Articles: opioid-analgesics.
-
Anaesthesiol Reanim · Jan 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Early detection of opiate-induced respiratory depression in the postoperative phase].
We examined in 30 patients the efficacy of regular assessments of respiratory rate (every 15 minutes) and blood gas analysis (at 30, 60, 120, 180 minutes) and continuous monitoring via pulsoximeter and capnometer in recognizing early ventilatory problems. For postoperative analgesia the patients received randomly and double-blind patient-controlled intravenous or epidural analgesia with sufentanil. Within 15 minutes after the initial intravenous bolus injection of 15 micrograms sufentanil respiratory depression occurred in 4 patients. ⋯ Oxygen saturation time patterns of pulsoximetry and blood gas analysis correlated significantly (p < 0.001), although the mean values of the methods differed (NS). In contrast, carbon-dioxide pressure time patterns of capnometry and blood gas analysis correlated less significantly (p < 0.01) although the mean values of the methods correlated significantly (p < 0.01). Concomittant monitoring via pulsoximeter and capnometer is therefore superior to regulary assessments of respiratory rate and blood gas analysis and potentially useful for the clinical routine.
-
Acta Neurochir. Suppl. · Jan 1995
Comparative StudySpinal cord stimulation versus spinal infusion for low back and leg pain.
The relative roles of spinal cord stimulation and the spinal infusion of opioids in the treatment of chronic, non-cancer lower body pain remains unclear. This report contains a retrospective analysis of patients with chronic lower body, neuropathic pain and treated over a 5 year period. Unilateral leg and/or buttock pain was treated initially with spinal stimulation and bilateral leg or mainly low back pain was treated initially with spinal infusions. 26 patients received spinal stimulation. ⋯ The review indicates that spinal infusions may be best for bilateral or axial pain that has not responded to spinal stimulation. Clonidine appears to be an alternative in high-dose morphine patients. New diamond-shaped electrode and dual quadripolar arrays appear to be very helpful for back, buttock, and/or bilateral leg pain patterns.
-
Anaesthesiol Reanim · Jan 1995
Review Comparative Study[Treatment of postoperative pain with peridural administration of opioids].
The advantages and disadvantages associated with epidural opioids require careful selection of the opioid and its dose regimen. There is no ideal opioid available for epidural use. Comparative pharmacokinetic data help selection of the appropriate epidural opioid. ⋯ Nalbuphine and butorphanol should not be selected for epidural use until the benefit/risk ratio is defined. The safety of patients is paramount. If patients are harmed by inappropriate opioids or dose regimens, this will unjustly discredit a valuable treatment of postoperative pain.
-
Clin Oncol (R Coll Radiol) · Jan 1995
Case ReportsUlcerative skin reaction from subcutaneous infusion of isotonic methotrimeprazine and diamorphine.
We report an ulcerative skin reaction resulting from a subcutaneous infusion of isotonic methotrimeprazine and diamorphine. Skin reactions are a recognized side effect of this treatment, although they are reduced by the use of the isotonic formulation of methotrimeprazine. Frank ulceration has not been previously reported. It occurred in our patient despite low doses of diamorphine and methotrimeprazine, an isotonic formulation, and a short infusion time.