Articles: postoperative-pain.
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As part of trust-wide practice development project to improve post-operative pain management, a descriptive study was conducted in the orthopaedic directorate of a large teaching hospital in the north of England. Sixty-five patients were included in this prospective study. Patients were interviewed post-operatively about their pain experience, and present and worst pain scores were recorded. ⋯ Reliance on pharmacological methods of pain relief was evident and interventions to help patients cope with night time pain were rarely documented. The results are discussed in light of a theoretical framework for acute pain management and current research. Implications for practice are discussed and areas for further research are suggested.
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Minerva anestesiologica · Mar 1998
Comparative Study Clinical Trial Controlled Clinical Trial[Postoperative analgesia with PCA in 300 patients. A comparison of four therapeutic regimes].
The results of patient-controlled analgesia (PCA) in 300 patients undergoing major operations in general surgery, urology, ENT and obstetrics-gynaecology are presented. ⋯ On the basis of personal experience, patient controlled analgesia has been demonstrated to be an effective, reliable and flexible procedure for the control of postoperative pain.
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Swiss medical weekly · Feb 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of propacetamol and morphine in postoperative analgesia].
To compare the analgesic efficacy and tolerance of propacetamol and morphine, 80 patients in good clinical condition were included in a prospective, parallel, randomized double blind trial after elective surgery expected to elicit light to moderate postoperative pain. At the end of general anesthesia, 40 patients received 30 mg/kg propacetamol and 40 0.2 mg/kg morphine, as a 15-min intravenous infusion. The groups were similar for age, weight and duration of anesthesia. ⋯ No significant differences were observed in blood oxygen saturation, blood pressure, heart rate, body temperature and vigilance evaluated by the trailmaking test. Nausea was present in 4 cases under propacetamol and 3 under morphine, and pruritus in 2 and 7 cases, respectively. In conclusion, propacetamol may represent an alternative to morphine for pain prevention after mildly to moderately painful surgery in situations where the use of opioids is unsuitable.
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J Pain Symptom Manage · Feb 1998
Comparative Study Clinical Trial Controlled Clinical TrialPain scores in infants: a modified infant pain scale versus visual analogue.
This study describes an observational system (modified infant pain scale, MIPS) with elements from a previously published observational scale and from assessments of video-recorded infant facial expressions. It was designed to allow rapid and repeated assessments of pain in infants after brief training by an observer without pediatric experience. Forty healthy term infants (17 +/- 7 weeks) undergoing elective surgery had simultaneous independent assessment of pain using two scales: a naive observer used the MIPS and an experienced pediatric nurse used a 10-cm unmarked horizontal visual analogue scale (VAS). ⋯ Infants had a broad range of MIPS scores, and the two scales categorized infants as "comfortable" or "not comfortable" with a high degree of concordance. The MIPS was easily incorporated into an infant's physical examination. We recommend its use for two-point clinical pain assessment.
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Randomized Controlled Trial Clinical Trial
Pre-emptive effect of multimodal analgesia in thoracic surgery.
Thirty subjects undergoing posterolateral thoracotomy were allocated randomly to receive one of two analgesic regimens: group Pre received i.v. morphine, i.m. diclofenac and intercostal nerve blocks from T2 to T11, 20 min before operation and placebo injections after operation. Group Post received placebo injections before operation, and i.v. morphine, i.m. diclofenac and intercostal nerve blocks from T2 to T11 at the end of surgery, before discontinuation of anaesthesia. ⋯ During the first 48 h after operation there were lower pain scores in group Pre when taking a vital capacity breath but there were no significant differences between the groups in any other measure. The effects of pre-emptive analgesia given before surgery appeared to be relatively modest in terms of analgesia, analgesic consumption and long-term outcome and were of limited clinical significance.