Articles: analgesia.
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Comparative Study
[Patient-controlled analgesia in the treatment of postoperative pain in children and adolescents].
We aimed to evaluate the efficacy, morphine requirements and side effects in patients managed with patient-controlled analgesia postoperatively. ⋯ In the majority of patients patient-controlled analgesia was effective and used doses of morphine were low. Though nausea/vomiting was the most common side effect, decreased respiratory rate was observed in some patients. Regular patient evaluation for vital signs and side effects is recommended.
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Randomized Controlled Trial Clinical Trial
Continuous epidural infusion of racemic methadone results in effective postoperative analgesia and low plasma concentrations.
To compare two protocols of epidural administration of racemic methadone for postoperative analgesia (continuous infusion and intermittent bolus), focussing on plasma concentration, analgesic efficacy and side effects. ⋯ Plasma methadone concentrations were significantly lower with continuous infusion. Plasma methadone accumulation, which is considered the main disadvantage for its purported influence on the incidence of side effects, did not occur at the doses used over the three days of treatment that we report.
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Randomized Controlled Trial Clinical Trial
Preemptive epidural analgesia for thoracic surgery.
The purpose of this study was to determine if preemptive epidural analgesia performed before thoracotomy incision and during the operation reduces postoperative pain. Patients in the treatment group received 8 mL of 0.25% bupivacaine and 2 mL of fentanyl (50 microg/mL) via the epidural route prior to skin incision, followed by an infusion of bupivacaine 0.1% and fentanyl 10 microg/mL at 6 mL/hr. ⋯ The patients in the treatment group required less isoflurane intraoperatively and had lower maximum pain scores in the first 6 hours postoperatively. No significant differences were noted after the first 6 hours.
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Anaesthesiol Reanim · Jan 2002
Case Reports[Critical infusion incident caused by incorrect use of a patient-controlled analgesia pump].
We report on the case of a 17-year-old male patient who received a PCA pump after nephrectomy for postoperative analgesia. The syringe of the PCA pump was filled with 50 mg morphine and positioned about 25 cm above the heart. Since the piston of the syringe was not bolted while the pump was switched off, an unnoticed accidental evacuation of the whole content of the syringe into the intravenous line of the patient occurred because of gravity. ⋯ This critical incident was caused by various factors: incorrect application in combination with insufficient experience or training, stress, inadequate handing-over of the patient and a lack of arrangements and instructions for procedures in routine situations. Suggestions for preventing such dangerous critical incidents are made and discussed. In particular, an algorithm for the correct procedure when inserting or changing the syringe of a syringe pump is presented.