Articles: analgesics.
-
Randomized Controlled Trial Clinical Trial
Evaluation of the analgesic effect of metoclopramide after opioid-free analgesia.
Metoclopramide may enhance opioid analgesia, but it is not known if the drug is analgesic itself. This question was examined in a double-blind, randomized study of 38 patients undergoing knee arthroscopy with opioid-free anaesthesia comprising propofol, isoflurane and nitrous oxide in oxygen. At the end of surgery, patients received either metoclopramide 0.5 mg kg-1 or placebo i.v. ⋯ There were no significant differences between the groups in the patterns of pethidine consumption. However, the VAS-pain scores tended to be smaller in the metoclopramide group; this difference was significant 30 min after operation. These results do not demonstrate conclusively a clinically relevant analgesic action of metoclopramide.
-
Anesthesia and analgesia · May 1993
Randomized Controlled Trial Clinical TrialEffects of ketorolac on postoperative analgesia and ventilatory function after laparoscopic cholecystectomy.
Ketorolac, a nonsteroidal anti-inflammatory drug, is alleged to produce postoperative analgesia without opioid-related side effects. Patients undergoing laparoscopic cholecystectomy were assigned randomly to receive either ketorolac or a placebo (saline) according to a double-blind protocol. Preoperative (baseline) pulmonary function was evaluated using a Respiradyne II monitor. ⋯ In the ketorolac group, only values of forced expiratory volume at 1 s and forced expiratory flow at 25%-75% of the forced vital capacity at 4 h after the operation were significantly higher than those in the saline group (P < 0.05). Incidences of nausea (45% vs 52%) and vomiting (10% vs 10%) were similar in both groups. In conclusion, ketorolac decreased the postoperative requirement for opioid analgesic medication.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Anesthesia and analgesia · Apr 1993
Randomized Controlled Trial Comparative Study Clinical TrialA-3665, a new short-acting opioid: a comparison with alfentanil.
A-3665 is a new short-acting synthetic opioid of the piperidine class. We conducted a double-blind, escalating dose comparison of A-3665 to alfentanil and placebo. Analgesic efficacy was assessed after the administration of A-3665 in increasing intravenous doses (0.25, 0.5, 1, 2, 4, 8, 16, 32, and 64 micrograms/kg) to nine groups of volunteers. ⋯ There was no significant difference in analgesic potency of A-3665 and alfentanil as measured by tolerance to tibial pressure at 3 min. At the dose of 16 micrograms/kg, both drugs significantly increased pain tolerance to tibial pressure compared with placebo at 3 min, but alfentanil continued to display significant analgesic effect versus placebo and versus A-3665 at 6, 11, and 15 min after injection. A-3665 caused significant respiratory depression at doses of 32 micrograms/kg and 64 micrograms/kg, but alfentanil did not induce significant respiratory depression at the doses tested.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Clinical Trial
Assessment of ketorolac as an adjuvant to fentanyl patient-controlled epidural analgesia after radical retropubic prostatectomy.
Opioids, although effective postoperative analgesics, are associated with undesirable side effects. In an attempt to determine whether adjuvant, nonopioid medication would permit a reduction of the amount of fentanyl required for postoperative analgesia, the efficacy of ketorolac, an injectable nonsteroidal antiinflammatory drug, was studied as an adjuvant to fentanyl patient-controlled epidural analgesia (PCEA) for postoperative pain management following radical retropublic prostatectomy. ⋯ Ketorolac is a beneficial adjuvant to fentanyl PCEA for postoperative pain management after radical retropubic prostatectomy.
-
Randomized Controlled Trial Clinical Trial
Dose-response for analgesic effect of amitriptyline in chronic pain.
A randomised, double-blind, multiple dose, crossover study with three 3-week treatment periods was set up to compare the analgesic efficacy and adverse effects of amitriptyline in oral doses of 25, 50 or 75 mg. Patients used diaries to assess their pain, and clinic assessments were made at the end of each treatment period. ⋯ The incidence of adverse effects was significantly higher with the 75 mg dose, and the principal adverse effects were dry mouth and drowsiness. In the context of chronic pain, the analgesic effect of amitriptyline was shown to have a dose-response unrelated to mood elevation, but there was a dose-response for the incidence of adverse effects.