Articles: analgesia.
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Rev Esp Anestesiol Reanim · Apr 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Ketorolac versus tramadol: comparative study of analgesic efficacy in the postoperative pain in abdominal hysterectomy].
To compare the analgesic efficacy of tramadol to that of ketorolac trometamol administered intravenously and at fixed times over the 24 hours after abdominal hysterectomy. ⋯ During the first 12 hours following surgery, a 100 mg dose of tramadol has been shown to provide more effective pain relief than 30 mg of ketorolac administered intravenously every 6 hours. The only drawback to administering the drug intravenously was the high incidence of postoperative vomiting.
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A 23-yr-old primagravida sustained a dural puncture during epidural catheter insertion and developed a headache that settled with oral diclofenac and codydramol. On the third day after delivery, she convulsed twice without warning. As plasma urate was increased, the putative diagnosis of an eclamptic fit was made, and magnesium therapy was started. ⋯ A coincidental arteriovenous malformation was noted. This case emphasises the need to consider the differential diagnoses of post-partum headache. The management of acute intracranial haematoma is described.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of the hemodynamic effects of paracervical block and epidural anesthesia for labor analgesia.
Both paracervical block (PCB) and epidural analgesia are sometimes associated with hemodynamic effects potentially harmful to the well-being of the fetus. Our study was designed to test the hypothesis that PCB would have a more profound effect on maternal and fetal blood flow than epidural analgesia. ⋯ There were small differences in the effects of PCB and epidural analgesia on uteroplacental circulation as well as on maternal hemodynamics. PCB may have a vasoconstrictive effect on the uterine artery. This and the fact that the parturients required rescue analgesia more frequently after PCB than after epidural block speaks for the feasibility of the latter in obstetrics.
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Clinical Trial
Efficacy and safety of patient-controlled analgesia for morbidly obese patients following gastric bypass surgery.
Adequate postoperative pain control is important to reduce potential cardiopulmonary complications. It is often difficult to determine dosages of narcotics for morbidly obese patients following Roux-en-Y gastric bypass (RYGBP) due to respiratory depression. Individualization of analgesic therapy, patient-controlled analgesia (PCA), can provide optimal dosage for pain control and minimize the side-effects. ⋯ PCA is safe and effective for morbidly obese patients following RYGBP.
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Comparative Study Clinical Trial
Epidural analgesia for pain relief in thoracic surgery.
The effectiveness and adverse effects of continuous epidural analgesia was studied in 104 patients undergoing thoracic operations at Siriraj Hospital. Patients were divided into 3 groups according to the type of surgical approach and the technique of epidural analgesia. Group 1 patients (n = 72) received thoracic epidural block using bupivacaine and morphine combined with light general anesthesia for exploratory thoracotomy; group 2 patients (n = 21) received the identical anesthetic technique, the operation was achieved through median sternotomy; group 3 patients (n = 11) had a similar type of operation to group 1, the anesthetic technique was lumbar epidural block using morphine and combined with light general anesthesia. ⋯ Postoperative respiratory depression was found 54.16 per cent in group 1, 33.33 per cent in group 2 and 9.09 per cent in group 3 (P < 0.05), and was mostly mild to moderate, except three patients in group 1 and one in group 2 who needed mechanical ventilatory support. There were no differences among the groups in the incidence of nausea/vomiting and pruritus. It is concluded that both thoracic and lumbar epidural morphine provide excellent postthoracotomy pain relief, whereas, respiratory depression is more common with thoracic than lumbar epidural morphine.