Articles: postoperative-pain.
-
Anesthesia and analgesia · Jul 1992
Randomized Controlled Trial Comparative Study Clinical TrialCombination of low-dose epidural morphine and intramuscular diclofenac sodium in postcesarean analgesia.
Epidural morphine is used for postcesarean analgesia, and nonsteroidal antiinflammatory drugs are frequently administered to relieve uterine cramps after vaginal delivery. To assess the efficacy of a combination of low-dose epidural morphine and intramuscular diclofenac sodium in postcesarean analgesia, a double-blind, randomized study was conducted. Epidural anesthesia was given to 120 parturients who were randomly allocated into four treatment groups: group A received normal saline solution, 10 mL epidurally and 3 mL intramuscularly (IM); group B received 10 mL of epidural saline solution and 75 mg (3 mL) of diclofenac IM; group C received 2 mg of morphine in 10 mL of epidural saline solution and 3 mL of saline solution IM; and group D received 2 mg of morphine in 10 mL of epidural saline solution and 75 mg of diclofenac IM. ⋯ Incidence of nausea or vomiting, or both, and pruritus occurred more frequently in groups C and D compared with group A or B (P less than 0.05). No bradypnea was observed during the study period. Diclofenac alone was not effective in postcesarean analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Optimal dose of epidural midazolam with bupivacaine for postoperative pain relief was investigated. Forty seven patients for upper abdominal surgery were divided into 5 groups. Each group had either 0.25% bupivacaine 6 ml (control group), 0.25% bupivacaine 6 ml + midazolam 0.025 mg.kg-1 (0.025 group), 0.05 mg.kg-1 (0.05 group), 0.075 mg.kg-1 (0.075 group), or 0.1 mg.kg-1 (0.1 group) administered epidurally for complaint of first postoperative pain. ⋯ The most optimal SS was obtained in 0.05 group. TNA was significantly longer in 0.025 and 0.05 groups than in the control group. It was concluded that the optimal dose of epidural midazolam with 0.25% bupivacaine 6 ml was 0.05 mg.kg-1 for postoperative pain relief after an upper abdominal surgery.
-
Comparative Study
Side effects of morphine patient-controlled analgesia and meperidine patient-controlled analgesia: a follow-up of 500 patients.
Many physicians, Certified Registered Nurse Anesthetists (CRNAs), and registered nurses have the clinical impression that either morphine sulfate or meperidine hydrochloride is a better drug to control postoperative pain. In this study, we evaluated pain relief and side effects for these two drugs to assess their potential differences. CRNAs conducted a structured interview of 500 female patients 24 hours after major gynecologic, urologic, or breast surgery. ⋯ Patients vomited more often after vaginal hysterectomy than patients having laparotomy, major oncology, or tuboplasty surgeries (P less than .05), and vaginal repair patients reported more vomiting than patients having major oncology or tuboplasty surgeries. Clinical impressions that either morphine or meperidine should be the preferred treatment for patients following gynecologic operations was not found by a 24-hour review of 500 patients for pain relief and side effects. Although mild itchiness occurred more frequently in the morphine PCA group, treatment was rarely necessary.
-
Clin. Pharmacol. Ther. · Jun 1992
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesic oral efficacy of tramadol hydrochloride in postoperative pain.
Tramadol hydrochloride is a synthetic opiate agonist with a plasma elimination half-life of 5 to 6 hours and peak plasma levels at about 1 1/2 hours. It derives its activity from attachment to the mu-receptor and blockage of norepinephrine reuptake. The purpose of this single-dose, double-blind, placebo-controlled study was to determine the analgesic effectiveness of an oral administration of two dose levels of tramadol hydrochloride (75 or 150 mg) compared with the combination of 650 mg acetaminophen plus 100 mg propoxyphene napsylate in 161 patients with severe postoperative pain after cesarean section. ⋯ The 150 mg dose of tramadol was significantly more effective than the acetaminophen-propoxyphene combination from hour 2 through hour 6 for the sum of pain intensity differences and total pain relief scores, as well as for the global rating of the medication. Tramadol hydrochloride at both dose levels is an effective analgesic agent and at 150 mg is statistically superior to the acetaminophen-propoxyphene combination. No serious adverse effects were observed; however, dizziness was more frequently reported with 150 mg tramadol.