Articles: postoperative-pain.
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Acta Anaesthesiol Scand · Oct 1987
Randomized Controlled Trial Clinical TrialThe effect of thoracic epidural analgesia on respiratory function after cholecystectomy.
To assess the effect of thoracic epidural analgesia (TEA) on postoperative respiratory function and pulmonary complications, a prospective randomized trial was conducted in patients undergoing cholecystectomy. One hundred patients were allocated to TEA (n = 30), TEA + general anesthesia (TEA + GA) (n = 30), or general anaesthesia (GA) (n = 40) groups. Respiratory function was analysed by measuring forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), functional residual capacity (FRC), total lung capacity (TLC), peak expiratory flow (PEF) in the supine and sitting postures, and arterial blood gases. ⋯ The preoperative difference of 27% in FRC between the sitting and supine postures was maintained after operation. PaO2 decreased by 0.8 kPa after TEA, by 1.5 kPa after TEA + GA with the lowest value on the 2nd postoperative day and by 1.5 kPa after GA, with the lowest value immediately after operation. Simultaneous hypercarbia indicated hypoventilation, which may have contributed to impaired respiratory function on the following days.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Oct 1987
The effects of age, epinephrine, and operative site on duration of caudal analgesia in pediatric patients.
The effects of age, operative site (penoscrotal or inguinal), and the addition of epinephrine 1:200,000 to bupivacaine on duration of postoperative analgesia after caudal block were prospectively and blindly evaluated in 341 children aged 13 months to 17 yrs. At the conclusion of the surgical procedures under halothane/N2O/O2 anesthetics (n = 419), caudal blocks were performed with 0.5 ml/kg of either 0.25% bupivacaine or 0.25% bupivacaine with 1:200,000 epinephrine injected at a rate of 0.5 ml/sec. ⋯ There were no major complications. The authors conclude that duration of analgesia is significantly influenced by age, operative site, and the addition of epinephrine 1:200,000 to bupivacaine.
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A 2-day study to assess the safety and efficacy of a combination analgesic, Stopayne (Rio Ethicals), was conducted in 23 postoperative plastic surgery patients with pain of moderate to severe intensity. Statistically significant pain relief was attained, with 2 (9%) patients reporting complete relief 1 hour after taking the tablets and 19 (82%) reporting satisfactory relief (P less than 0.01). ⋯ The average time taken for analgesia to occur was 37.7 min and it lasted an average of 3.8 h. On being woken by pain 18 (78%) patients reported that they were able to sleep again after taking the study drug; 19 patients reported that the tablets helped them to fall asleep.
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Previous erratic use of intermittent intramuscular and intravenous morphine or pethidine for postoperative analgesia prompted a prospective trial of continuous intravenous morphine delivered by an infusion pump. The rate was adjusted to keep the patient free of pain--as assessed by observation in the infant and enquiry in the older child. ⋯ The results of a cohort of 20 patients (aged 3 months-12 years) are presented. Thanks to positive parental and nursing staff support, and absence of complications, administration of postoperative analgesia with continuous intravenous morphine infusion is now standard practice in this unit.