Articles: postoperative-pain.
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Acta Anaesthesiol Scand · Jan 1992
Randomized Controlled Trial Clinical TrialEpidural bupivacaine, sufentanil or the combination for post-thoracotomy pain.
Analgesia with epidural bupivacaine, sufentanil or the combination was studied in 50 patients who had undergone thoracotomy. During operation all patients received an initial dose of bupivacaine 0.5% with adrenaline 5 micrograms.ml-1 (5-10 ml) by thoracic epidural catheter. One hour later the patients were divided into three groups: the bupivacaine group (bupivacaine 0.125%), the sufentanil group (50 micrograms sufentanil in 60 ml normal saline) and the combination group (50 micrograms sufentanil in 60 ml bupivacaine 0.125%). ⋯ The sufentanil group had much better pain scores, but on exercise these patients experienced more pain than the combination group. The combination group had, overall, better pain scores. In the combination group, there were better respiratory results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled versus conventional analgesia for postsurgical pain relief in adolescents.
We performed a randomized nonblinded, cross-over comparison of patient-controlled analgesia (PCA) with conventional intramuscular analgesia in 10 adolescents (13-18 years) undergoing spinal fusion for idiopathic scoliosis. PCA use afforded more effective pain control (p < 0.02) on a 10-point linear pain intensity scale than did intramuscular injections, while causing an equal amount of sedation and no side effects. PCA appears to be a promising technique for providing postoperative pain relief in this group of adolescents. Further studies are needed to define its role for other pediatric conditions.
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In order to evaluate postoperative pain treatment following thoracic surgery, 214 medical records of patients who were operated during 1986-1988 were examined. Nurses' comments concerning pain and the amounts of analgesics given during the 2 postoperative days were recorded. The 150 patients who were still alive in December 1989 were sent a postal questionnaire which asked about the pain and the efficacy of pain relief they had received after their operation. ⋯ During the first postoperative week little pain was experienced by 60% of the patients, considerable pain by 35% and excruciating pain by 5% of the patients being interviewed. The postoperative pain relief was rated as good in 60% of the answers, satisfactory in 38% and poor in 2%. Persistent post-thoracotomy pain lasting for more than 6 months was reported by 44% of the patients, of whom 66% had received treatment for the pain.
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The effectiveness of postoperative pain relief and the frequency of side effects with three different doses of epidural diamorphine (2.0, 3.5 and 5 mg) was investigated. The study was carried out double-blind in 30 women undergoing awake elective caesarean section. Postoperative pain intensity was measured on a linear analogue scale. ⋯ Three patients in the 2 mg group failed to achieve scores of zero but were comfortable. No nausea or vomiting was seen but the incidence of itching was 0, 30% and 80% in the 2.0, 3.5 and 5 mg groups respectively. We conclude that epidural diamorphine 2 mg is adequate for relief of post-caesarean pain and higher doses may increase the incidence of unwanted side-effects.