Articles: postoperative-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.
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Acta Anaesthesiol Belg · Jan 1992
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia for major abdominal surgery with continuous thoracic epidural infusion of bupivacaine with sufentanil, versus bupivacaine with morphine. A randomized double blind study.
Forty-six patients undergoing major abdominal surgery were given postoperative epidural analgesia for four days with bupivacaine-sufentanil or bupivacaine-morphine. Both groups received a bolus of 8 ml bupivacaine 0.5% followed after 30 minutes by an infusion of 20 ml/h bupivacaine 0.1%. The sufentanil group (group A: 21 patients) received a loading dose of 50 micrograms sufentanil and a continuous infusion of 5 micrograms/h sufentanil. ⋯ There was also a high incidence of hypotension after the loading dose of bupivacaine 0.5%. Although we noticed a large incidence of pruritus, no patient needed naloxone reversal. In view of these side effects we recommend a lower loading dose of both bupivacaine and sufentanil.
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Case Reports
Delayed presentation of an extradural abscess complicating thoracic extradural analgesia.
Extradural abscess is a rare but recognized complication of extradural anaesthesia. Previous reports have been associated with a short time interval between extradural catheterization and presentation. We report a patient with rheumatoid arthritis, receiving steroid therapy, in whom an extradural abscess did not present until 23 days after the insertion of a thoracic extradural catheter to provide postoperative analgesia.
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Langenbecks Arch Chir · Jan 1992
Review[Acute pain in surgery: the significance of a neglected problem].
Acute pain represents a significant problem in surgical patients. However, the management of acute pain in Germany is unsatisfactory, mostly because surgeons are not interested in the pain of their patients, and anesthesiologists do not give pain treatment on surgical wards. The aim of this article is therefore to point out the significance of the problem of "acute pain" for surgeons. ⋯ It is not sufficient to know the methods and advantages of appropriate management of acute pain; one must also understand the dangers. Problems caused by the treatment of pain should be recognized from a clinical point of view. Surgeons must take a greater interest in the problem of "pain", which should lead to the establishment of new concepts in the management of acute pain in surgical patients.