Articles: analgesia.
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Br J Oral Maxillofac Surg · Dec 2000
Treatment of postoperative pain in oral and maxillofacial surgery.
We questioned 75 patients after inpatient oral and maxillofacial operations to find out how satisfied they were with the extent to which their pain had been controlled. Seventy (93%) had had postoperative pain. ⋯ Seventeen (24%) reported that the pain was worse than they had expected, but 74 of the 75 patients were satisfied with the pain control they received. We conclude that patients' expectations of pain control are low and that questions about satisfaction should not be used in isolation.
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This study describes the methods of anaesthesia and analgesia used in 349 major lower limb amputations for vascular disease over a seven year period (1992-8). The main type of anaesthesia was general in 55%, spinal in 29%, and epidural in 14%: there were no significant differences for ASA grade, age, or amputation level, nor any statistical differences in mortality for each method of anaesthesia. ⋯ Thirty seven percent of patients were prescribed carbamazepine for phantom pain. There have been substantial changes in postoperative analgesia following amputation, and epidurals are now common practice, despite the controversy about their role in preventing phantom pain.
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Commun Dis Public Health · Dec 2000
Case control study of epidural catheter infections in a district general hospital.
Ten infections associated with the use of epidural catheters for post-operative pain relief were identified in patients of a district general hospital in 1997 and 1998. A case control study showed that the infections were commoner in the summer months and associated with analgesia infused by syringes rather than pumps. Infection rates and risk factors can be analysed regularly if pain teams maintain a database of epidural catheters inserted, which includes information about infections.
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Postoperative analgesia for the ambulatory surgery patient is frequently inadequate. Continuous regional analgesia improves outcome and patient satisfaction in hospitalized patients. This paper describes the successful use of continuous regional analgesia following orthopedic surgery in the ambulatory setting.
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Rev Esp Anestesiol Reanim · Dec 2000
[Locoregional anesthesia for external ear surgery and postoperative analgesia].
To evaluate a change in the classical technique for local-regional anesthesia (periauricular "V" infiltration) for surgery on the outer ear, specifically adding a new infiltration of the osteocartilaginous juncture of the external acoustic meatus and the auditory foramen, as an alternative to general anesthesia in adults, including assessment of postoperative analgesia. ⋯ The described local-regional blockade of the outer ear used as the only anesthetic method, is indicated for both cosmetic surgery and repair of outer ear injuries, given its excellent analgesia during and after surgery. The characteristics of this type of block of the pavilion make it ideal for major outpatient surgery and a valid alternative to general anesthesia in adults.