Articles: analgesics.
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Little research was found to indicate that pain is managed well in hospitalized patients and few studies were found regarding pain management for critical care patients. ⋯ Results from this study suggest that nurses in both intensive care and surgical units do not appropriately assess, manage or evaluate pain and pain-related side effects. Patients who experience pain expect to have their pain controlled. Efforts must be made to change nurses' pain management behaviors.
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In the last 10 years, the American Association of Critical-Care Nurses has twice ranked pain management as a priority issue for research and practice. Recent research findings suggest that undermedication of patients continues both in and out of critical care. Postoperative cardiac surgery patients have reported detailed recollections of pain experiences while in critical care, yet little is known about management of postoperative cardiac surgery pain. ⋯ The finding of small and infrequent analgesic doses is consistent with other studies conducted in and out of critical care. Important inconsistencies, or variations in practice, exist in both the prescription and administration of analgesics for postoperative cardiac surgery patients in the critical care setting.
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Review Comparative Study
[Classification, mode of action and side effects of analgesics].
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Stereotact Funct Neurosurg · Jan 1994
Comparative StudyAnalgesic action of acute and chronic intraspinally administered opiate and alpha 2-adrenergic agonists in chronic neuropathic pain.
Intrathecal (IT) administration of opiate analgesics has become a popular method of pain control in patients with pain of both malignant and nonmalignant origin. Therapeutic efficacy for nonmalignant pain states might be improved by having a broader range of available pharmacologic agents for intrathecal administration. Toward this aim, we have applied a new model of neuropathic pain in the rat to evaluate the relative analgesic efficacy and potential cross tolerance of both acutely and chronically administered IT morphine (MS) and tizanidine (TZ), an alpha 2-adrenergic agonist. ⋯ The animals rapidly became tolerant to these agents so that by day 4, neither drug had an analgesic effect. No significant cross tolerance between MS and TZ was observed. Thus, both IT MS and TZ are analgesic in experimental chronic neuropathic pain.(ABSTRACT TRUNCATED AT 400 WORDS)
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Am J Hosp Palliat Care · Jan 1994
Intermittent subcutaneous infusion of opioids in hospice home care: an effective, economical, manageable option.
Administration of oral opioids is not always possible for terminally-ill patients. Obstruction, emesis, or inability to swallow frequently force us to seek alternative routes of administration. When the rectal route is contraindicated, impractical, or otherwise rejected by the patient or caregivers, we must resort to the parenteral route. ⋯ Of the 42 percent of patients able to indicate a pain rating (0-10 scale) all rated their pain at 2 or below while using the subcutaneous route. No objective signs of pain were noted by caregivers or hospice nurses in the 58 percent of patients who were unable to rate their pain. The mean duration of time the needle remained in place was 4.62 days, with a range of 1-26 days.(ABSTRACT TRUNCATED AT 250 WORDS)