Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Subcutaneous-PCA: an alternative to IV-PCA for postoperative pain management.
Patients (n = 120) undergoing major orthopedic (e.g., total hip replacement), urologic (e.g., radical prostatectomy), or gynecologic (e.g., total abdominal hysterectomy) procedures were randomly assigned to receive either morphine or oxymorphone postoperatively using a patient-controlled analgesic (PCA) delivery system. The opioid analgesic was administered either intravenously (IV-PCA) or subcutaneously (SQ-PCA) during the 72-h study period. ⋯ Postoperative analgesia scores and patient satisfaction were similar in all four PCA treatment groups. Thus, SQ-PCA with either oxymorphone or morphine represents a clinically acceptable alternative to IV-PCA in the treatment of postoperative pain.
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Forty-four patients were treated with a continuous infusion of lumbar epidural hydromorphone (0.05%) after thoracic operations. Postoperatively, visual analog pain scores were obtained. ⋯ The incidence of side effects (hypoventilation, pruritus, and nausea) was less than reported with other epidurally administered opioids. Continuous infusion of lumbar epidural hydromorphone produced safe, predictable analgesia after thoracotomy.
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J Pain Symptom Manage · Dec 1990
Comparative Study Clinical Trial Controlled Clinical TrialDiscordance between self-report and behavioral pain measures in children aged 3-7 years after surgery.
This study examined concurrent self-reports of pain intensity and behavioral responses in 25 children aged 3-7 yr. Behavioral (Children's Hospital of Eastern Ontario Pain Scale, CHEOPS) and self-report (the Oucher and Analogue Chromatic Continuous Scale) measures of pain were obtained following major surgery. ⋯ Many children who reported severe pain manifested few of the behavioral indicators of distress used in the CHEOPS. This behavioral response pattern may occur commonly in children experiencing pain after surgery and may limit the applicability of current behavioral scales as sole measures of pain intensity in younger children.
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Randomized Controlled Trial Clinical Trial
Addition of clonidine enhances postoperative analgesia from epidural morphine: a double-blind study.
This study was undertaken to evaluate the analgesic effect of the combination of epidural morphine and clonidine versus epidural morphine alone in patients with postoperative pain. A randomized double-blind design was used, and 91 patients scheduled for post-operative pain relief by epidural morphine were studied. Patients received either a continuous epidural infusion of morphine and clonidine (group 1; n = 45) or morphine alone (group 2; n = 46) over the 72 h after major abdominal surgery. ⋯ Although the total consumption of analgesics was significantly higher in group 2 (P less than 0.05), pain scores were lower in group 1 than group 2 during the entire observation period (P less than 0.05). Epidural clonidine produced a significant decrease (P less than 0.05) in heart rate and blood pressure, whereas the respiratory rate was not affected. Due to the better pain relief in group 1, the forced vital capacity was increased (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Dec 1990
Randomized Controlled Trial Clinical TrialLidocaine local anesthesia for arthroscopic knee surgery.
Forty-five patients were evaluated during knee arthroscopy performed using local anesthesia produced by lidocaine with epinephrine to determine the dose-response relationship for operative analgesia. Serum lidocaine concentrations were also measured. Patients were randomized prospectively to receive 20 mL of 0.5%, 1.0%, or 1.5% lidocaine with epinephrine intraarticularly. ⋯ Serum lidocaine concentrations before and 15, 30, 60, and 120 min after instillation of lidocaine were highest in the 1.5% lidocaine group with a peak concentration of 278 ng/mL. No patient had symptoms of lidocaine toxicity. We recommend that lidocaine concentrations of 1.0% or 1.5% be used when 20 mL is instilled intraarticularly for knee arthroscopy based on patient comfort and absence of lidocaine toxicity.