Articles: analgesia.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Postoperative peridural analgesia. Continuous versus patient-controlled administration of a low-dose mixture of sufentanil, clonidine and bupivacaine].
The purpose of our study was to find out whether patient-controlled epidural administration (PCEA) of a mixture containing a low-dose local anaesthetic, opioid and alpha 2-agonist provides as good or better postoperative analgesia as continuous epidural administration of the same analgetic solution. ⋯ In patients at rest both continuous and patient-controlled epidural administration of analgesics provides excellent analgesia after major abdominal surgery. Contrariwise, patients on exercise who could use a PCA-device experienced more pain compared to those with a continuous epidural infusion technique. On the other hand the patients of the PCA-group consumed less epidural analgesics. We did not notice any severe side effects such as respiratory depression or cardiovascular instability during the study.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pharmacokinetic and clinical study of ropivacaine and bupivacaine in women receiving extradural analgesia in labour.
We have compared, in a randomized, double-blind study, the pharmacokinetics of ropivacaine and bupivacaine during labour. Total and free plasma concentrations of ropivacaine and bupivacaine were measured after the first of two extradural doses. ⋯ At 20 min, Cpmax (free) of ropivacaine (0.04 mg litre-1) was higher than that of bupivacaine (0.02 mg litre-1) (P = 0.0025). The clinical effectiveness of the block was similar in both groups.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of 0.25% ropivacaine and bupivacaine for epidural analgesia for labor and vaginal delivery.
Part 1: To measure ropivacaine levels in the mother and infant at delivery after continuous lumbar epidural infusion. Part 2: To compare epidural ropivacaine to epidural bupivacaine for labor analgesia in regard to effectiveness, motor blockade, and maternal and neonatal effects. ⋯ Both ropivacaine and bupivacaine produced excellent analgesia for labor with no major adverse effect on the mother or neonate.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal sufentanil compared with epidural bupivacaine analgesia in labour.
Epidural analgesia for pain relief during labour has certain disadvantages including slow onset. However, intrathecal sufentanil provides rapid onset and well-controlled analgesia lasting 1-4 h. The aim of this study was to compare the analgesia and the side effects of intrathecal sufentanil with epidural bupivacaine during labour. ⋯ Pain scores were significantly lower between 5 and 90 min after injection in patients receiving intrathecal sufentanil. Pruritus was significantly more frequent among those receiving intrathecal sufentanil. The rapid onset and effective analgesia of intrathecal sufentanil may in certain situations be advantageous.
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The efficacy and side effects of 100 lumbar epidural treatments with low concentrations of bupivacaine (1 mg mL-1), fentanyl (2 micrograms mL-1) and adrenaline (2 micrograms mL-1) combined with rectal paracetamol were prospectively evaluated in children aged 4-14 years after femoral osteotomy. The mean treatment time was 43 h and the mean dose was 0.18 mL kg-1 h-1. Ninety-nine per cent of the children were either without pain or experienced very low pain at rest for at least 80% of the treatment time. ⋯ Sixty-three per cent of the patients experienced nausea or vomiting, but antiemetic treatment was indicated in only 11%. One epidural treatment had to be stopped in a child who did not respond to antiemetics. The incidence of pruritus was high (49%), but the symptoms were mild and limited.