Articles: postoperative-pain.
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Eur. J. Clin. Pharmacol. · Jan 1985
Randomized Controlled Trial Clinical TrialMultiple doses of paracetamol plus codeine taken immediately after oral surgery.
A double-blind randomized analgesic trial was carried out in 180 patients undergoing surgical removal of an impacted lower wisdom tooth. The patients received the first dose of either paracetamol 1000 mg plus codeine 60 mg, paracetamol 500 mg plus codeine 30 mg or placebo immediately after surgery during the effect of the local anaesthetic. The mean pain intensity, the duration of effect and the number of patients needing additional analgesics were all significantly dose related. ⋯ In addition, the analgesic efficacy was calculated over a 12 hour period after first medication and thereby including the efficacy of a second dose, if taken. Paracetamol 1000 mg plus codeine 60 mg followed by paracetamol 500 mg plus codeine 30 mg after around 5 hours was a very effective treatment and over 40% of these patients did not need any further pain relief during the evaluation period. In conclusion, an effective analgesic taken immediately after oral surgery reduces the total pain and diminishes the need of analgesics.
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Acta Anaesthesiol Scand · Jan 1985
Epidural morphine for postoperative pain: experience with 1085 patients.
A prospective study of the effect and side-effects of epidural morphine for pain relief in 1085 patients after thoracic, abdominal, urologic, or orthopaedic surgery was performed. Morphine chloride was diluted in saline or bupivacaine and administered through an epidural catheter placed at a segmental level appropriate for the type of surgery. The initial dose was 4 or 6 mg morphine and supplementary doses were given when needed to obtain complete freedom from pain during deep breathing or nursing care. ⋯ Postoperative nausea or vomiting was more frequent in women than in men (P less than 0.001). There was a higher incidence of nausea or vomiting in men experiencing pain than in men who were completely pain-free after abdominal surgery (P less than 0.001). Respiratory depression was rare and occurred as a gradually decreasing respiratory rate.(ABSTRACT TRUNCATED AT 250 WORDS)
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A questionnaire was sent to 302 qualified nurses in an attempt to elicit their current practice of administering postoperative analgesics, knowledge of the drugs, opinions regarding prescribing habits and comments on how pain control could be improved; 211 nurses replied (70% response). Knowledge was good but practice poor in that 56% give less than six doses postoperatively and the majority of nurses do not give analgesics until the patient is in pain; 66% thought the amount of analgesic given was a poor indication of pain experienced; 62% felt that prescribing by doctors was inconsistent and 90% thought it could be improved. ⋯ The nurses wished for more involvement in pain management and for more education of patients preoperatively. A selection of comments is included and possible simple methods for improving pain control are discussed.
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Int J Clin Pharmacol Ther Toxicol · Jan 1985
Epidural morphine as postoperative analgesic following cesarean section under epidural analgesia.
Low dosage epidural morphine (4 mg) provided adequate postoperative pain relief in patients undergoing elective cesarean section under epidural analgesia. In the control group (n = 11), all but one patient needed opiates postoperatively, but 9 patients out of the 11 receiving epidural morphine needed only mild analgesics or no analgesics at all, postoperatively. Slight nausea and facial itching were the most common unwanted effects in the epidural morphine group. Low dosage epidural morphine is a useful tool in postoperative pain treatment following cesarean section.