Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ibuprofen and acetaminophen in the relief of postpartum episiotomy pain.
A single-dose, double-blind, randomized clinical trial was conducted to examine the relative analgesic efficacy of ibuprofen 400 mg (n = 36), acetaminophen 1000 mg (n = 37), and placebo (n = 38) in postpartum patients who had moderate to severe pain after episiotomy. At regular intervals over 4 hours, patients evaluated pain severity and relief on categorical scales and completed a categorical overall evaluation at the end of the trial. ⋯ No adverse effects were reported. Based on the results of this conventional postpartum episiotomy pain model, both agents are considered efficacious and ibuprofen 400 mg is a more effective analgesic for the relief of acute pain than acetaminophen 1000 mg.
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The purpose of this study was to determine if patient-controlled analgesia (PCA) is an effective method of postoperative pain relief for children. Fifteen general surgery patients, aged 11 to 18 years, were treated for pain with PCA. ⋯ The average amount of medication administered by PCA was compared with the amount given to similar group of children treated by traditional administration; overall, the PCA group received less morphine than the traditional group. This study indicates that PCA is a valuable addition to pain management for the pediatric patient.
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Twenty patients who underwent thoracotomy were given 2mg of epidural morphine postoperatively. Serum morphine concentrations were determined, analyzed pharmacokinetically, and compared with the degree of analgesia obtained. Excellent analgesia was attained in 11 patients and fair analgesia in the remaining 9 patients. ⋯ Maximal concentration (Cmax) was calculated to be 38.5 +/- 4.2 ng.ml-1 in the excellent analgesia group and 25.7 +/- 4.3 ng.ml-1 in the fair group. The area under the concentration-time curve (AUC) in the fair group was approximately 20% of that in the excellent group. It is concluded that serum morphine levels correlated with analgesic effect in patients receiving epidural morphine after thoracotomy.
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Comparative Study Clinical Trial Controlled Clinical Trial
Intrathecal methadone and morphine for postoperative analgesia: a comparison of the efficacy, duration, and side effects.
A double-blind study of patients selected at random compared the analgesic and adverse effects of intrathecal methadone (1 mg) with those of intrathecal morphine (0.5 and 1 mg). The study was conducted on 30 patients who underwent major orthopedic or urologic surgery. The intrathecal opioid was administered at the end of surgery, and assessments began 1 h thereafter and continued for 20 h. ⋯ Nausea and vomiting were common to all groups. Intrathecal morphine (0.5 and 1 mg) provides superior postoperative analgesia to 1 mg methadone. Various explanations for the observed differences between the drugs are discussed, including the possibility that the dose of methadone used in the subarachnoid space was inadequate and that a larger dose might have produced an effect equal to that of morphine.