Articles: opioid-analgesics.
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Anesthesia and analgesia · Feb 1982
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine for postoperative pain relief: a comparative study with intramuscular narcotic and intercostal nerve block.
The relatively new technique of epidural morphine analgesia was compared with two well established method of pain relief in 90 patients undergoing gallbladder surgery and divided randomly into three groups of 30 patients each. The first group received intramuscular narcotic analgesic ketobemidone, the second group was given 0.5% bupivacaine-epinephrine intercostal nerve block, and the third group received a single dose of 4 mg of epidural morphine for postoperative pain relief. The mean duration of analgesia after ketobemidone was 5.5 hours, and after intercostal block 11 hours. ⋯ Delayed respiratory depression was not encountered after epidural morphine. It is concluded that a single dose of 4 mg of epidural morphine provides excellent regional analgesia of long duration without drowsiness or circulatory of respiratory depression thus facilitating early ambulation. The technique is superior to more common methods of pain relief after gallbladder surgery, e.g., intercostal nerve block and intramuscular narcotics.
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Acta Anaesthesiol Scand Suppl · Jan 1982
Multiple dose kinetics of ketobemidone in surgical patients.
Twelve patients scheduled for major abdominal surgery were selected for a study of the kinetics of ketobemidone during the day of surgery and in a follow-up study 3-5 days after surgery. In six patients ketobemidone was administered as ketobemidone plain and in the other six, it was given as Ketogin, a combination formula containing a spasmolytic substance in addition to ketobemidone. Plasma samples were collected for approximately 24 h following induction of anesthesia, during which time multiple doses of ketobemidone were administered. ⋯ Plasma clearance did not change significantly between the two periods of study, being 18.0 +/- 4.4 ml . kg-1 . min-1 peroperatively and 21.7 +/- 7.6 ml . kg-1 . min-1 postoperatively. Peroperative Vd area was significantly larger than post-operative Vd area, 5.84 +/- 2.62 l . kg-1 and 3.63 +/- 0.38 l . kg-1, respectively. T1/2 terminal decreased from 3.84 +/- 1.6 h peroperatively to 2.06 +/- 0.44 h postoperatively.
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Acta Anaesthesiol Belg · Jan 1982
Comparative StudyDouble-blind comparison of the postoperative respiratory depressant effects of alfentanil and fentanyl.
Alfentanil was compared with fentanyl in a double blind study of 90 female patients undergoing laparoscopic sterilizations. The analgesic was combined with droperidol and etomidate for induction and with etomidate, nitrous oxide and occasional increments of succinylcholine for maintenance of anesthesia. Twenty-four percent of the patients required reversal of postoperative respiratory depression after fentanyl compared with 7% after alfentanil (p = 0.042). ⋯ However, 84% of patients were alert on awakening after alfentanil compared with 62% of patients after fentanyl (p = 0.032). Duration and quality of postoperative analgesia were similar in both groups. Cardio-vascular stability was satisfactory in all patients and side effects were minor and infrequent.