Articles: pain.
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Acta Anaesthesiol Scand · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialSublingual buprenorphine as postoperative analgesic: a double-blind comparison with pethidine.
Buprenorphine and pethidine as postoperative analgesics were compared in 96 women having gynaecological operations by lower laparotomy. A fixed dose of the respective drug was given in a double-blind and double-dummy manner, initially intramuscularly and thereafter by sublingual buprenorphine (0.4 mg) or intramuscular pethidine (75 mg) at the request of the patient during the first 24 h postoperatively. ⋯ There were no significant differences between the groups regarding respiratory depression and nausea. It appears that sublingual buprenorphine is as effective and safe as intramuscular pethidine in the postoperative period.
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Randomized Controlled Trial Clinical Trial
Determinants of pain assessment by nurses.
In this replication study pain assessment and patient perception by nurses was studied in relation to patient characteristics and nurse characteristics. Nurses were randomly assigned to one of 24 descriptions of a hypothetical patient of constant age and unspecified sex. The 24 descriptions varied by duration of pain, presence of a physical pathology, diagnosis category, and depression symptoms. ⋯ Nursing experience seems also to be important in pain assessment. First-year student nurses attributed less pain to the hypothetical patient than third- and fourth-year student nurses and registered nurses. In addition they perceived the patient as more positive when physical pathology was present or when no symptoms of depression were present.
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Acta Derm. Venereol. · Jan 1990
Randomized Controlled Trial Clinical TrialPain control in the surgical debridement of leg ulcers by the use of a topical lidocaine--prilocaine cream, EMLA.
The analgesic effect of EMLA 5% cream for surgical cleansing of leg ulcers was investigated in an open study and in a double-blind comparison with placebo. Eighty patients with ulcers of venous or arterial origin participated. The cream was applied under occlusion and removed before cleansing. ⋯ The median VAS pain scores for EMLA and placebo were 18.5 and 84 mm (p less than 0.01). There were no severe adverse reactions. The results show that there is a need for pain control in surgical debridement of leg ulcers and that EMLA cream gives satisfactory analgesia for this procedure.
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Randomized Controlled Trial Clinical Trial
EMLA for pain relief during arterial cannulation. A double-blind, placebo-controlled study of a lidocaine-prilocaine cream.
The aim of the study was to evaluate the effect of a lidocaine-prilocaine cream (EMLA cream, Astra) in relieving pain during arterial cannulation. The study had a random, double-blind, placebo-controlled design and included altogether 90 patients. All the patients were premedicated with an opioid before cannulation. ⋯ Between these groups pain experience measured by VAS did not show any significant difference although the mean value was lower in the EMLA group. Observer ratings showed a significant (p less than 0.01) difference in distribution towards lower ratings in the EMLA group. In conclusion EMLA was found to have a weak, but measurable effect when the application time exceeded 90 minutes but not after 60 minutes.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bupivacaine use after knee arthroscopy: pharmacokinetics and pain control study.
Bupivacaine (Marcaine) pharmacokinetics were determined in 11 patients receiving the drug intraarticularly after arthroscopic procedures performed on the knee with patients under general anesthesia. Forty milliliters of 0.25% bupivacaine (100 mg) were given as a bolus into the intraarticular space of the knee of each patient. The thigh tourniquet was released 2-3 min after injection and blood samples were obtained 5, 10, 15, 20, 30, 60, 120, 180, 250, and 300 min after tourniquet release. ⋯ Peak levels can be minimized with shorter tourniquet inflation times and with longer injection to tourniquet release intervals. Ninety healthy adult outpatient knee arthroscopy patients also were studied to evaluate the effectiveness of bupivacaine in relieving postoperative knee discomfort when injected immediately postoperatively. The subjects were randomized into four groups: (a) intraarticular injection of saline, (b) intraarticular injection of bupivacaine, (c) subcutaneous injection of bupivacaine at the portal sites, and (d) both intraarticular and subcutaneous injection of bupivacaine.(ABSTRACT TRUNCATED AT 250 WORDS)