Articles: analgesia.
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Prolapsing haemorrhoids and rectal mucosal prolapse are commonly seen in colorectal practice. Conventional treatment of haemorrhoids and mucosal prolapse by variations of the ligation-excision technique can achieve good results in expert hands. However, post-operative complications are well recognized and may result in prolonged in-patient stay. The aim of this study was to evaluate prospectively a submucosal resection anoplasty technique using a circular stapling device in a consecutive series of patients requiring surgery for haemorrhoids or mucosal prolapse, and to assess the suitability of this technique for day case surgery. ⋯ Transanal stapled anoplasty achieves good functional results and patient satisfaction in the surgical management of haemorrhoids and mucosal prolapse. With careful surgical technique, strict attention to haemostasis and adequate post-operative analgesia this procedure can feasibly be carried out on a day case basis. Minor complications are similar to those of conventional surgery. Though longer-term follow up is required, no major complications were observed in this consecutive series.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled epidural analgesia with morphine in renal transplant patients.
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Acta Obstet Gynecol Scand · May 2000
Fetal oxygen saturation during epidural and paracervical analgesia.
We wanted to assess changes in fetal oxygenation during maternal epidural or paracervical analgesia in labor. ⋯ There was a small but significant difference in fetal oxygenation between epidural and paracervical groups during the observation period. The magnitude of the difference is hardly clinically significant. A larger, randomized study is needed to elucidate the mechanisms behind this finding.
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Clinical Trial
[Patient-controlled analgesia for prolonged pain in the child. An open-label feasibility study of a standardized method].
Patient-controlled analgesia (PCA) has been shown to be superior to a continuous morphine infusion for the treatment of ongoing pain in children over five years of age. Nevertheless, prescription parameters such as the bolus dosage and the possible association of a continuous background infusion have not yet been standardized. ⋯ This standardized technique of PCA can be used extensively in children over five years of age. It can be used as a reference for further studies.
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Comparative Study
Opiate-induced analgesia is increased and prolonged in mice lacking P-glycoprotein.
P-glycoprotein is a transmembrane protein expressed by multiple mammalian cell types, including the endothelial cells that comprise the blood-brain-barrier. P-glycoprotein functions to actively pump a diverse array of xenobiotics out of the cells in which it is expressed. The purpose of this study was to determine if P-glycoprotein alters the analgesic efficacy of clinically useful opioids. ⋯ These results suggest that P-glycoprotein acts to limit the entry of some opiates into the brain and that acute administration of P-glycoprotein inhibitors can increase the sensitivity to these opiates.