Articles: pain.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Intraoperative cryoanalgesia for postthoracotomy pain relief.
In a randomized study, 63 patients were investigated for the benefits of cryoanalgesia after thoracotomy. Analgesia and its dependent effects such as enhancement of mobility, respiratory function, and reduced need of narcotics were evaluated. ⋯ However, moderate to severe neuralgia was found in a number of patients in the cryoanalgesia group in the late postoperative period. Cryoanalgesia for pain relief after thoracotomy is not recommended.
-
Randomized Controlled Trial Clinical Trial
Transdermal fentanyl for the relief of pain after upper abdominal surgery.
Transdermal fentanyl (n = 22) was compared with placebo (n = 18) in a double-blind study of pain after upper abdominal surgery. All patients also received i.v. morphine on demand for supplementary analgesia. ⋯ After operation, pain scores were significantly lower and peak expiratory flow rates significantly higher in the transdermal fentanyl group, who demanded significantly less morphine than the control group. Mean plasma fentanyl concentrations at 12 and 24 h were within the therapeutic range (1.5 and 2.0 ng ml-1, respectively).
-
Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind comparison of epidural ketamine and diamorphine for postoperative analgesia.
Twenty patients who had abdominal hysterectomy under general anaesthesia were randomly assigned to receive either epidural ketamine (30 mg), or epidural diamorphine (5 mg) peri-operatively and on first request for analgesia. Failure to obtain satisfactory analgesia with one of the agents was treated by epidural administration of the other. Pain was assessed by an independent observer, and by the patient using a visual analogue scale. ⋯ The mean (SD) time to first request for analgesia was 272 (206) and 72 (41) minutes in the diamorphine and ketamine groups respectively (p less than 0.01). All patients in the diamorphine group obtained adequate analgesia, but all patients in the ketamine group were changed to epidural diamorphine. Epidural ketamine does not appear to be a sufficiently effective alternative to epidural diamorphine for routine use in postoperative pain.
-
Randomized Controlled Trial Clinical Trial
Prevention of tourniquet pain by spinal isobaric bupivacaine with clonidine.
In order to assess the effect of spinal clonidine on tourniquet pain, 30 patients scheduled to undergo orthopaedic surgery under spinal anaesthesia were allocated randomly to two groups. Patients in group I (n = 15) received 0.5% isobaric bupivacaine 15 mg plus isotonic saline 1 ml. Patients in group II (n = 15) received 0.5% bupivacaine 15 mg plus clonidine 1 ml (150 micrograms). ⋯ Three patients in group I, but none in group II, experienced tourniquet pain. Hypotension and bradycardia were not worsened by spinal clonidine. The use of clonidine may be a useful technique to augment bupivacaine spinal block.
-
Ann R Coll Surg Engl · Jul 1989
Randomized Controlled Trial Clinical TrialCaudal anaesthesia for postoperative pain relief in children: a comparative trial of different regimens using plain bupivacaine.
A comparative trial between three different dosage regimens of bupivacaine administered by the caudal route, used for the prevention of postoperative pain in children undergoing elective inguinal herniotomy or ligation of patient processus vaginalis was undertaken. The regimens compared were bupivacaine 0.25% (1 ml/kg), bupivacaine 0.25% or 0.5%: (Age (years +2)/10 ml per dermatome to be blocked. ⋯ Time to onset of analgesia, as indicated by changes in intraoperative heart rate in response to surgical stimulation were also similar in all groups. No evidence of postoperative motor weakness or disturbance of bladder function was found and there were no symptoms or signs attributable to local anaesthetic toxicity.