Articles: analgesics.
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Anesthesia and analgesia · May 1991
Randomized Controlled Trial Clinical TrialPentamorphone for management of postoperative pain.
The efficacy, duration, and safety of the synthetic opioid pentamorphone in the treatment of acute postoperative pain were evaluated in a randomized, double-blind study of 72 patients given 0.08, 0.16, or 0.24 micrograms/kg of pentamorphone or a placebo intravenously in the recovery room after major abdominal or orthopedic surgery. Only patients given 0.24 micrograms/kg of pentamorphone experienced decreased pain intensity and increased sedation, both transient in duration. ⋯ No acute cardiorespiratory changes were observed. Pentamorphone (0.08-0.24 micrograms/kg) was ineffective for treating acute postoperative pain after major surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Caffeine as an analgesic adjuvant. A double-blind study comparing aspirin with caffeine to aspirin and placebo in patients with sore throat.
Despite its frequent clinical use in analgesic agents, caffeine has not been accepted unequivocally as an analgesic adjuvant. To evaluate this activity of caffeine, we used new study methods in a randomized controlled trial on patients with acute sore throat due to tonsillopharyngitis. Patients were randomly assigned to receive a single dose of one of three treatments: 800 mg of aspirin with 64 mg of caffeine (n = 70), 800 mg of aspirin (n = 68), or placebo (n = 69). ⋯ For patients with fever, both active treatments were equally effective antipyretic agents. We conclude, therefore, that 800 mg of aspirin, given alone or with 64 mg of caffeine, is an effective analgesic and antipyretic agent. Because the aspirin-caffeine combination is significantly more effective than aspirin alone as an analgesic, we also conclude that 64 mg of caffeine is an analgesic adjuvant.
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Regional anesthesia · Mar 1991
Randomized Controlled Trial Comparative Study Clinical TrialEpidural analgesia during and after cesarean delivery. Comparison of five opioids.
A randomized, double-blind study was designed to determine the effects on maternal intraoperative analgesia of adding one of the following opioids to the local anesthetic at the onset of epidural block, before surgery and neonatal delivery: morphine (3 mg), fentanyl (75 micrograms), sufentanil (50 micrograms), buprenorphine (0.3 mg) and oxymorphone (1 mg). The duration of postoperative analgesia, the presence of side effects and the neonatal outcome were also studied. Ninety healthy multiparas, at term, undergoing elective cesarean delivery using lumbar epidural anesthesia with 2% lidocaine were randomized in six equal groups to receive one of the opioids or saline. ⋯ Morphine provided the longest pain-free interval, followed by oxymorphone, buprenorphine, sufentanil and fentanyl. Postoperatively, the number of patients having pruritus and vomiting was significantly higher in the morphine and buprenorphine groups, respectively (p less than 0.01 versus others). No adverse neonatal effects were noted in any group.
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Obstetrics and gynecology · Mar 1991
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled epidural analgesia during labor.
This study compared the safety, efficacy, local anesthetic usage, patient satisfaction, and anesthesia manpower demands of patient-controlled epidural analgesia and continuous epidural infusion during labor. After establishment of epidural analgesia, 88 parturients with vertex presentation were assigned randomly to receive either patient-controlled epidural analgesia or continuous epidural infusion, using 0.125% bupivacaine containing 1 microgram/mL of fentanyl. Inadequate analgesia was treated in both groups with a 10-mL "top-up" of 0.25% bupivacaine. ⋯ Use of local anesthetic solution was examined with respect to cervical dilatation and did not increase late in labor. Patients generally viewed infusion technology favorably. These findings suggest that patient-controlled epidural analgesia is safe and effective, reduces anesthesia manpower needs, and is well accepted.
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Randomized Controlled Trial Clinical Trial
Sucrose as an analgesic for newborn infants.
The effectiveness of sucrose as an analgesic agent for newborn infants was assessed during two standard painful hospital procedures: blood collection via heel lance and circumcision. Infants who drank 2 mL of a 12% sucrose solution prior to blood collection cried 50% less during the blood collection procedure than did control infants who had received 2 mL of sterile water. Crying of infants who ingested sucrose returned to baseline levels within 30 to 60 seconds after blood collection whereas control infants required 2.5 to 3.0 minutes to return to baseline. ⋯ A water-moistened pacifier reduced crying to 49% (P less than .01). Crying was reduced further to 31% (P less than .05) by providing infants with a sucrose-flavored pacifier to suck. These findings, which parallel results obtained in studies of pain in infant rats, provide a potent yet simple, benign intervention to help alleviate stress and pain routinely experienced by human infants.