Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative use of continuous passive motion, transcutaneous electrical nerve stimulation, and continuous cooling pad following total knee arthroplasty.
Three rehabilitation modalities relating to in-hospital postoperative care following unilateral total knee arthroplasty (UTKA) were studied regarding their effect on pain management and UTKA outcome: (1) continuous passive motion (CPM); (2) CPM with transcutaneous electrical nerve stimulation (TENS); and (3) CPM with continuous cooling pad (CCP). Phase I: CPM. Twenty-two UTKA patients were randomized into two postoperative care groups: (1) 12 with CPM; and (2) 10 with no CPM. ⋯ No significant difference was found regarding total or intramuscular hospitalization pain medication consumption. However, oral hospitalization pain medication consumption was significantly less for the CCP group (P less than .01). This postoperative UTKA study demonstrates significantly decreased total in-hospital pain medication consumption when comparing CPM vs no CPM, significantly decreased oral in-hospital pain medication consumption when comparing CPM with CCP vs CPM without CCP, but no difference when comparing CPM with TENS vs CPM without TENS.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of patient-controlled analgesia and epidural morphine for postcesarean pain and recovery.
A greater awareness of the advantages and limitations of new methods of administering postcesarean analgesia would help the obstetrician care for the recovering patient. Patient-controlled analgesia and epidural morphine are two new modalities for postoperative pain relief. The purpose of this prospective investigation was to compare their effectiveness, safety, side effects, patient satisfaction and cost. ⋯ No complications were encountered with patient-controlled analgesia, but pruritus and alarms from apnea monitors occurred commonly in the epidural morphine group. The costs to the patient were similar for the two groups. Patient-controlled analgesia using a combined continuous infusion and demand dosing is an acceptable alternative to epidural morphine after cesarean delivery.
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Comparative Study Clinical Trial Controlled Clinical Trial
Pain control after cesarean birth. Efficacy of patient-controlled analgesia vs traditional therapy (IM morphine).
A clinical trial compared the efficacy of a mechanical device to deliver patient-controlled analgesia (PCA) (n = 25) with intramuscularly administered morphine (n = 17) for postcesarean pain management. Hypotheses were: (1) patient-controlled administration of narcotics will be superior (increased satisfaction, reduced pain, decreased sedation, increased ambulation, decreased length of stay), and (2) functional vital capacity will increase post-operatively with PCA. No differences in demographic variables were identified (P = less than or equal to .001). ⋯ No differences in vital capacity were identified. The hypothesis related to the superiority of PCA was accepted, while the association between PCA and increased vital capacity was not supported. The use of mechanical PCA devices provides an effective and safe means of managing postcesarean pain.
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One-hundred and ninety-two obese patients presented for upper abdominal surgery, of which 110 received general anesthesia with opioid analgesia and 82 patients received general anesthesia with opioid analgesia plus a single-shot intercostal nerve block of 0.5% bupivacaine in 1: 200,000 adrenaline. A significant increase in the time to first post-operative opioid dose and a significant reduction in the number of doses over the first 12 and 24 h periods were noted in the patients receiving intercostal nerve block.