Articles: analgesia.
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Randomized Controlled Trial Clinical Trial
Comparative study of continuous extrapleural intercostal nerve block and lumbar epidural morphine in post-thoracotomy pain.
To compare the efficacy of continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200,000 epinephrine and continuous lumbar epidural block with morphine in controlling post-thoracotomy pain and to measure serum bupivacaine concentrations during extrapleural infusion. ⋯ There is no significant difference in the degree of post-thoracotomy pain control measured by the VAS score when analgesia is provided by continuous extrapleural intercostal nerve block with bupivacaine 0.5% in 1:200,000 epinephrine or lumbar epidural block with morphine. Larger amounts of rescue analgesia were used by patients in the continuous extrapleural group with bupivacaine than those in the continuous lumbar epidural block with morphine. Serum bupivacaine concentrations rise without clinical toxicity.
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Anaesth Intensive Care · Dec 1997
Review Comparative StudyOpioid requirements and responses in Asians.
The provision of good analgesia can be influenced by ethnic differences in how pain is expressed, the attitudes of patients and health professionals towards pain management and pharmacological differences in the responses to opioids. It is difficult to generalize results so that they are applicable to any ethnic group as a whole. There is also the question of how best to categorize ethnic Asians who have been in Australasia for several generations. ⋯ An individualized pain management program is essential for any patient, whatever his or her ethnic origin. The use of patient-controlled analgesia will minimize some of the problems that may occur because of poor communication between the patient and the healthcare staff. Nevertheless, in a multicultural society like Australia's, health professionals should be conscious of the many factors that may influence the effects of prescribed treatment to manage pain in different ethnic groups.
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La Clinica terapeutica · Dec 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Peridural analgesic therapy in orthopedic surgery: comparison of ropivacaine and bupivacaine].
The aim of our study was to compare the efficiency of ropivacaine and bupivacaine, in epidural administration, in postoperative analgesia. 20 patients, undergone knee surgery, in epidural anaesthesia (bupivacaine 0.5%-2 mg/Kg-1 administered in level L3L4), was divided into 2 groups (10 each one) and the local anaesthetics in study was administered by epidural catheter with an elastomeric pump: A (ropivacaine 0.15%) and B (bupivacaine 0.15%). The results demonstrate that ropivacaine is better than bupivacaine to keep a check on analgesia in postoperative pain.
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We report the peripartum anaesthetic management for vaginal delivery of a chronic pain patient with an implanted intrathecal pump. This is the first report describing labour analgesia in a patient with such a device. As intrathecal systems become more popular for the management of nonmalignant pain, this situation is likely to be encountered with increasing frequency in the future. ⋯ The presence of an existing intrathecal delivery system does not preclude the use of supplemental epidural analgesia during labour.
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Acta Anaesthesiol. Sin. · Dec 1997
The efficacy of intrathecal coadministration of morphine and bupivacaine for labor analgesia.
Intrathecal (i.t.) opioids can provide labor analgesia, but the onset of pain relief is slow. Bupivacaine has the beneficial property of less motor blockade than other local anesthetics. This study retrospectively examined the efficacy of concomitant use of i.t. morphine and bupivacaine for labor pain relief. ⋯ Our results showed that a single injection of i.t. morphine and bupivacaine provided rapid onset and effective analgesia with manageable side effects and without major complications. Thus, i.t. morphine and bupivacaine provides an alternative to epidural analgesia for most women in labor.