Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
Target-controlled infusion of alfentanil for postoperative analgesia: a feasibility study and pharmacodynamic evaluation in the early postoperative period.
We have examined the feasibility of target-controlled infusion of alfentanil (TCIA) and the pharmacodynamics of alfentanil in the early postoperative period. Patients were allocated randomly to one of the three groups to receive balanced anaesthesia with bolus injections of fentanyl (group F), sufentanil (group S) or alfentanil (group A). In the recovery room all patients received the same analgesic regimen, comprising TCIA. ⋯ EC50 of alfentanil was determined in 28 patients; mean values were 26 ng ml-1 (group F), 39 ng ml-1 (group S) and 52 ng ml-1 (group A). We conclude that TCIA, under the conditions studied, resulted in a fast onset of adequate analgesia, irrespective of the opioid administered during operation. Also, there was no effect of opioids administered during operation on postoperative pharmacodynamics of alfentanil.
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Anaesthesiol Reanim · Jan 1997
Randomized Controlled Trial Comparative Study Clinical Trial[Pain therapy after thoracotomies--systemic patient-controlled analgesia (PCA) with opioid versus intercostal block and interpleural analgesia].
Both regional analgesia and systemic opioid therapy (e.g. PCA) are commonly used for pain relief following thoracic surgery. Many anaesthesiologists are reluctant to use thoracic epidural analgesia on general surgical wards. ⋯ Intercostal blocks and interpleural analgesia significantly reduce opioid demand following thoracotomy and are effective means of postoperative pain management. Nevertheless, in contrast to epidural analgesia, both methods have to be supplemented by, or combined with, systemic analgesics in most patients. On the other hand, compared to epidural analgesia, ICB and IPA are less invasive and easier to manage on general surgical wards.
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J. Oral Maxillofac. Surg. · Jan 1997
Comparative Study Clinical Trial Controlled Clinical TrialA comparison of patient-controlled and fixed schedule analgesia after orthognathic surgery.
The purpose of this prospective study was to compare the effectiveness of patient-controlled intravenous (i.v.) opioid analgesic administration (PCA) with fixed schedule and dosage oral/rectal administration of naproxen, and opioid analgesics intramuscularly/orally as needed (i.m./p.o. prn) for postoperative analgesia over a period of 48 to 56 hours after surgery. ⋯ In patients undergoing orthognathic surgery, the naproxen and PCA regimens provided better analgesia than the codeine regimen.
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Best Pract Benchmarking Healthc · Jan 1997
ReviewBenchmarking for unrelieved pain in a postanesthesia care unit.
The problem of unrelieved pain in the PostAnesthesia Care Unit (PACU) is an outcomes management concern. This article discusses the steps taken by the PACU staff to establish a benchmark for unrelieved pain and to evaluate the effect of the Multidisciplinary Pain Management Initiative (MPMI) action plan on the outcomes of length of stay and cost.