Articles: analgesics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the analgesic and emetic properties of ketorolac and morphine for paediatric outpatient strabismus surgery.
In a prospective, double-blind, randomized study, we have compared i.v. ketorolac and morphine in paediatric outpatients undergoing strabismus surgery. Forty-two ASA I or II children, aged 2-12 yr, were allocated randomly to receive either ketorolac 0.75 mg kg-1 i.v. or morphine 0.1 mg kg-1 i.v. and metoclopramide 0.15 mg kg-1. Anaesthesia was induced with propofol and maintained with propofol and nitrous oxide. ⋯ There was no difference in pain behaviour scores or recovery times. The incidence of nausea and vomiting during the first 24 h was 19% in the ketorolac group and 71% in the morphine group (P < 0.001). We concluded that ketorolac was an effective analgesic for this type of surgery and that it was associated with less postoperative emesis than morphine and metoclopramide.
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Arzneimittel Forsch · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialKetorolac versus diclofenac sodium in cancer pain.
In a randomized single-blind study carried out simultaneously in five Departments for Pain Therapy and Palliative Care, the analgesic efficacy and side effects of oral ketorolac (ketorolac tromethamine, Tora-Dol, CAS 74103-07-4) and diclofenac sodium were compared in a population of 100 advanced cancer patients suffering from somatic and/or visceral pain. The treatment was carried out in agreement with the first step of the WHO pharmacological strategy in cancer pain. ⋯ A greater number of keterolac patients could pass to the second WHO step later than diclofenac patients. As to the tolerability, both drugs turned out to be similar, except for "sleepiness", which was four times more frequent (p < 0.05) in the diclofenac group.
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative pain relief in children following caudal bupivacaine and buprenorphine--a comparative study.
Eighty-five paediatric patients (age range: 6 mths-12yrs) undergoing lower abdominal surgery were studied for post-operative pain relief following either caudal bupivacaine (GpI: n = 43) or buprenorphine (GpII: n = 42). Bupivacaine was administered as 0.5ml/kg body weight of 0.25% solution and buprenorphine as 4 micrograms/ml and volume of 0.5 ml/Kg body weight in normal saline. Post-operatively pain was graded on a 4-point scale and behaviour on a 5-point scale. ⋯ Bupivacaine provided good pain relief in the early post-operative hours but buprenorphine provided pain relief lasting for 24 hrs or more post-operatively. Post-operative behaviour of 10 patients receiving buprenorphine was graded as cheerful as compared to 2 from bupivacaine group. Till the end of observation period (i.e. 8 hr post-operatively), majority of patients receiving buprenorphine remained cheerful.
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Anesthesia and analgesia · Apr 1994
Randomized Controlled Trial Clinical TrialQuantifying the interaction of rocuronium (Org 9426) with etomidate, fentanyl, midazolam, propofol, thiopental, and isoflurane using closed-loop feedback control of rocuronium infusion.
The present study was designed to evaluate the interactions of rocuronium with etomidate, fentanyl, midazolam, propofol, thiopental, and isoflurane using closed-loop feedback control of infusion of rocuronium. Sixty patients were randomly assigned to one of six sequences where anesthesia was maintained with etomidate, fentanyl, midazolam, propofol, or thiopental and nitrous oxide, or with isoflurane and nitrous oxide. The possible interaction of rocuronium with the anesthetics was quantified by determining the asymptotic steady-state rate of infusion (Iss) of rocuronium necessary to produce a constant 90% neuromuscular block. ⋯ Iss values calculated per lean body mass were 0.64 +/- 0.22, 0.60 +/- 0.15, 0.61 +/- 0.21, 0.67 +/- 0.31, 0.63 +/- 0.15, and 0.39 +/- 0.17 mg.kg-1.h-1 in the etomidate, fentanyl, midazolam, propofol, thiopental, and isoflurane groups, respectively. The isoflurane group had a lower steady-state rate of infusion of rocuronium than the other five groups (P < 0.05). Compared to intravenous anesthetics, etomidate, fentanyl, midazolam, propofol, or thiopental, isoflurane reduced the infusion requirement of rocuronium by 35%-40%.
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Southern medical journal · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of oral ketorolac, intramuscular morphine, and placebo for treatment of pain after orthopedic surgery.
Using a randomized, double-blind, placebo-controlled, parallel, single-dose, single-center, 6-hour study, we compared the analgesic response and tolerability of oral ketorolac tromethamine and intramuscular morphine sulfate and placebo. The study group comprised 176 patients with moderate, severe, or very severe pain after hip or knee surgery at a teaching hospital. Patients received either 10 mg of ketorolac orally, 10 mg of morphine intramuscularly, 5 mg of morphine IM, or placebo. ⋯ The 10-mg dose of morphine showed a small advantage over ketorolac in peak analgesic effect, but the onset of pain relief was comparable among the active agents. The incidence of adverse events among the active-treatment groups was similar, though there was a numerical trend favoring ketorolac over 10 mg of morphine. We found oral ketorolac to be an effective alternative to parenteral opioids for the treatment of pain after hip or knee surgery in patients who can tolerate oral medication.