Articles: analgesics.
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialPain outcomes after thoracotomy: lumbar epidural hydromorphone versus intrapleural bupivacaine.
To evaluate postthoractomy analgesia in patients receiving lumbar epidural hydromorphone versus intrapleural bupivacaine. ⋯ Epidural hydromorphone is superior to intrapleural bupivacaine in achieving satisfactory pain outcomes during the first 5 hours after thoracotomy.
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Clinical TrialEffects of thoracic epidural analgesia on coronary hemodynamics and myocardial metabolism in coronary artery bypass surgery.
A possible influence of thoracic epidural analgesia on coronary hemodynamics and myocardial metabolism in coronary artery bypass grafting was investigated. ⋯ With regard to the coronary circulation and myocardial metabolism, no hard data supporting the use of thoracic epidural analgesia in coronary artery bypass grafting were found.
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J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intrapleural versus intravenous morphine for postthoracotomy pain management.
To compare the analgesic effects of intrapleural and intravenous morphine administration for postthoracotomy pain management. ⋯ IPM achieved better analgesia than IVM and this effect is probably attributable to peripheral effects of morphine.
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Anesthesia and analgesia · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intravenous and epidural clonidine for postoperative patient-controlled analgesia.
Both epidural and intravenous clonidine are used to provide postoperative analgesia, but in predetermined doses. This double-blind randomized study was designed to 1) determine the clonidine dose inducing pain relief after major orthopedic surgery, when controlled by patient, either intravenously or epidurally; and 2) assess whether these two administration routes are clinically equivalent. At the first complaint of pain after scoliosis correction, patients received an initial dose of 8 micrograms/kg clonidine during 30 min either intravenously (n = 12) or epidurally (n = 12). ⋯ Plasma clonidine concentrations were higher in the intravenous group than in the epidural group (2.5 +/- 0.6 vs 1.5 +/- 0.5 ng/mL after the initial dose and 2.1 +/- 0.5 vs 1.5 +/- 0.4 ng/mL during self-administration; mean +/- SD). We conclude that analgesia can be achieved postoperatively by both epidural and intravenous clonidine administration. The epidural route is associated with significant reductions in self-administered clonidine dose, and thus in the plasma clonidine concentration, and the level of sedation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Oct 1995
Randomized Controlled Trial Comparative Study Clinical TrialComputer-controlled infusion of alfentanil versus patient-controlled administration of morphine for postoperative analgesia: a double-blind randomized trial.
This study compared the efficacy of computer-controlled infusion of alfentanil (CCiA) with patient-controlled administration of morphine (PCAM) for postoperative analgesia. Twenty patients were randomly allocated to one of the two study groups to receive either an intravenous CCiA or PCAM regimen. Pain scores measured on a visual analog scale (VAS) and the number of valid demands were used as variables to evaluate the efficacy of the postoperative analgesic therapy. ⋯ The MDPE and MDAPE were 8% and 22%, respectively. The maximum alfentanil concentrations associated with pain and the minimum effective analgesic concentrations of alfentanil varied considerably both inter- and intraindividually. In conclusion, compared to a standard intravenous PCAM regimen, a CCiA is faster in onset of analgesia and is as effective in providing postoperative analgesia.