Articles: analgesics.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Clinical TrialDouble-blind randomized evaluation of intercostal nerve blocks as an adjuvant to subarachnoid administered morphine for post-thoracotomy analgesia.
Thoracotomy is associated with pain and compromised pulmonary function. Intercostal nerve blocks (INB) and subarachnoid morphine (SM) act on different portions of the pain pathway. Each is effective for post-thoracotomy pain relief. The combination of these two modalities in relieving post-thoracotomy pain and improving postoperative pulmonary function has not been investigated. ⋯ Although postoperative INB provided modest improvements in pain and pulmonary function when used as an adjuvant to 0.5 mg SM for post-thoracotomy analgesia, the benefits were transient. The authors do not recommend adding INB for patients undergoing lateral thoracotomy who receive 0.5 mg SM.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of EMLA cream versus nitrous oxide for pediatric venous cannulation.
To compare the analgesic and anxiolytic effects of nitrous oxide (N2O) when inhaled by face mask with those of a cutaneous application of a eutectic mixture of local anesthetics (EMLA) cream with lidocaine and prilocaine during pre-operative venous cannulation in children. ⋯ N2O administered by face mask appears to provide greater anxiolysis and attendant superior analgesia for pediatric venous cannulation than a cutaneous application of EMLA cream.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialPain relief for thoracotomy. Comparison of morphine requirements using an extrapleural infusion of bupivacaine.
The effectiveness of a continuous infusion of extrapleural bupivacaine for relief of postoperative pain was assessed in patients undergoing posterolateral thoracotomy under general anesthesia by comparing morphine requirements. ⋯ Continuous extrapleural infusion of bupivacaine through unkinkable catheters sited during thoracotomy resulted in decreased intravenous patient-controlled analgesia use and decreased verbal categoric pain scores at rest and during movement.
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Randomized Controlled Trial Clinical Trial
Sucrose reduces pain reaction to heel lancing in preterm infants: a placebo-controlled, randomized and masked study.
In term infants sucrose given by mouth has been reported to reduce duration of crying after a heel prick. This study was designed primarily to investigate the effect of sucrose administered orally immediately before heel lancing on the nociceptive reaction in preterm infants as assessed by change in heart rate and duration of crying. A secondary objective was to document changes in cerebral blood volume during acute pain. ⋯ We found the heart increased by a mean of 35 beats/min (bpm) after sucrose and 51 bpm after placebo (median difference 16 bpm, interquartile range 1-30 bpm, p = 0.005). Infants cried 67% of time after sucrose and 88% after placebo (median difference 10%, interquartile range 3-33%, p = 0.002). Cerebral blood volume decreased in 5 of 14 infants after sucrose and in 6 of 14 infants after placebo (difference not significant).
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Randomized Controlled Trial Clinical Trial
Efficacy of controlled-release codeine in chronic non-malignant pain: a randomized, placebo-controlled clinical trial.
Treatment decisions for the use of opioid analgesics in chronic non-malignant pain are based primarily on survey data, as evidence from well-controlled clinical trials has been lacking. Forty-six patients with chronic non-malignant pain were enrolled in a randomized, double-blind, placebo-controlled evaluation of controlled-release (CR) codeine. Following a 3-7-day diary familiarization period, patients were randomly assigned to 7 days of treatment each with CR codeine q12h or placebo. ⋯ Ninety-three percent of patients completing the study requested long-term, open-label treatment with CR codeine. Pain intensity scores at the completion of 19 weeks of long-term evaluation were comparable to those during the double-blind CR codeine treatment. We conclude that treatment with CR codeine results in reduced pain and pain-related disability in patients with chronic non-malignant pain.