Articles: postoperative-pain.
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Most patients receiving spinal narcotics can be monitored adequately by well-trained nurses on postoperative or postdelivery wards. Patients at high risk (e.g., those with preexisting lung disease or many elderly patients) do need monitoring in the intensive care unit. Also requiring special monitoring are patients for whom epidural narcotics alone will not cover their pain, such as young patients with multiple trauma. Patients without these restrictions, however, can be monitored successfully outside the intensive care unit, although the dose of epidural narcotic should be kept as low as possible.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic efficacy and safety comparison of ketorolac tromethamine and Doleron for the alleviation of orthopaedic post-operative pain.
The analgesic efficacy and safety of ketorolac tromethamine (ketorolac), a potent analgesic with anti-inflammatory and antipyretic activities, were evaluated and compared with Doleron, a combination analgesic, in 115 patients with moderate to severe orthopaedic post-operative pain. This was a randomized, double-blind (double-dummy), parallel-group comparison of a single oral dose of one capsule of 10 mg ketorolac with a single oral dose of two Doleron tablets (each tablet contained 150 mg dextropropoxyphene napsylate, 350 mg aspirin and 150 mg phenazone). During the 6 h following treatment, 80% of ketorolac treated patients and 82% of Doleron treated patients experienced adequate pain relief. ⋯ Nausea (two patients in each treatment group), vertigo (none on ketorolac, three on Doleron) and sore throat (none on ketorolac, two on Doleron) were the only drug-related adverse events reported by more than one person in a treatment group during the trial. A total of 82% of patients given ketorolac and 76% given Doleron experienced no adverse events. A single oral dose of 10 mg ketorolac was shown to be as effective and safe as two Doleron tablets in the treatment of moderate to severe orthopaedic post-operative pain.
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Regional anesthesia · Jul 1989
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of continuous epidural analgesia with sufentanil and bupivacaine during and after thoracic surgery on the plasma cortisol concentration and pain relief.
The effect of continuous epidural analgesia with bupivacaine 0.125% and sufentanil 0.83 micrograms.ml-1 on the plasma cortisol concentration and postoperative pain relief was compared with that of intermittent intravenous peroperative and on-demand intramuscular postoperative analgesia with nicomorphine 0.2 mg.kg-1. The study was performed on two groups of ten patients for three consecutive days after thoracic surgery. In the epidural group, a better quality of analgesia was found as measured with the Inverse Linear Analgesia Scale (ILAS) (1 = severe pain, 10 = no pain) than in the group that received intramuscular analgesia. ⋯ L-1 on day 1. The measured mean plasma cortisol concentration was found to exceed normal limits (150-700 nmol. L-1) only in the systemic group and only on day 1.