Articles: opioid-analgesics.
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Acta Anaesthesiol Belg · Jan 1995
Case ReportsContinuous cervical intrathecal administration of morphine with a new infusion pump, the Anschütz IP 35.1: a case report.
The continuous intrathecal administration of low-dose morphine is an effective treatment for chronic neuropathic pain. Several implantable devices can be used for such treatments but they all have limitations. In this case report we opted for a new type of implantable pump, the Anschütz, for the combined cervical intrathecal administration of morphine and clonidine in a patient with severe cervicobrachialgia.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialCaudal analgesia with buprenorphine for postoperative pain relief in children.
Caudal buprenorphine was investigated as a postoperative analgesic in a randomized double blind study in thirty children aged 5-12 years undergoing lower abdominal and lower limb surgery. Comparison was made between two groups of patients, one group receiving plain bupivacaine and the other a combination of plain bupivacaine with buprenorphine. Postoperative analgesia was assessed using a linear analogue scale, and by the response to direct questioning of children using an illustration of sequence of faces. ⋯ The degree and duration of analgesia was far superior in the buprenorphine group and there was a highly significant difference in the requirement of postoperative analgesia between the two groups. There were no major adverse side effects and no motor weakness in either groups, however the incidence of nausea and vomiting was higher in the buprenorphine group. It is concluded that a combination of bupivacaine with buprenorphine administered through the caudal epidural space is a safe and reliable means of providing postoperative pain relief in children for up to 24 h.
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Paediatric anaesthesia · Jan 1995
Comparative StudyIntrathecal morphine (ITM) for postoperative pain control in children: a comparison with nalbuphine patient controlled analgesia (PCA).
This is a retrospective study covering the ten-year period 1984-1993. Single shot spinal morphine (ITM) is compared with PCA nalbuphine for postoperative pain relief in children having abdominal or thoracic procedures. The records of 52 patients meeting selection criteria were examined. ⋯ No difference in duration of hospital stay or ICU stay could be demonstrated. We conclude that ITM provides better pain relief, without more serious complications, than PCA nalbuphine. We recommend it as a safe, effective technique to treat postoperative pain in children following thoracic or upper abdominal procedures.
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Eur. J. Clin. Pharmacol. · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe cognitive and psychomotor effects of opioid analgesics. II. A randomized controlled trial of single doses of morphine, lorazepam and placebo in healthy subjects.
Twelve subjects (8 male) took part in a randomised double blind four way crossover design study comparing four treatments: (i) morphine sulphate 10 mg, (ii) morphine sulphate 15 mg, (iii) lorazepam 1 mg (positive control) and (iv) placebo. Cognitive function was assessed using choice reaction time, number vigilance, memory scanning, immediate and delayed word recall, word recognition, picture recognition, critical flicker fusion threshold (CFFT) and subjective measures of alertness, calmness and contentment. Lorazepam produced a marked impairment in the tests of attention and memory. ⋯ Morphine 15 mg produced a significant improvement in accuracy on the choice reaction time test at the 2, 4 and 6 h assessments. These results show minimal impairment of cognitive and psychomotor function after single oral doses of morphine and with possible improvement in one test. Further studies are required to examine the effect of repeated doses.
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Scand. J. Rheumatol. · Jan 1995
Randomized Controlled Trial Clinical TrialPain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine.
Pain intensity, muscle strength, static muscle endurance, pressure pain threshold, and pain tolerance at tender points and control points were assessed in 31 patients with fibromyalgia (FM), before and after intravenous administration of morphine (9 patients), lidocaine (11 patients), and ketamine (11 patients). The three different studies were double-blind and placebo-controlled. The patients were classified as placebo-responders, responders (decrease in pain intensity by > 50%) and non-responders. ⋯ Tenderness at tender points decreased and endurance increased significantly, while muscle strength remained unchanged. The present results support the hypothesis that the NMDA receptors are involved in pain mechanisms in fibromyalgia. These findings also suggest that central sensitization is present in FM and that tender points represent secondary hyperalgesia.