Articles: analgesia.
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To determine the adverse event and complication rate for the use of procedural sedation and analgesia for painful procedures and diagnostic imaging studies performed in a pediatric emergency department. ⋯ The adverse event rate for procedural sedation and analgesia performed by pediatric emergency physicians was 2.3% with no serious complications noted.
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Int J Obstet Anesth · Oct 1999
Randomized Controlled Trial Clinical TrialComparison of intermittent epidural bolus, continuous epidural infusion and patient controlled-epidural analgesia during labor.
The aim of the study was to compare efficacy and side-effects produced by three techniques of epidural analgesia during labor: intermittent bolus (1B), continuous epidural infusion (CEI) and patient-controlled epidural analgesia (PCEA). One hundred and fifty parturients allocated randomly to three groups received the same epidural solution of bupivacaine 0.125% with sufentanil 0.5 microg/mL. In the first group (IB: n=50) boluses were administered by the anesthesiologist and titrated to achieve adequate analgesia. ⋯ The other side-effects were equally distributed in the three groups. We concluded that PCEA with bupivacaine and sufentanil is a valuable technique and a good alternative to the IB method. Compared to the CEI technique, PCEA allows a decrease in local anesthetic consumption without impairing the quality of anesthesia.
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Int J Obstet Anesth · Oct 1999
Randomized Controlled Trial Clinical TrialDose response study of subarachnoid diamorphine for analgesia after elective caesarean section.
Subarachnoid diamorphine provides excellent analgesia after elective caesarean section but the optimum dose is still uncertain. We therefore investigated the effects of three regimens of subarachnoid diamorphine. Forty parturients were assigned to one of four groups. ⋯ The mean (SD) dose of PCA morphine used over 24 h was 39.4 (14.7), 25.6 (16.5), 21.6 (15.9) and 3.1 (3.6) mg, and mean time to first use of morphine was 1.6 (0.5), 3.0 (1.4), 3.4 (2.4) and 14.1 (9.4) h, in the 0, 0.1 mg, 0.2 mg and 0.3 mg groups respectively. Side-effects of pruritus, nausea and vomiting were dependent on the dose of spinal diamorphine but did not require treatment in any patients. We conclude that 0.3 mg subarachnoid diamorphine provides significantly better postoperative pain relief than the smaller doses with an acceptable increase in side-effects.
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Randomized Controlled Trial Comparative Study Clinical Trial
Is combined spinal-epidural analgesia associated with more rapid cervical dilation in nulliparous patients when compared with conventional epidural analgesia?
The combined spinal-epidural technique provides rapid onset of labor analgesia and, anecdotally, is associated with labors of shorter duration. Epidural analgesia, by contrast, has been suggested to prolong labor modestly. It is unclear, however, whether more rapid cervical dilation in patients who receive combined spinal-epidural analgesia is a physiologic effect of the technique or an artifact of patient selection. The authors hypothesized that anesthetic technique may influence the rate of cervical dilation, and we compared the effects of combined spinalepidural with those of epidural analgesia on the rate of cervical dilation. ⋯ In healthy nulliparous parturients in early labor, combined spinal-epidural analgesia is associated with more rapid cervical dilation compared with epidural analgesia. Further study is needed to elicit the cause and overall effect of this difference.
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Randomized Controlled Trial Clinical Trial
Randomized controlled trial to examine the influence of thoracic epidural analgesia on postoperative ileus after laparoscopic sigmoid resection.
The aim of the study was to evaluate whether perioperative epidural analgesia had any effect on the duration of postoperative ileus after laparoscopic sigmoid resection. ⋯ Perioperative thoracic epidural analgesia did not have a clinically relevant effect on the duration of postoperative ileus after laparoscopic sigmoid resection.