Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Morphine compared with diamorphine. A comparison of dose requirements and side-effects after hip surgery.
The dose requirements and side effects of morphine were compared with those of diamorphine administered by patient-controlled analgesia in 40 patients following elective total hip replacement. Patients were allocated randomly to receive in a double-blind manner either morphine or diamorphine for postoperative pain relief. There were no significant differences between the two groups with regard to postoperative sedation, nausea, well-being, pain relief and requirements for antiemetic drugs. The dose requirement for diamorphine was approximately 50% of that for morphine.
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Based upon a tripartite theoretical model of pain, the Pain Rating Index (PRI) of the McGill Pain Questionnaire (MPQ) continues to be one of the most frequently used instruments to measure clinical pain. Although a number of exploratory factor analytic studies have failed to consistently support the theoretical structure of the instrument, one previous confirmatory factor analytic study of chronic pain did statistically support the a priori model. Because it has been suggested that acute pain may not involve the same dimensions as chronic pain, this study provided a direct test of the theoretical structure of the MPQ through multi-sample confirmatory factor analysis (CFA) using data provided by women experiencing pain during labor (n = 185) and women experiencing acute postoperative pain (n = 192). Results of the LISREL CFA analysis indicated that the a priori, 3-factor, oblique model originally proposed by Melzack provided the most parsimonious representation of the data across the 2 samples of acute pain.
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Anesthesia and analgesia · Jun 1991
Randomized Controlled Trial Clinical TrialEvaluation of the effect of perineuronal morphine on the quality of postoperative analgesia after axillary plexus block: a randomized double-blind study.
A randomized, double-blind study was performed on 50 patients scheduled for elective hand and forearm surgery under axillary plexus block to evaluate the effect of perineuronal morphine on the quality of postoperative analgesia. Patients were divided into two groups. ⋯ In group B (n = 25), 1.0 mL of 0.9% saline was added to the local anesthetic solution and patients received an intramuscular injection of 5 mg of preservative-free morphine in 1.0 mL of 0.9% saline in the thigh. The addition of morphine to the local anesthetic solution for the axillary block did not shorten the onset time of the block, improve the quality of postoperative pain relief, or provide longer lasting analgesia than that obtained with intramuscular morphine.
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The aim of the postoperative pain therapy is besides the amelioration of the patients well-being, also lessening of unwanted vegetative reactions and avoidance of the need for excessive care situations. There are numerous ways of therapy and medication at our disposal for this purpose. The first line of drugs are the analgesically most active opiates; they can be combined with antiphlogistics and antipyretics, in order to decrease the specific opiate-induced side effects. ⋯ In comparison to the conventional way, its therapeutic success was described as convincing, even overwhelming. Difficulties or deficiencies in the postoperative pain therapy are mostly caused by lack of time and insufficient knowledge and experience of the personnel, on the other hand also by limited technical possibilities of monitoring the patient. A possible solution may be the setting-up of a special service for the treatment of postoperative pain.