Articles: postoperative-pain.
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This article reviews methods to relieve postoperative pain in most children. It also discusses the major barriers to treatment and considers the provision of opioids via a painless route as an alternative to the more usual intramuscular (and painful) route.
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Clinical Trial Controlled Clinical Trial
Low-dose intrathecal morphine for postoperative pain control in patients undergoing transurethral resection of the prostate.
Thirty patients undergoing lidocaine spinal anesthesia for transurethral resection of the prostate (TURP) were studied to evaluate the effectiveness of low-dose intrathecal morphine (ITM) for postoperative analgesia. In a double-blinded fashion, groups of ten patients received either 0.1 mg morphine, 0.2 mg morphine, or placebo (control group) intrathecally with lidocaine 75 mg. Standard postoperative analgesics were available to all patients. ⋯ Six patients (60%) in the 0.2 mg ITM group, two patients (20%) in the 0.1 mg ITM group, and one patient (10%) in the control group experienced nausea and vomiting. No clinically evident respiratory depression occurred in any of the subjects. The authors conclude that administration of 0.1 mg or 0.2 mg of morphine intrathecally is effective in reducing postoperative pain following TURP and that 0.1 mg ITM is not associated with nausea and vomiting.
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Randomized Controlled Trial Comparative Study Clinical Trial
Less pain with epidural morphine after knee arthroplasty.
Twenty-two patients were randomly allocated to systemic opioids or epidural morphine the first 10 days after total knee arthroplasty. Pain was recorded daily in a visual analogue scale, and knee motion was measured on Day 10. Pain was lower in the epidural group, with no difference in knee flexion or range of motion.
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Case Reports
Post-axillary dissection pain in breast cancer due to a lesion of the intercostobrachial nerve.
Seven patients with breast carcinoma and post-axillary dissection pain are described. They complained about pain in the axilla, inner side of the upper arm and/or shoulder. All had undergone a partial or radical breast amputation including an axillary lymph node dissection. ⋯ The pain was not associated with lymphedema and only one patient had undergone radiotherapy to the axillary and supraclavicular area. Post-axillary dissection pain is probably a more appropriate name than the usual post-mastectomy pain for this syndrome. During the dissection, the intercostobrachial nerve is often lesioned, which may give rise to neuropathic pain of that nerve.
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Pediatr. Clin. North Am. · Aug 1989
ReviewThe management of pain associated with pediatric procedures.
This article provides guidelines for the psychological and pharmacologic management of pain and anxiety for children undergoing medical procedures. The goals of intervention are presented, as well as issues warranting consideration in planning intervention to reduce procedure-related distress.