Articles: pain.
-
Anesthesia and analgesia · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialLocal analgesia without anesthesia using peripheral perineural morphine injections.
Twenty-five patients with chronic pain were treated with nerve blocks. They were divided into two groups, A and B, according to the volume of local anesthetic required for surgical anesthesia by standard nerve block techniques. The 16 patients in group A had pain in the distribution of small nerves, which could be blocked with 5 ml or less. ⋯ Morphine (6 mg) was added, in a random, double-blind fashion, to one of the injections. A second pair of injections was subsequently done, using morphine by the alternative route. Perineural morphine provided statistically longer lasting pain relief than did either intramuscular morphine or perineural bupivacaine.
-
Clin. Pharmacol. Ther. · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialKetorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain.
Ketorolac tromethamine, a nonnarcotic, prostaglandin synthesis-inhibiting analgesic, was compared with morphine sulfate for relief of moderate to severe postoperative pain. The 155 patient participants received single intramuscular doses of either ketorolac, 10, 30, or 90 mg, or morphine, 6 or 12 mg, administered in a double-blind, randomized fashion. Pain scores (verbal and visual analog) were recorded at baseline and assessed at 30 minutes and then hourly to 6 hours. ⋯ There were no serious side effects reported. The only side effect reported in more than 3% of patients was 8% somnolence with morphine. This study shows ketorolac to be a safe and effective analgesic for relief of postoperative pain.
-
Acta Anaesthesiol Scand · May 1987
Clinical Trial Controlled Clinical TrialPostoperative pain relief and bupivacaine plasma levels during continuous interscalene brachial plexus block.
Interscalene brachial plexus block was performed on 40 patients for prophylactic pain relief after shoulder surgery. A dose of 1.25 mg/kg of 0.5% bupivacaine was injected for the block (Group 1) and continued with an infusion of 0.25% bupivacaine 0.25 mg/kg/h (Group 2). If the postoperative analgesia was insufficient, the patients received i.m. oxycodone 0.15 mg/kg. ⋯ At 30 min, the mean bupivacaine plasma concentration was 1.0 microgram/ml in Group 1 and 0.9 microgram/ml in Group 2. The mean plasma level of bupivacaine increased from 0.7 microgram/ml after 180 min to 1.1 micrograms/ml (P less than 0.01) after 24 h of infusion, providing some evidence of accumulation during infusion. The dizziness and confusion experienced by three patients could be associated with the local anaesthetic, as they obtained relief after the infusion was stopped.
-
Randomized Controlled Trial Clinical Trial
Trazodone hydrochloride in the treatment of dysesthetic pain in traumatic myelopathy: a randomized, double-blind, placebo-controlled study.
Dysesthetic pain following traumatic myelopathy is characterized by diffuse burning and tingling sensations distal to the level of spinal injury. The dysesthetic pain syndrome (DPS) can compromise performance of functional abilities and inhibit participation in rehabilitation programs. Recent laboratory evidence suggests that antidepressant medications with selective inhibition of serotonin reuptake in the brain may be associated with superior analgesic effect compared to such non-selective agents as amitriptyline. ⋯ However, significantly more patients randomized to trazodone complained of side effects and prematurely terminated their participation in the study. The results of this investigation are consistent with those of other earlier trials which indicate that such antidepressant medications as trazodone hydrochloride which selectively inhibit presynaptic reuptake of serotonin, may not be effective in the control of certain pain syndromes. These results do not preclude the possible utility of these agents in the treatment of other pain syndromes or at higher doses than previously studied.