Articles: analgesics.
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Ninety eight general surgical patients were studied prospectively to determine the degree and severity of postoperative pain during the first 18 hrs following surgery. In 93% of the patients there was some degree of postoperative pain and in 64.4% the pain was moderate, severe or intolerable. Only 64.2% of the patients complained of pain to the medical staff, the remainder kept silent despite their sufferings. ⋯ More diligent approach to the problem of postoperative pain is needed. Adequate dosage and more frequent administrations of analgesic should be given to post-operative patients. Moreover, patients need to be taught that intolerable pain is not an acceptable postoperative sequelae in exchange for cure.
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Comparative Study Clinical Trial Controlled Clinical Trial
A highly successful and novel model for treatment of chronic painful diabetic peripheral neuropathy.
To investigate why, in spite of a vast variety of treatment agents, the alleviation of pain in patients with diabetic neuropathy is difficult. Previous studies have not used a treatment algorithm based on anatomic site and neuropathophysiological source of the neuropathic pain. ⋯ This study presents a new rationale and hypothesis for the successful treatment of chronic painful diabetic peripheral neuropathy. It uniquely bases the treatment algorithm on the types and sources of the pain.
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Mayo Clinic proceedings · Aug 1993
ReviewManagement of postoperative pain: influence of anesthetic and analgesic choice.
Improved control of postoperative pain is being increasingly scrutinized yet concomitantly demanded by patients, physicians, and even the federal government. Our ever-increasing subspecialization in medicine has compartmentalized much of perioperative care and has created substantial difficulty for physicians in understanding the overall influence of other physicians' perioperative decisions, including control of pain. ⋯ Additionally, outcome studies show that provision of improved analgesia and minimization of the perioperative stress response enhance clinical outcome in both low- and high-risk patients. This article highlights new information on how anesthetic and analgesic management influences perioperative pain and decreases the incidence of complications in surgical patients.
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Anaesth Intensive Care · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia after caesarean section with intramuscular ketorolac or pethidine.
We compared, in a double-blind randomised study, intramuscular ketorolac 30 mg (n = 49) and intramuscular pethidine 75 mg (n = 51) for analgesia after elective caesarean section under general anaesthesia. Anaesthesia was induced with thiopentone and suxamethonium and maintained with atracurium, nitrous oxide and isoflurane. Intravenous fentanyl 100 micrograms was given after delivery of the neonate. ⋯ However, four patients in the ketorolac group and six patients in the pethidine group requested no further analgesia within 24 hours. Pain VAS and overall assessment of analgesia was similar between groups, although more side-effects (nausea, dizziness) were noted in the pethidine group. Ketorolac 30 mg and pethidine 75 mg provided similar but variable quality of analgesia after caesarean section.