Articles: postoperative-pain.
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Ugeskrift for laeger · Dec 1993
Randomized Controlled Trial Clinical Trial[Preoperative or postoperative local anesthesia. Effect on postoperative pain treatment].
A randomized, double-blind trial was conducted to compare the efficacy of preincisional and postincisional wound infiltration with 1% lidocaine (40 ml) on postoperative pain. Thirty-seven patients scheduled for elective inguinal herniotomy participated. ⋯ The preincisional lidocaine infiltration group also had fewer patients requiring supplemental analgesics (58%) than the postincisional group (94%) (p < 0.05). We conclude that preincisional infiltration of the surgical wound with lidocaine is a more effective method for postoperative analgesia than postincisional infiltration.
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Anesthesia and analgesia · Dec 1993
Randomized Controlled Trial Clinical TrialPostoperative pain: the effect of low-dose ketamine in addition to general anesthesia.
In a randomized, double-blind study, postoperative pain was assessed in 22 patients undergoing elective open cholecystectomy with two types of anesthesia: standardized general anesthesia (control group), and low-dose ketamine as an addition to the same method of general anesthesia, before surgical incision (ketamine group). After the operation we found that the time from the end of surgery to the first request for analgesic was longer in the ketamine group. Postoperatively, patients in both groups were treated with patient-controlled analgesia (PCA) in exactly the same way. ⋯ The mean dose of morphine given in patients of the control group during the first 24 h was 48.7 mg vs 29.5 mg in the ketamine group. Mean visual analog scale (VAS) and verbal rating scale (VRS) were higher in patients in the control group during the first 5 h after surgery (P < 0.02), but between 5 and 24 h after surgery VAS and VRS were not significantly different (P > 0.05). Our results indicate that postoperative pain can be decreased when ketamine in low doses is added to general anesthesia before surgical stimulation.
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While there are increasing demands for improved post-operative analgesia and the implementation of Acute Pain Services (APS), the safety of such an approach remains under discussion. This paper analyses the safety outcome of 3016 consecutive post-operative patients treated under the care of a formalised Acute Pain Service. No serious complication resulting in morbidity or mortality occurred. ⋯ Patient-controlled analgesia (PCA) alone had a significantly lower rate of respiratory depression than PCA with a background infusion or continuous morphine infusion. In 1069 patients receiving continuous regional analgesia (epidural, interpleural, peripheral) no trauma to nervous structures, no infection and no local anaesthetic toxicity occurred. In conclusion, an anaesthesiology-based APS can provide postoperative pain relief using a wide range of relatively invasive techniques without endangering patient safety.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ketorolac and indomethacin are equally efficacious for the relief of minor postoperative pain.
Injectable ketorolac is an effective analgesic in ambulatory surgery patients. However, no studies have compared ketorolac with other NSAIDs in this setting. The analgesic efficacy of intramuscular ketorolac, rectal indomethacin and placebo was compared in healthy women undergoing gynaecological or breast surgery as outpatients. ⋯ However, no differences were observed between the two NSAIDS. Side effects were similar in all groups. We conclude that im ketorolac and pr indomethacin are equally effective analgesics in this group of patients.
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Randomized Controlled Trial Clinical Trial
Effect of extradural diamorphine on analgesia after caesarean section under subarachnoid block.
We have examined the efficacy, duration of action and side effects of extradural diamorphine alone and in combination with 1:200,000 adrenaline in a randomized, double-blind controlled study of 45 patients who underwent Caesarean section under spinal anaesthesia. Saline 10 ml, diamorphine 2.5 mg in saline 10 ml or diamorphine 2.5 mg in 1:200,000 adrenaline 10 ml were administered via the extradural route at delivery of the baby. ⋯ The addition of adrenaline increased the quality of analgesia 8 h after operation, but had no effect on the total amount of i.m. morphine administered during the first 24 h. The incidence of side effects was similar in all groups.