Articles: pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesia from morphine and ketamine. A comparison of infusions of morphine and ketamine for postoperative analgesia.
Ketamine 4 micrograms/kg/minute produced pain relief similar to that from morphine 33 micrograms/minute in a double-blind study that compared analgesia from constant-rate intravenous infusions of the two drugs in 60 patients. The analgesic efficacy of the infusions, as assessed by pain scores and the requirement for supplementary self-administered morphine, was poor. Ventilatory depression, the most significant side effect, occurred only in patients who received morphine infusion. The low dose ketamine infusion did not provide clinically useful analgesia even though adequate plasma concentrations were achieved.
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Acta Anaesthesiol Scand · Oct 1987
Randomized Controlled Trial Comparative Study Clinical TrialPost-operative analgesia by high thoracic epidural versus intramuscular nicomorphine after thoracotomy. Part III. The effects of per- and post-operative analgesia on morbidity.
One hundred and twenty-nine patients were subjected to three different types of thoracic operations. The patients were randomly allocated to balanced intravenous anaesthesia including i.v. nicomorphine during surgery and epidural nicomorphine post-operatively (epidural group, n = 58) or to balanced intravenous anaesthesia without i.v. opiates but with high thoracic epidural regional block during the operation and with post-operative intramuscular nicomorphine (intramuscular group, n = 71). Post-operative nicomorphine was only given at the request of the patients, and as frequently as needed to obtain satisfactory pain relief. ⋯ The requirements of nicomorphine over a period of 3 days were significantly lower in the epidural group 42 mg (s.d. = 18) versus 92 mg (s.d. = 33) in the intramuscular group. Significantly fewer pulmonary complications were observed in the epidural group: 7 atelectases compared to 27 in the intramuscular group. The epidural group showed no signs of ventilatory depression in spite of a catheter inserted at the T3-T4 level.
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Abdominal pain in an athlete may be due to an intra-abdominal injury or abdominal disease unrelated to athletics; both are uncommon. Because such processes may be life-threatening, awareness of their typical patterns is imperative for all involved in sports medicine. Evaluation of an athlete with abdominal pain is thus directed at deciding if the athlete has significant abdominal disease, and then using appropriate diagnostic methods to determine the specific process.