Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
Analgesic and respiratory effects of epidural sufentanil in patients following thoracotomy.
Immediately following thoracotomy, 22 patients were entered into a randomized, double blind study comparing the effects of three lumbar epidural doses of sufentanil on postoperative pain and respiratory pattern. Patients were given either 30 micrograms (group I), 50 micrograms (group II), or 75 micrograms (group III) of epidural sufentanil in 20 ml N saline. Repeat doses were given on request for the 24-h study period. ⋯ Analgesia was not significantly prolonged by increasing the dose of sufentanil. SRR occurred in all four groups (group I: 2/9; group II: 2/6; group III: 7/7; group IV: 2/10 P less than 0.05 I, IV:II, I, IV:III, II:III). The number of episodes of SRR/hr was highest in group II (group I: 0.6 +/- 0.8, group II: 4.12 +/- 0.6, group III: 1.8 +/- 2.0, group IV: 0.5 +/- 0.2) (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Obstetrics and gynecology · Jul 1988
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled analgesia for post-cesarean section pain.
Recent reports have suggested that patient-controlled analgesia is an effective means of narcotic administration in postoperative patients. This prospective investigation was undertaken to determine the efficacy and safety of patient-controlled anesthesia infusion after cesarean section. During a recent ten-month period, 130 patients were assigned randomly to receive meperidine by pump or intramuscular injection. ⋯ The patient-controlled analgesia method provided less sedation and more immediate pain relief without the need for painful injections. The additional cost of renting the infuser device was offset by combined patient and nursing satisfaction. We conclude that patient-controlled infusion of meperidine is safe and effective in satisfying individual patient needs after cesarean section.
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Comparative Study Clinical Trial Controlled Clinical Trial
Topical anesthesia with lidocaine aerosol in the control of postoperative pain.
Postoperative pain was assessed in patients undergoing inguinal hernia repair. Ten patients received lidocaine aerosol in the surgical wound before skin closure, ten patients received placebo aerosol devoid of lidocaine, and ten patients were untreated. The lidocaine-treated group had significantly lower pain scores and meperidine requirements during the first postoperative day compared to the control groups. ⋯ Results show that lidocaine aerosol used as topical anesthetic in the surgical wound is simple to use, and results in a long-lasting reduction of pain after a single administration. Moreover, postoperative mobilization is facilitated, and the requirement for postoperative analgesics is reduced. Wound healing was normal, and no adverse reactions to lidocaine were reported.
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Anesthesia and analgesia · Jun 1988
Comparative Study Clinical Trial Controlled Clinical TrialComparison of continuous epidural infusion of fentanyl-bupivacaine and morphine-bupivacaine in management of postoperative pain.
The short duration of epidural fentanyl has limited its direct comparison with epidural morphine in previous reports. The following study was performed of continuous postoperative epidural infusions at 5 ml/hr fentanyl 10 micrograms/ml (n = 59) or morphine 0.1 mg/ml (n = 48), both with bupivacaine 0.1%, in patients having cesarean sections. Postoperative evaluations included the frequency and magnitude of clinically evident respiratory depression, the adequacy of analgesia, nausea, pruritus, the ability to ambulate, and other side effects for 24 hours. ⋯ No patient developed respiratory depression in either group. Patient and staff acceptance of the continuous epidural technique was excellent because there were only minor catheter-related problems associated with its use. It is concluded that continuous epidural fentanyl combined with bupivacaine offers excellent postoperative analgesia with minimal side effects.