Articles: analgesics.
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In a double-blind, randomized, placebo-controlled study, 112 patients scheduled for knee-joint arthrotomies or minor orthopaedic operations received 75 mg diclofenac, 600 mg apazone, the combination of 75 mg diclofenac and 600 mg apazone, or placebo (50 ml NaCl 0.9%) as a single i.v. dose immediately after operation. Postoperative pain intensity was measured by a numeric rating scale. All patients were allowed to self-administer piritramide from a PCA (patient-controlled analgesia) pump (Prominjekt, Pharmacia, Sweden) in 2-mg boluses every 5 min during the first 6 h and subsequently every 15 minfor another 18 h after surgery. ⋯ The incidence of typical side effects of opioids and antipyretic anti-inflammatory analgesics (nausea, vomiting, stomach ache, headache, vertigo) was low, and they were easily controlled in all cases. Postoperative combined application of the nonsteroidal anti-inflammatory analgesics diclofenac and apazone results in a significantly lower opioid requirement (about 60%) after minor orthopaedic surgery. The opioid-sparing effect appears to be superior to that of diclofenac (44%) or apazone (42%) alone, but this was not statistically significant.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of intramuscular ketorolac and pethidine in the alleviation of renal colic.
To compare the analgesic efficacy of a single 30 mg intramuscular dose of ketorolac with that of intramuscular pethidine 100 mg, in a double-blind, parallel-group investigation of patients presenting with pain suggestive of renal colic. ⋯ Ketorolac can be considered a viable alternative to pethidine for the treatment of renal colic.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of morphine and ketorolac for intravenous patient-controlled analgesia in postoperative cancer patients.
To compare the effectiveness of intravenous patient-controlled (i.v.-PCA) ketorolac to i.v.-PCA morphine in the treatment of postoperative pain in cancer patients. ⋯ These results indicate that ketorolac supplemented with small doses of morphine is associated with a lower incidence of nausea, vomiting, and pruritus compared to morphine alone. This combination should be considered where immunosuppression from operation and administration of morphine is undesirable.
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Pain following removal of impacted third molar teeth has proven to be a useful clinical model for evaluating oral analgesics. Moreover, as the underlying pathophysiology becomes elucidated the model serves as a tool for monitoring the relative contributions of different pain events, including peripheral and central sensitization. Non-steroidal anti-inflammatory drugs (NSAIDs) demonstrate high potency in this model, reflecting the large contribution that peripheral prostaglandins may make to the pathophysiology of postoperative pain. ⋯ Such enhanced activity is also demonstrated by higher doses of certain NSAIDs, e.g. ketoprofen 100 mg. This may reflect the existence of complimentary analgesic activities within a single therapeutic agent. As a clinical research tool the dental pain model has several attributes which suggest that it will continue to be of value in identifying potentially improved analgesic strategies for postoperative pain.