Articles: postoperative-pain.
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Oral Surg. Oral Med. Oral Pathol. · Nov 1990
Comparative Study Clinical Trial Controlled Clinical TrialA study of the comparative efficacy of four common analgesics in the control of postsurgical dental pain.
Four common oral analgesics were tested in a single-blind trial to determine their relative efficacy in the management of postsurgical pain in 103 patients who had their impacted third molars surgically removed under general anesthesia. The analgesics tested were acetylsalicylic acid (26 patients), ibuprofen (26 patients), a paracetamol/codeine/caffeine combination (Solpadeine) (25 patients), and dihydrocodeine (26 patients). ⋯ Dihydrocodeine was found to be a poor analgesic in this pain model. There were no adverse reactions to any of the preparations.
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Patient-controlled analgesia (PCA) has been found to be an effective method of pain management for adults. Children are now being considered for self-administration of analgesia. With careful patient selection and preparation, nurses and children find patient-controlled analgesia to be an effective way to maintain comfort in the postoperative period.
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Clin. Orthop. Relat. Res. · Nov 1990
Comparative StudyThe effect of continuous epidural analgesia on postoperative pain, rehabilitation, and duration of hospitalization in total knee arthroplasty.
Efficacies of three alternate methods of postoperative analgesia were studied in 156 patients who had total knee arthroplasty (TKA). Forty-two of these patients received parenteral meperidine hydrochloride or morphine (Group 1), 58 patients received periodic epidural injections of morphine (Group 2), and 56 patients received continuous epidural infusions of bupivacaine hydrochloride and Duramorph (Group 3). The postoperative course of all patients was documented in terms of the incidence and severity of pain, range of joint motion, duration of hospitalization, and occurrence of complications. ⋯ However, the use of epidural analgesia did not reduce the incidence of complications, including nausea. Continuous infusion of epidural bupivacaine and Duramorph provided good-to-excellent control of postoperative pain after TKA. However, better analgesics are needed to reduce the high incidence of side effects associated with various treatment methods.
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Patients undergoing head and neck surgery often have significant pain because of the anatomic area involved, the nature of the surgery and trauma associated with the anesthesia and surgery, or the use of packing postoperatively. A patient-controlled analgesia (PCA) infuser is available that allows the patient to direct delivery of their own analgesia. The physician orders the narcotic analgesic dose to be given, the interval between doses, and the total amount of analgesic to be delivered over 4 hours. ⋯ This system allows the patients to initiate intravenous delivery of their narcotic analgesic, and maintain control of pain, using small incremental doses of the analgesic agent. This PCA pump has been used successfully in a number of patients undergoing various general, head and neck, and facial aesthetic procedures. The general concept of the PCA pump, guidelines for use, and contraindications are presented.
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Anesteziol Reanimatol · Nov 1990
Comparative Study[A comparative evaluation of the permeability of the dura mater in parturients and the efficacy of epidural anesthesia using morphine following cesarean section].
Spinal dura mater permeability has been compared in 15 women dead in labour or of severe multiple combined traumas. The quantitative index for the assessment of transmeningeal morphine and dicaine diffusion was permeability coefficient calculated according to Fick's equation. ⋯ However, a decrease of the diffusion barrier is not clinically manifested during epidural morphine analgesia due to an equivalent increase in the rate of intravascular opiate adsorption. The conclusion is made that it is advisable to add the usual adrenaline dose (1:200,000) to the anesthetic solution to enhance the degree of anesthesia adequacy and to decrease the danger of the onset of general narcotic and respiratory depression on the fetus in the early neonatal period.