Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
[The effect of subcutaneous administration of buprenorphine with patient controlled analgesia system for post-operative pain relief].
We conducted a study comparing patients receiving continuous subcutaneous administration of analgesia with self controlled analgesia system (CSAA group) with those receiving continuous epidural infusion (Epi group) for postoperative analgesia after abdominal surgery. Fourteen patients were randomized into two groups: CSAA group (n = 7) received 20 micrograms.h-1 of buprenorphine (Bu) subcutaneously with additional 20 micrograms of Bu using Baxter infusor BB+PCA; Epg group (n = 7) received continuous epidural infusion of 0.4 mg of Bu and 46 ml of 0.25% bupivacaine daily (16.7 micrograms.h-1 of Bu) using Baxter infusor 2 ml.h-1 type. In both groups, patients received supplemental 0.1 mg of Bu subcutaneously as needed. ⋯ There was no severe side effect in both groups. We conclude that continuous subcutaneous administration of analgesic was effective for postoperative analgesia, and almost the same analgesic effect was obtained as compared with continuous epidural analgesia. We calculated that the adequate dose of Bu subcutaneously during early postoperative period to be about 30 micrograms.h-1 of Bu.
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Regional anesthesia · Nov 1994
Randomized Controlled Trial Clinical TrialEpidural catheters for obstetrics. Terminal hole or lateral eyes?
Controversy exists over the choice of the ideal epidural catheter for obstetric use, particularly whether the catheter should have a single terminal hole or three lateral eyes. ⋯ The use of terminal eye epidural catheters in our obstetric patients has led to an unacceptably high incidence of both unsatisfactory blocks and catheter replacement. Lateral eye catheters produced better results in our circumstances.
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Acta Anaesthesiol Scand · Nov 1994
Randomized Controlled Trial Clinical TrialThoracic epidural analgesia in aortocoronary bypass surgery. I: Haemodynamic effects.
Tachycardia and hypertension may cause myocardial ischaemia in patients with coronary heart disease going through major surgery. Thoracic epidural analgesia (TEA) has been reported to be beneficial in this situation. The haemodynamic effects of TEA in aortocoronary bypass surgery were investigated in 30 male patients < 65 years old and with ejection fraction > 0.5. ⋯ More ketanserin to HF group patients and methoxamine to epidural group patients were given. After bypass heart rate increased in all groups. Lower MAP 0.5 h after bypass and higher filling pressures in the early post bypass period in the epidural groups, most pronounced in the HF+TEA group, were noted.(ABSTRACT TRUNCATED AT 250 WORDS)
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Clinical Trial Controlled Clinical Trial
[Effect of celiac plexus block and thoracic epidural block on arterial ketone body ratio].
We evaluated the effect of intraoperative celiac plexus block (CPB) and thoracic epidural block (TEB) on arterial ketone body ratio (AKBR) in the patients undergoing total or partial gastrectomy. Mean arterial pressure (MAP), heart rate, AKBR, and arterial blood gas were measured at the end of esophago-jejunostomy, gastro-duodenostomy, or gastro-jejunostomy (pre-block) and at the end of operation (post-block), respectively. After pre-block measurement, CPB with 99.5% ethanol 15-20 ml was carried out in 8 patients with advanced gastric cancer (CPB group); TEB with 2% lidocaine was performed on 8 patients (TEB group); and neither CPB nor TEB was done on 8 patients (control group). ⋯ However, there were no difference in AKBR, pH, and BE between pre-block values and post-block values in TEB group as in the control group. These findings suggest that ethanol used in CPB reduces the redox state of hepatic mitochondria and increases lactate. Therefore we should pay attention to the changes in AKBR, pH, and BE after celiac plexus block with ethanol.
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To evaluate the effectiveness of patient-controlled analgesia (PCA) in postoperative cardiac surgery patients. ⋯ PCA is an effective means of controlling postoperative pain in cardiac surgery patients.