Articles: analgesics.
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Randomized Controlled Trial Comparative Study Clinical Trial
The analgesic action of dexmedetomidine--a novel alpha 2-adrenoceptor agonist--in healthy volunteers.
The analgesic efficacy of dexmedetomidine (DEX)--a novel alpha 2-adrenoceptor agonist--was studied in man. Single intravenous doses of fentanyl (FEN; 2 micrograms/kg), DEX (0.25, 0.50 and 1.0 micrograms/kg) and placebo were administered to 5 healthy male volunteers in a double-blind, crossover study in randomized order. The analgesic effect of the different treatments was measured by determining the time course of pain threshold with dental dolorimetry and by quantitating subjective pain induced by a standard ischemic pain stimulus on the upper arm using a visual analogue scale (VAS). ⋯ FEN and DEX both had analgesic effects on ischemic pain, which was seen as a statistically significant decrease in subjective VAS ratings. FEN appeared to be more effective than DEX; the difference was not, however, statistically significant. Neither of the drugs affected the pain threshold measurements.
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Acta Anaesthesiol Scand · Aug 1991
Randomized Controlled Trial Comparative Study Clinical TrialPremedication before elective breast surgery, a comparison between ketobemidone and midazolam.
One hundred female patients scheduled for elective breast surgery (mean age 60 +/- 11 years were randomly assigned to receive one of two premedications: ketobemidone (Ketogan) 1-1.5 ml or midazolam 4-5 mg, intramuscularly. The effects on preoperative anxiety and postoperative emetic sequelae were studied. All patients were anaesthetised with thiopentone, fentanyl and atracurium, and ventilated with a mixture of nitrous oxide in oxygen with supplementary isoflurane. ⋯ No difference was seen in the frequency of emetic sequelae: 20 patients in the midazolam group and 14 patients in the ketobemidone group vomited once or more during the 24-h observation period. There was no difference between the two groups in time until an analgetic was required. In conclusion, midazolam seemed more effective in reducing preoperative anxiety than ketobemidone without any negative effects on postoperative emesis or time until an analgetic was required.
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Anesthesia and analgesia · Aug 1991
Randomized Controlled Trial Comparative Study Clinical TrialEffect of intravenously administered dexmedetomidine on pain after laparoscopic tubal ligation.
Ninety-six women undergoing laparoscopic tubal ligation were randomized to receive intravenously either 0.2 or 0.4 microgram/kg of dexmedetomidine, 60 micrograms/kg of oxycodone, or 250 micrograms/kg of diclofenac for postoperative pain in a double-blind study design. The study drugs were administered in the recovery room for moderate or severe pain and were repeated until pain subsided or disappeared. In the group receiving diclofenac, 83% of the patients required analgesic supplementation with morphine. ⋯ Both doses of dexmedetomidine decreased heart rate when compared with diclofenac (P less than 0.001). In the group given 0.4 microgram/kg of dexmedetomidine, 33% of the patients required atropine for bradycardia. The authors conclude that after laparoscopic tubal ligation, intravenously administered dexmedetomidine relieves pain and reduces opioid drug requirement but is attended by sedation and a high incidence of bradycardia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Does the anesthetic technique influence the postoperative analgesic requirement?
In order to determine the effect of two standard general anesthetic techniques on the postoperative analgesic requirement, 53 adults undergoing elective intra-abdominal surgery were randomly assigned to one of two anesthetic treatment groups according to an open parallel protocol design. One of the groups received an opioid-based anesthetic; the other group was administered an inhaled anesthetic. The postoperative analgesic requirement was quantified using a Baxter PCA device. ⋯ During the first 8 hours after discharge from the recovery room there was a trend toward higher PCA morphine usage in the inhaled anesthetic group (25.6 +/- 15 mg vs. 18.6 +/- 13 mg); however, this difference was not statistically significant (p = 0.08). From 8 to 40 hours after surgery, the morphine usage was nonsignificantly higher in the opioid group (64 +/- 30 mg vs. 56 +/- 38 mg, p = 0.43). In conclusion, the general anesthetic technique used during an elective operation appeared to have little if any effect on the postoperative analgesic requirement after discharge from the recovery room.
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Randomized Controlled Trial Clinical Trial
Anti-inflammatory and combined anti-inflammatory/analgesic medication in the early management of iliotibial band friction syndrome. A clinical trial.
Forty-three athletes presenting with unilateral iliotibial band friction syndrome (ITBFS) were randomly divided into three groups for the first 7 days of treatment (placebo-controlled, double-blind): 1--placebo (N = 13); 2--anti-inflammatory medication (N = 14) (Voltaren; Geigy); and 3--analgesic/anti-inflammatory combined medication (N = 16) (Myprodol; Rio Ethicals). All subjects rested from day 0 to day 7 and all groups received the same physiotherapy outpatient treatment programme from day 3 to day 7. On days 0, 3 and 7 the subjects performed a functional treadmill running test (maximum 30 minutes) during which they reported pain (scale 0-10; 0 = no pain, 10 = unbearable pain) each minute. ⋯ In contrast, during the running test only group 3 improved their total running time and distance from day 0 to day 7, whereas in all the groups the area under the pain v. time curve decreased from day 0 to day 7. All the other groups improved total running time and running distance from day 3 to day 7. All three treatment modalities are effective in the early treatment of ITBFS but physiotherapy in combination with analgesic/anti-inflammatory medication is superior.(ABSTRACT TRUNCATED AT 250 WORDS)