Articles: analgesics.
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The relief of pain is one of the most common reasons for seeking care in an emergency department. We conducted a retrospective chart review to see whether children received analgesic treatment similar to that of adults with the same acute, painful conditions. Charts of 112 pediatric patients from the Children's Hospital of Philadelphia ED and 156 patients from the Medical College of Pennsylvania ED were reviewed. ⋯ On discharge from the ED, 55% of all patients had no pain medications prescribed; and children were less likely than adults to receive analgesics at discharge (P less than .001). Pediatricians and emergency physicians are reluctant to use analgesics for children in pain. The data suggest that these physicians need additional education about management of acute pain.
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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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Naunyn Schmiedebergs Arch. Pharmacol. · Aug 1990
A bradykinin antagonist inhibits carrageenan edema in rats.
Bradykinin has been implicated in acute inflammatory reactions. Intradermal injection elicits increased vascular permeability and hyperalgesia, and bioassays have suggested increased bradykinin concentration in inflammatory exudates. Poorly specific inhibitors of kallikrein, the enzyme catalyzing formation of bradykinin, inhibit certain acute inflammatory reactions. ⋯ Subplantar injection of carrageenan led to an increase in immunoreactive bradykinin and metabolic product, desArg9bradykinin. NPC 567 inhibited the development of edema in response to carrageenan, to a maximum 65%. Thus, bradykinin appears to be a major mediator of increased vascular permeability in response to carrageenan.
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From research reports published over the last 20 years, it appears that moderate to severe uncontrolled pain may be the norm for hospitalized patients despite recent advances in the management of pain. Research on the extent of under-management of pain and the factors associated with it is examined and summarized in this paper. ⋯ A clinical decision making model is also reviewed and it is suggested that this model could be applied to pain management problems. Further, it is suggested that this model may be very useful in developing educational interventions to improve health practitioners' clinical skills in pain management.
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Anesteziol Reanimatol · Jul 1990
[Moradol (butorphanol tartrate) as the analgesic component of current combination general anesthesia].
A technique is described for the use of moradol as an agent ensuring analgesia in modern combined general anesthesia during abdominal and thoracic surgery, cardiac surgery, cardiopulmonary bypass included, and diagnostic manipulations. Moradol was particularly effective for long-term surgery. ⋯ Agonist opioid activity of moradol was maximum 10 min after its intravenous administration, therefore a 5 to 10 min exposition upon moradol injection prior to hypnotic drug administration is suggested. Bolus drug dose (150 mg/kg) for induction to anesthesia was an adequate protection against pain impulsation in surgical trauma in the course of 3-4 hours of surgical intervention.