Articles: postoperative-pain.
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Acta Anaesthesiol Scand · May 1985
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory performance after upper abdominal surgery. A comparison of pain relief with intercostal blocks and centrally acting analgesics.
The respiratory capacity was studied during the first 2 days postoperatively in 94 patients, aged 19 to 75 years and undergoing surgery through an upper abdominal incision. Postoperative pain relief was randomly administered, either by intercostal block (i.c.b.) and centrally acting analgesics on demand, or by centrally acting analgesics alone. Respiratory studies comprising forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF) and analysis of arterial blood gases were made. ⋯ Thus postoperative i.c.b. following cholecystectomy performed through a subcostal incision resulted in higher FVC, FEV1 and PEF values than without i.c.b. at least during the time of effective nerve block. I.c.b. after subcostal incision also improved arterial oxygen tension. The patients undergoing cholecystectomy and receiving a second i.c.b. 8 h after the first one had better respiratory function than the patients without any block during the first 2 days postoperatively.
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In fit unpremedicated patients undergoing minor operations and who were ambulant on the afternoon of the operations, pretreatment with magnesium sulphate given intravenously did not reduce the incidence of suxamethonium induced myalgia below that in a similar series who received no prophylactic therapy. The injection of magnesium in conscious patients is followed by unpleasant side effects.
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Randomized Controlled Trial Clinical Trial
Effects of the extradural administration of local anaesthetic agents and morphine on the urinary excretion of cortisol, catecholamines and nitrogen following abdominal surgery.
Twenty patients undergoing major abdominal surgery were allocated randomly to receive either general anaesthesia with low-dose fentanyl plus intermittent systemic morphine for postoperative pain or the same general anaesthetic plus extradural analgesia during and following surgery (local anaesthetics from before skin incision until 24 h after skin incision plus extradural morphine 4 mg every 12 h from 3 h to 72 h after skin incision). Postoperative pain scores were lower (P less than 0.05) in the group receiving extradural analgesia, but this regimen failed to prevent the increase in the urinary excretion of cortisol, adrenaline, noradrenaline and nitrogen both on separate days and on cumulative measurements over 4 days. Pain scores did not correlate to urinary excretion of the various endocrine-metabolic indices either on separate days or over the cumulative 4-day period. It is concluded that the relief of pain per se has no major influence on the catabolic response to abdominal surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Zomepirac, dihydrocodeine and placebo compared in postoperative pain after day-case surgery. The relationship between the effects of single and multiple doses.
Zomepirac 100 mg and dihydrocodeine 30 mg were compared with placebo in a controlled randomized, double-blind, single-dose postoperative study. Patients continued to receive either zomepirac or dihydrocodeine for pain relief for 5 days at home in a double-blind study, being allowed to titrate the consumption of tablets to their degree of pain. ⋯ In the multiple dosing phase, zomepirac was statistically better than dihydrocodeine. Non-parametric statistical tests indicated highly significant correlations between single- and multiple-dose analgesic measurements for both zomepirac and dihydrocodeine.