Articles: analgesia.
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Zhonghua Fu Chan Ke Za Zhi · May 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical assessment of the effect of intravenous patient controlled intravenous analgesia and epidural patient controlled epidural analgesia in postoperative analgesia].
To compare the clinical effect and side-effect of intravenous patient controlled intravenous analgesia (PCIA) with patient controlled epidural analgesia (PCEA). ⋯ Both PCIA and PCEA have excellent analgesic effect. PCIA has lower incidence of urinary retention, and has higher sedative incidence compared with PCEA.
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Am. J. Gastroenterol. · May 2001
Randomized Controlled Trial Clinical TrialPatient-administered nitrous oxide/oxygen inhalation provides safe and effective analgesia for percutaneous liver biopsy: a randomized placebo-controlled trial.
Although percutaneous liver biopsy (PLB) can be a painful procedure, common practice has not included intravenous sedation or analgesia. Patient-administered nitrous oxide/oxygen (N2O/O2) inhalation has demonstrated analgesic efficacy in various procedures associated with mild to moderate pain. The aim of this study was to investigate the safety and efficacy of analgesia with N2O/O2 inhalation for PLB. ⋯ Patient-administered N2O/O2 inhalation provides safe and effective analgesia, at a reasonable cost, for PLB. Its routine use could be useful for the management of patients with chronic liver disease undergoing PLB as it may enhance patients compliance with future biopsies.
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Reg Anesth Pain Med · May 2001
Fetal heart rate abnormalities after regional analgesia for labor pain: the effect of intrathecal opioids.
Intrathecal opioids used to relieve labor pain have been associated with uterine hyperactivity and nonreassuring fetal heart rate abnormalities. We retrospectively evaluated all charts of singleton, term, vertex-presenting parturients in active labor requesting neuraxial pain relief during a 1-year period for the occurrence of nonreassuring fetal heart rate tracings. ⋯ Based on this retrospective analysis, we conclude that intrathecal sufentanil in a dose of 7.5 microg has the potential to result in more nonreassuring fetal heart rate tracings compared with both intrathecal analgesia using a bupivacaine (2.5 mg)/sufentanil (1.5 microg) mixture and epidural analgesia using bupivacaine, sufentanil, and epinephrine. Reg Anesth Pain Med 2001;26:257-262.
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Subdural haematoma is a well-documented complication of accidental dural puncture, and is thought to be preventable by prompt treatment with an epidural blood patch. An accidental dural puncture occurred in a 39-yr-old primagravida during the siting of an epidural catheter for pain relief in labour. ⋯ After discharge from hospital, and 14 days after the dural puncture, the headache recurred, together with expressive dysphasia, poor co-ordination and sensory loss in the right arm. A magnetic resonance imaging scan demonstrated a left sided subdural haematoma, which was drained successfully with complete recovery.
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Anesthesia and analgesia · May 2001
Randomized Controlled Trial Multicenter Study Clinical TrialProlonged epidural infusions of ropivacaine (2 mg/mL) after colonic surgery: the impact of adding fentanyl.
We evaluated the safety and efficacy of a 72-h epidural infusion of ropivacaine and measured the impact of adding fentanyl 2 microg/mL to the required infusion rate, on the quality of postoperative pain relief and the incidence of side effects, after colonic surgery. One hundred fifty-five patients scheduled for elective colonic surgery were randomized in this trial. Epidural infusions of ropivacaine 2 mg/mL with fentanyl 2 microg/mL (R + F) and without fentanyl (R) were commenced during surgery and continued for 72 h postoperatively. This was a prospective, randomized, double-blinded, multi-center trial. The median infusion rate required was less in the R + F group (9.3 vs 11.5 mL/h, P < 0.001). Median pain scores at rest and on coughing were lower in the R + F group (P < 0.0001). The incidence of hypotension was more in the R + F group (P = 0.01). Time to readiness for discharge was delayed in the R + F group (median 6.6 vs 5.5 days, P = 0.012). The addition of fentanyl to ropivacaine resulted in decreased infusion rates and enhanced pain control; however, adverse effects were increased and readiness to discharge was delayed. ⋯ Epidural infusions of ropivacaine with and without fentanyl were administered to patients to control pain after colonic surgery. Patients who received ropivacaine with fentanyl had better pain control, increased side effects, and delayed readiness to discharge. This study questions the value of adding opioids to epidural infusions of local anesthetics.