Articles: pain.
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Randomized Controlled Trial Clinical Trial
Analgesic effect of aspirin, mefenamic acid and their combination in post-operative oral surgery pain.
A double-blind randomized single dose study of the analgesic effects of 650 mg aspirin, 250 mg mefenamic acid, the combination of 650 mg aspirin and 250 mg mefenamic acid and placebo on 120 patients with pain following oral surgery was conducted. Patients evaluated their pain intensity and extent of pain relief at 1, 2, 3 and 4 h after drug administration. For most parameters, including the sum of the pain intensity differences and the sum of the hourly pain relief scores, each of the drugs was more effective than placebo. Aspirin-mefenamic acid in combination was more effective than both drugs alone, and aspirin and mefenamic acid alone were equally effective for most of the analgesic variables.
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Randomized Controlled Trial Clinical Trial
Postoperative analgesia with fentanyl: pharmacokinetics and pharmacodynamics of constant-rate i.v. and transdermal delivery.
We have investigated the use of constant-rate delivery of fentanyl by i.v. and transdermal routes for the treatment of pain after major surgery. Forty-five males, ASA I-III, received in a double-blinded fashion either placebo (n = 6) or fentanyl (n = 39) i.v. at one of four dose rates (25, 50, 100 or 125 micrograms h-1). Stable serum concentrations of fentanyl were produced by the end of surgery and were maintained for a total of 24 h. ⋯ Post-operative morphine requirements were minimal (less than 0.5 mg h-1) and PaCO2 remained acceptable in all patients. Serum concentrations of fentanyl increased slowly (15 h to plateau) and decreased slowly (apparent half-life, 21 h). We conclude that delivery of analgesic doses of fentanyl is feasible by the transdermal route.
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Randomized Controlled Trial Clinical Trial
Epidural sufentanil for post-operative pain relief: effects of adrenaline.
The analgesic, respiratory and haemodynamic effects of epidural sufentanil 75 micrograms (Group 1) or sufentanil 75 micrograms with adrenaline 75 micrograms (Group 2) were studied in 20 patients following abdominal surgery in a double-blind randomized trial. Pain relief, assessed on a linear analogue scale, sedation, heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR) and arterial carbon dioxide tension (PaCO2) were recorded before, and for 12 h after, injection. Good post-operative pain relief was obtained after 4 min in Group 1 and 6 min in Group 2. ⋯ The patients in Group 1 showed more marked sedation 1 h after injection. Changes of HR and MAP were similar in both treatment groups. Side-effects were observed more frequently in Group 2, although the differences were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
The efficacy of hypnosis- and relaxation-induced analgesia on two dimensions of pain for cold pressor and electrical tooth pulp stimulation.
This study evaluated the efficacy of hypnosis- and relaxation-induced suggestions for analgesia for reducing the strength and unpleasantness dimensions of pain evoked by noxious tooth pulp stimulation and by cold pressor stimulation. The Tellegen Absorption Questionnaire was used to assess hypnotic susceptibility for 28 subjects in order to match treatment groups according to sex and susceptibility scores. Tooth pulp stimulation consisted of a 1 sec train of 1 msec pulses at a frequency of 100 Hz, applied at 20 sec intervals to the central incisor. ⋯ Tooth pulp and cold pressor stimulation represent qualitatively different stimuli with respect to both the type of nerves activated and the mode of stimulus application. Discrete, randomly presented levels of noxious electrical stimulation to the teeth activate predominantly small fibers and produce brief pain sensations that vary unpredictably in intensity. In contrast, continuous cold stimulation to the forearm activates a variety of nociceptive and non-nociceptive fibers and produces progressive cold and pain sensations with a predictable increase in intensity from cold sensations to paresthesia and severe pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal morphine in the management of pain following cardiac surgery. A comparison with morphine i.v.
Forty-four patients undergoing coronary revascularization received either intrathecal morphine 1 mg (n = 15), intrathecal morphine 2 mg (n = 15), or i.v. morphine 30 mg (n = 14) after the induction of anaesthesia. Morphine 2.5 mg i.v. was given, as required, in the postoperative period and pain score, respiratory rate and PaCO2 measured every 2 h. FVC, FEV1 and PEFR were measured before, and 24 h after, the induction of anaesthesia. ⋯ Postoperative PEFR was significantly better in patients given intrathecal morphine (P less than 0.01). These results suggest that intrathecal morphine provided better analgesia after cardiac surgery than did a conventional regimen. The lower dose (1 mg) was associated with less respiratory depression as assessed by PaCO2 measurements.