Articles: postoperative-pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy of oxymorphone extended release in postsurgical pain: a randomized clinical trial in knee arthroplasty.
Patients with moderate or severe pain following knee arthroplasty and washout from standard patient-controlled analgesia (PCA) were randomized to receive 20 mg of an extended-release (ER) oxymorphone formulation (n = 65) or placebo (n = 61) q12h for 1 day. Oxymorphone PCA was used as rescue analgesic. Oxymorphone ER provided significant improvements over placebo for most standard single-dose analgesic parameters, including mean total pain relief (TOTPAR) over 0 to 12 hours (19.30 vs. 13.72; p = 0.0056), as well as for all multiple-dose (24-h) efficacy assessments. ⋯ Oxymorphone ER was effective and generally well tolerated. A single dose was active from 2 hours until > or = 12 hours after administration. Comparisons with other oral opioids are warranted, especially in the setting of outpatient and day surgery.
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Randomized Controlled Trial Clinical Trial
Randomized controlled trial of preservation or elective division of ilioinguinal nerve on open inguinal hernia repair with polypropylene mesh.
Our study aimed to evaluate the effect of preservation or elective division of the ilioinguinal nerve on pain and postoperative symptoms after open inguinal hernia repair with mesh. ⋯ Pain after open hernia repair with polypropylene mesh is not affected by elective division of the ilioinguinal nerve; sensory disturbances in the area of distribution of the transected nerve are significantly increased.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pre-operative and post-operative effect of a pain management programme prior to total hip replacement: a randomized controlled trial.
Patients may wait some time for total hip replacement with conservative management of pain and disability, but no attempts to rehabilitate them. This study randomised 40 patients accepted for and awaiting total hip replacement to a brief rehabilitative psychologically based pain management programme (PMP) or to a control group with no intervention. Patients were assessed before randomisation, 3 months after the PMP or equivalent waiting time, and again one year later after total hip replacement. ⋯ Six patients opted to delay, but this did not differ between groups. Post-hip replacement both groups improved in pain and some aspects of activity (AIMS) with greater improvement in the PMP group for physical activity and total AIMS scores, suggesting that some techniques had continued to be of use post-surgically. Rehabilitative pain management may be useful to patients pre-operatively in managing everyday pain, but not to the extent that they opt to delay surgery; it may also improve their function after hip replacement.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair.
Laparoscopic preperitoneal inguinal hernia repair is associated with a short hospital stay and an early return to normal activity. Therefore, early postoperative pain control is important. The aim of this study was to evaluate the effect of preperitoneal Bupivacaine instilled into the preperitoneal cavity on pain following laparoscopic mesh repair of inguinal hernia. ⋯ Preperitoneal Bupivacaine attenuates pain following laparoscopic inguinal hernia repair and should be considered in these cases.
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Randomized Controlled Trial Clinical Trial
Evaluation of a local anaesthesia regimen following mastectomy.
Breast surgery can be emotionally distressing and physically painful. Acute pain following surgery is often related mainly to the axillary surgery and is aggravated by arm and shoulder movement. We conducted a prospective double-blind, randomised, placebo-controlled trial to determine the influence of local anaesthetic irrigation of axillary wound drains on postoperative pain during the first 24 h following a modified Patey mastectomy (mastectomy with complete axillary node clearance). ⋯ Morphine consumption, visual analogue and verbal rating pain scores were recorded. There were no statistical differences in morphine requirements or pain scores between the two groups, nor were there differences in anti-emetic or supplemental analgesic consumption. Bupivacaine irrigation used in this manner does not appear to offer an effective contribution to postoperative analgesia.