Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
Preemptive epidural analgesia for thoracic surgery.
The purpose of this study was to determine if preemptive epidural analgesia performed before thoracotomy incision and during the operation reduces postoperative pain. Patients in the treatment group received 8 mL of 0.25% bupivacaine and 2 mL of fentanyl (50 microg/mL) via the epidural route prior to skin incision, followed by an infusion of bupivacaine 0.1% and fentanyl 10 microg/mL at 6 mL/hr. ⋯ The patients in the treatment group required less isoflurane intraoperatively and had lower maximum pain scores in the first 6 hours postoperatively. No significant differences were noted after the first 6 hours.
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Clinical Trial
Control of acute pain after major abdominal surgery in 585 patients given tramadol and ketorolac by intravenous infusion.
The aim of this study was to assess the efficacy and safety of postoperative pain relief using tramadol and ketorolac in continuous intravenous infusion. The 585 patients included in the study underwent major surgery according to a protocol involving the parenteral administration of 100 mg tramadol approximately 40 min before the end of surgery. This was followed by the continuous intravenous infusion of 600 mg tramadol and 180 mg ketorolac diluted with physiological solution to a total volume of 96 ml. ⋯ The method adopted was of limited cost and was well accepted by both patients and staff. On the basis of the data obtained, it is possible to affirm that the post-operative pain protocol proposed is effective, safe, without significant side effects, and of limited cost. Therefore, it is the first choice protocol for our operating unit after major abdominal surgery.
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Anaesthesiol Reanim · Jan 2002
Case Reports[Critical infusion incident caused by incorrect use of a patient-controlled analgesia pump].
We report on the case of a 17-year-old male patient who received a PCA pump after nephrectomy for postoperative analgesia. The syringe of the PCA pump was filled with 50 mg morphine and positioned about 25 cm above the heart. Since the piston of the syringe was not bolted while the pump was switched off, an unnoticed accidental evacuation of the whole content of the syringe into the intravenous line of the patient occurred because of gravity. ⋯ This critical incident was caused by various factors: incorrect application in combination with insufficient experience or training, stress, inadequate handing-over of the patient and a lack of arrangements and instructions for procedures in routine situations. Suggestions for preventing such dangerous critical incidents are made and discussed. In particular, an algorithm for the correct procedure when inserting or changing the syringe of a syringe pump is presented.
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Randomized Controlled Trial Clinical Trial
Evaluation of the safety and efficacy of the perioperative administration of rofecoxib for total knee arthroplasty.
Nonsteroidal anti-inflammatory drugs (NSAIDs) frequently are discontinued before elective total knee arthroplasty (TKA) because of the increased incidence of perioperative bleeding. Rofecoxib, a selective cyclooxygenase 2 inhibitor, does not interfere with the coagulation system and may be a safer NSAID for patients undergoing TKA. ⋯ The administration of rofecoxib resulted in improved preoperative pain scores and no significant increase in the incidence of perioperative bleeding or international normalized ratio compared with placebo. Rofecoxib does not need to be discontinued before elective TKA.
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Randomized Controlled Trial Clinical Trial
Magnesium infusion reduces perioperative pain.
Magnesium has antinociceptive effects in animal and human models of pain. These effects are primarily based on the regulation of calcium influx into the cell. The aim of this study was to determine whether perioperative infusion of magnesium would reduce postoperative pain and anxiety. ⋯ Continuous magnesium infusion, including the pre-, intra-, and postoperative periods reduces analgesic requirements. These results demonstrate that magnesium can be an adjuvant for perioperative analgesic management.