Articles: pain.
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Clin. Pharmacol. Ther. · Aug 1983
Randomized Controlled Trial Clinical TrialMetkephamid and meperidine analgesia after episiotomy.
Metkephamid is an analog of methionine enkephalin. The efficacy, safety, and time course of analgesia with 70 or 140 mg metkephamid were compared with those of 100 mg meperidine and placebo in 59 hospitalized women with severe postpartum episiotomy pain. There were two separate trials with single intramuscular doses and identical designs, including parallel groups, randomized blocks, and double-blind conditions. ⋯ Although dizziness was experienced with meperidine, the two metkephamid doses induced other side effects, including sensation of heavy limbs, dry mouth, eye redness, and nasal stuffiness. None were distressing. Our results suggest that 140 mg metkephamid compares favorably with 100 mg meperidine for analgesia after episiotomy, but it induces minor side effects more frequently.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pretreatment with vecuronium as a prophylactic against post-suxamethonium muscle pain. Comparison with other non-depolarizing neuromuscular blocking drugs.
One hundred and ninety-eight patients undergoing minor surgery were assessed for evidence of post-suxamethonium muscle pain on the 1st and 2nd days following surgery. Patients were allocated to nine groups and were given one of four non-depolarizing neuromuscular blocking drugs (vecuronium, gallamine, tubocurarine or pancuronium) 1 or 2 min before the administration of suxamethonium. A control group received an inert medication. ⋯ This frequency was decreased to around 20% following pretreatment. In general, the frequency of pain was less in the groups receiving pretreatment at 1 min, but the difference was not significant. The groups receiving vecuronium before suxamethonium had the lowest overall frequency of pain over the 2 days (19%), although this was not significantly different from other pretreatments.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural buprenorphine for pain relief after major abdominal surgery. A controlled comparison with epidural morphine.
In a controlled trial epidural buprenorphine was compared with epidural morphine as the sole means of analgesia after major abdominal surgery. Bolus injections of buprenorphine 60 micrograms in 10 ml or morphine 2 mg in 10 ml of normal saline were given on demand for the first 48 hours postoperatively. Both drugs produced significant reduction in pain scores as assessed by the linear visual analogue scale and both produced prolonged analgesia at this dosage, which could be extended by further 'top-ups'. The authors conclude that, for postoperative epidural analgesia, buprenorphine may be the opiate of choice and the reasons for this are discussed.
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Anesthesia and analgesia · Jul 1983
Randomized Controlled Trial Clinical TrialEpidural morphine for the relief of postoperative pain after cesarean delivery.
To determine the safety, efficacy, and dose response of epidurally administered morphine for analgesia after cesarean delivery, 40 healthy women who underwent cesarean delivery with epidural anesthesia were randomly assigned to receive one of four regimens for relief of postoperative pain: intramuscular administration of morphine, 7.5 mg (N = 10); or epidural administration of morphine, 2 mg (N = 10), 5 mg (N = 10), or 7.5 mg (N = 10). Evaluations were made of intensity and relief of pain, time to administration of additional analgesic medications, changes in vital signs and blood-gas tensions, and adverse effects. Intramuscular administration of 7.5 mg of morphine effectively relieved pain for only a short time. ⋯ There were no significant changes in vital signs or blood-gas tensions. Side effects included pruritus and nausea, which occurred frequently but were usually mild and easily treated. We concluded that either 5 mg or 7.5 mg of morphine epidurally administered was effective and safe in providing prolonged analgesia after cesarean delivery.
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Randomized Controlled Trial Clinical Trial
The role of epidural morphine in the postcesarean patient: efficacy and effects on bonding.
This study was designed to determine in postcesarean patients whether in addition to superior analgesic effects, epidural morphine administration results in secondary benefits in maternal well-being and maternal-infant interaction. Following elective cesarean section with bupivacaine epidural anesthesia, 40 healthy mothers received 5 mg preservative-free morphine sulfate in 10 ml of saline, either by the epidural (Group 1, n = 20) or the intravenous (Group 2, n = 20) route, in a randomized, double-blind fashion. Each received a simultaneous injection of saline by the alternate route. ⋯ Itching occurred in 58% of Group 1 patients and only 16% of Group 2 patients (P less than 0.01); the incidences of nausea, vomiting, and urinary retention were not statistically different between the groups. No respiratory depression was observed. Benefits of epidural morphine in this patient population appear limited to the provision of improved analgesia and earlier mobility.