Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy and tolerability of nonprescription ibuprofen versus celecoxib for dental pain.
Many clinicians appear confused about the purported clinical advantages of the new generation COX-2 inhibitors compared to both over-the-counter and prescription nonsteroidal anti-inflammatory analgesic agents (NSAIDs). Infact, there is a paucity of published information comparing the safety and efficacy of these two classes of drugs when used to treat acute pain. This study was designed to compare the safety and analgesic efficacy of an over-the-counter (OTC) analgesic, ibuprofen (Advil Liqui-Gels), to the leading prescription COX-2 inhibitor celecoxib (Celebrex). ⋯ Both active treatments were well tolerated, with no differences in incidence or severity of adverse events. Of particular interest, there were no differences in gastrointestinal-related side effects when comparing these doses of ibuprofen liquigels to celecoxib. In conclusion, ibuprofen liquigels were a significantly more effective analgesic and provided relief significantly faster compared with celecoxib in the treatment of postsurgical pain.
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Pain is one of the most important considerations in the care of thoracic surgical patients. Failure in pain management is associated with increased mortality and morbidity. Acute pain management aspires to stop the painful stimuli before it is transferred to the CNS. ⋯ Chronic pain can be treated in many ways, and input from a pain clinic might be beneficial. The single best approach to chronic pain is to prevent it. This can be achieved by selecting the right incisional approach, instituting early physical therapy, and achieving optimal postoperative pain control.
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Review Comparative Study
Selecting new drugs for pain control: evidence-based decisions or clinical impressions?
Selecting drugs for pain control in dentistry should be based on scientific research rather than clinical impressions. This article highlights the scientific attributes of analgesic medications that make them practical for treating postoperative dental pain. ⋯ Selecting drugs for the short-term relief of postoperative dental pain should be based on a careful assessment of all relevant pharmacological characteristics of a given agent, especially those related to maximum dosage, duration of action and efficacy.
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Randomized Controlled Trial Clinical Trial
Double-blind, randomized, controlled trial of local anesthetic use for iliac crest donor site pain.
Autogenous iliac crest bone grafts are often used for persons undergoing anterior cervical fusion (ACF). Study findings have shown that pain at the iliac crest donor site can often be more severe than that at the primary operation site. A method used to eliminate pain after bone harvesting involves infiltration of a local anesthetic directly into the site. ⋯ The bupivacaine group's mean morphine intake for the first 24 hours after surgery was found to be lower (32 mg; placebo 44 mg), whereas participants younger than 49 years who received bupivacaine were found, on average, to have stayed in the hospital one day less (3.6 days) than placebo group participants (4.5 days). Younger participants receiving bupivacaine required less morphine and had, on average, a reduced length of stay. The clinical implication of using local anesthetic for the relief of donor site pain suggests that it is a safe and efficacious technique.
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Acta Anaesthesiol Scand · Aug 2002
Randomized Controlled Trial Clinical TrialPostoperative pain relief following intrathecal bupivacaine combined with intrathecal or oral clonidine.
The purpose of the present study was to evaluate the postoperative analgesic and adverse effects of equal doses of oral or intrathecal clonidine in spinal anaesthesia with bupivacaine plain. ⋯ Addition of intrathecal clonidine prolonged analgesia and decreased morphine consumption postoperatively more than oral clonidine. Hypotension was more pronounced after oral than after intrathecal clonidine. Intrathecal clonidine is therefore recommended.