Articles: analgesics.
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Acta Anaesthesiol Belg · Jan 1990
Randomized Controlled Trial Clinical TrialSurgical analgesia for knee arthroscopy with epidural lignocaine and sufentanil--effect of varying sufentanil doses.
In a double blind trial the additional analgesic effect of the combination of epidural lignocaine 2% + epinephrine 1/200,000 with varying epidural Sufentanil doses was studied per- and postoperatively in patients undergoing arthroscopy of the knee. Fifty patients were randomly divided into five groups. They received epidural lignocaine 2% + epinephrine 1/200,000 in addition with respectively 0, 20, 30, 40 or 50 micrograms Sufentanil. ⋯ On the other hand, at 40 and 50 micrograms of Sufentanil significantly more patients demonstrated respiratory depression and pronounced sedation during surgery as compared to lignocaine alone. Patients in these groups had better postoperative analgesia. In addition nausea, vomiting and pruritus were seen in some patients at all doses of Sufentanil.
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Ann Fr Anesth Reanim · Jan 1990
Review Multicenter Study Clinical Trial[Anesthetics responsible for anaphylactic shock. A French multicenter study].
Combined allergological and anaesthetic consultations have been started in the last few years in eight French Teaching Hospitals so as to explore peranaesthetic anaphylactoid shocks. A survey was carried out in these centers in order to collect patients investigated with the same protocol, for the assessment of the incidence of anaphylaxis in France, as well as the involved drugs. Investigations were always carried out at least 6 to 8 weeks after the accident. ⋯ It would therefore seem mandatory to carry out after any anaphylactoid accident an assessment with sensitive and specific tests for anaphylaxis. Diagnosing anaphylaxis means that the involved drug should be used never again in that patient. Because muscle relaxants are by far the most involved drugs, anaesthetists should use them only when really required.
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Adequate pain relief during the postoperative period has long been recognized as difficult to accomplish. The reasons for this are mentioned in a brief review of methods of pain control, and an overview of the detrimental effects of acute pain is given. ⋯ It was also noted that only 30-35% of the maximum doses of analgesics prescribed were actually given within the immediate postoperative period. The possible reasons for these findings are discussed.
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Recent evidence suggests that postoperative pain is poorly controlled and it is reported that nearly 75% of hospitalized patients failed to receive adequate pain relief. It was hypothesized that there was no difference between expected and experienced pain and that pain scores on the first postoperative day would be 'low'. Factors affecting the management of pain were identified using a patient questionnaire. ⋯ The nurse did not play a key role in the preoperative information given to the patient. Patients experienced 'worsened' pain in the morning and evening. Nurses questioning patients about their pain often failed to identify those in pain.
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Gynecol. Obstet. Invest. · Jan 1990
Acupuncture before delivery: effect on pain perception and the need for analgesics.
Pain experience and the amount of analgesics needed during labor were studied in 32 primiparous women who had received repeated treatment with acupuncture (AP) during the month prior to term and in 16 nontreated primiparous women. The women's psychological profiles were evaluated by a psychiatric interview at week 38 of pregnancy. Treatment with AP did not reduce the need for analgesics in labor. ⋯ Experience of pain was not reduced in subjective assessments in women treated with AP. There was a strong correlation between assessments of pain made during labor and 6 months after delivery. In the group that did not receive AP, cerebrospinal fluid dynorphin A was significantly lower in parturients who chose epidural anesthesia.