Articles: analgesics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anesthesia for craniotomy: a double-blind comparison of alfentanil, fentanyl, and sufentanil.
Using a prospective, randomized, and double-blind study design, alfentanil (n = 15), fentanyl (n = 14), or sufentanil (n = 16), in combination with N2O, were administered to patients undergoing craniotomy for supratentorial tumor resection. Physicians were given two syringes, one of which was labeled as "load" for the initial loading dose and the other as "maintenance" for continuous infusion. The concentration of drug in each syringe was adjusted to permit administration on a milliliter per kilogram basis. ⋯ Administration of isoflurane, antihypertensive medications, and naloxone were not different among groups. Although decreases in blood pressure seen with induction were similar among groups, alfentanil-treated patients received ephedrine more frequently before intubation. Thirty minutes after entry into the postanesthesia recovery area, respiratory rate and pH were lowest in sufentanil-treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Review Randomized Controlled Trial Clinical Trial
Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men.
Postoperative use of as-needed intramuscular narcotics is potentially hazardous in frail elderly patients. Patient-controlled analgesia (PCA) allows patients to self-administer small boluses of narcotic, allowing better dose titration, enhanced responsiveness to variability in narcotic requirements, and reduction in serum narcotic level fluctuation. Although theoretically useful, this method has not bee well studied in the elderly or medically ill. ⋯ Patients who had previously received intramuscular injections reported that PCA was easier to use and provided better analgesia. Serum morphine levels showed significantly less variability on postoperative day 1 with PCA, compared with intramuscular injections. We conclude that PCA is an improved method of postoperative analgesia in high-risk elderly men with normal mental status, compared with as-needed intramuscular injections.
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Anesthesia and analgesia · Aug 1990
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative pain control with a continuous infusion of epidural sufentanil in the intensive care unit: a comparison with epidural morphine.
A prospective, randomized, double-blind trial was conducted to compare the analgesic actions and side effects of sufentanil continuously infused (5 micrograms/h) into the lumbar epidural space (L2-3) with those of an infusion of lumbar epidural morphine (0.5 mg/h). Forty patients admitted to an intensive care unit after elective major abdominal surgery participated over a varying period of 24-40 h. Post-operative pain was treated with an epidural bolus of either sufentanil (50 micrograms) or morphine (5 mg), followed by a continuous infusion of the same opiate. ⋯ The incidence of nausea and vomiting, pruritus, and drowsiness was similar in the two groups. In spontaneously breathing patients there were no respiratory complications requiring treatment. Forced vital capacities were statistically significantly better during the first 1-4 h with sufentanil.
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Randomized Controlled Trial Clinical Trial
Parturition pain treated by intracutaneous injections of sterile water.
Forty-five pregnant women in the first stage of labour presenting with lower back pain were randomized into 2 groups. One group received intracutaneous injections of sterile water in the lumbosacral region, while the other group was given corresponding subcutaneous injections of isotonic saline, regarded as a placebo treatment. ⋯ However, the requirement of pethidine (meperidine) was similar in the 2 groups. The analgesic method presented was found to be an effective treatment against lower back pain during the first stage of labour and it is speculated that the mode of action resembles acupuncture.
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Randomized Controlled Trial Clinical Trial
Clinical analgesic assay of repeated and single doses of heroin and hydromorphone.
A direct comparison of the analgesic activities of heroin and hydromorphone was carried out in cancer patients with postsurgical pain. Intramuscular doses of 5 and 10 mg of heroin were compared with 1 and 2 mg of hydromorphone in a randomized, double-blind, 4-point parallel group assay. Design innovations in the study provided that about half the patients would receive prior repeated doses of the same drug as the test medication, and half would receive the alternate medication. ⋯ Covariate analysis indicated that time since last analgesic was positively related to analgesia, and amount of prior opioid had a negative relationship. To a lesser extent, increase in patient age was associated with an increase in analgesic scores. Taking these covariates into account served to increase the sensitivity of the analysis.