Articles: analgesia.
-
Comparative Study Clinical Trial
The effects of epidural blockade on the acute pain in herpes zoster.
To evaluate the relief of acute pain and possible preventive effects on postherpetic neuralgia through the use of an epidural blockade in the acute stage of herpes zoster. ⋯ We believe that an epidural blockade combined with an antiviral agent is a very effective treatment modality for the pain of acute herpes zoster, and we recommend its use for the prevention of postherpetic neuralgia, with a view to shortening the total duration of pain, especially late residual pain.
-
Anesthesia and analgesia · Nov 1999
Randomized Controlled Trial Comparative Study Clinical TrialInterscalene brachial plexus analgesia after open shoulder surgery: continuous versus patient-controlled infusion.
In this prospective, randomized, double-blinded study, we assessed the efficacy of patient-controlled analgesia (PCA) for continuous interscalene analgesia after open shoulder surgery. Sixty patients were divided into three groups of 20. During a 48-h period, they received, via an interscalene catheter, a continuous infusion of 0.125% bupivacaine with sufentanil 0.1 microg/mL and clonidine 1 microg/mL at 10 mL /h in Group 1; a continuous infusion of the same solution at 5 mL/h plus PCA boluses (2.5 mL/30 min) in Group 2; and only PCA boluses (5 mL/30 min) of the same solution in Group 3. Pain scores, sensory block, supplemental analgesia, bupivacaine consumption, side effects, and satisfaction scores were recorded. At 24 and 48 h, sensory block was more frequent and pain control was significantly better in Groups 1 and 2 than in Group 3 (P < 0.001). In Group 3, larger doses of paracetamol were required. Bupivacaine consumption was significantly less in Groups 2 and 3 than in Group 1 (P < 0.001). Satisfaction was significantly higher in Groups 1 and 2 than in Group 3 (P < 0.01). Side effects were comparable in the three groups. We conclude that continuous interscalene analgesia requires a background infusion after open shoulder surgery. Because it reduces the local anesthetic consumption and allows the patients to rapidly reinforce the block shortly before physiotherapy, a basal infusion rate of 5 mL/h combined with PCA boluses (2.5 mL/ 30 min) is the recommended technique. ⋯ In this study, we demonstrated that continuous interscalene analgesia requires a background infusion to provide efficient pain relief after open shoulder surgery. A basal infusion of 5 mL/h combined with patient-controlled analgesia boluses (2.5 mL/30 min) seems to be the most appropriate technique.
-
J Am Assoc Gynecol Laparosc · Nov 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparison of anesthetic methods for microlaparoscopy in women with unexplained infertility.
To evaluate the effectiveness of ketamine compared with fentanyl as analgesia or sedation for microlaparoscopy. ⋯ Microlaparoscopy in infertile women was performed more effectively under sedation with ketamine than with fentanyl.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of patient-controlled analgesia (PCA) with tramadol or morphine.
To compared the clinical efficacy of tramadol and morphine using a patient-controlled analgesia (PCA) delivery system. ⋯ Tramadol PCA can provide effective analgesia following major orthopedic surgery provided sufficiently high doses are given for loading and by patient demand. However, the incidence of nausea/vomiting is also higher causing decreased satisfaction.
-
In the obstetric setting, spinal and epidural analgesia/anesthesia are the 2 most frequently used forms of analgesia and anesthesia. One of the potential complications of these procedures is the postdural puncture headache (PDPH), and there is a high probability that the anesthetist will have occasion to evaluate the headache complaints of the parturient. The author reviews the differential process and discusses some of the causes and treatments of headaches in the parturient.