30 patients undergoing knee arthroscopy was performed. Group I (n = 15) received 50 mg of 0.25% bupivacaine and 1 mg of morphine, and group II (n = 15) received 50 mg of 0.25% bupivacaine and 100 micrograms of fentanyl. The visual analogue scale was recorded at intervals of 1, 2, 3, 4, 6, 12, 24, and 48 hours after the operation. ⋯ In group I, pain scores were lower than group II (P < .05) during the 1st, 2nd, 3rd, 12th, 24th, and 48th hours. The duration of analgesia on group I was significantly longer than group II. The combination of intraarticular morphine and bupivacaine has a longer analgesic duration and effect than a combination of fentanyl and bupivacaine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anaesthesia and adverse effects after intrathecal pethidine hydrochloride for urological surgery.
Anaesthesia, postoperative analgesia and the incidence of adverse effects after intrathecal pethidine hydrochloride 0.50 mg.kg-1 and 0.75 mg.kg-1 were assessed and compared with a conventional technique using isobaric bupivacaine 13.75 mg in patients undergoing transurethral resection of the prostate gland. Sensory and motor block were significantly shorter with both pethidine regimens than with bupivacaine (p < 0.001). Although sensory and motor block were shorter after pethidine 0.50 mg.kg-1 than after pethidine 0.75 mg.kg-1 the difference in duration was clinically insignificant. ⋯ Pruritus was seen only in patients receiving pethidine. Intra-operative sedation occurred more often in patients receiving both pethidine 0.50 mg.kg-1 and 0.75 mg.kg-1 compared with patients receiving bupivacaine (p < 0.04). Both pethidine regimens provided acceptable anaesthesia and there were no significant differences between the two regimens in quality of intra-operative anaesthesia, incidence of adverse events or postoperative analgesia.