Articles: pain.
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Small doses of epidural and intrathecal opioids produce effective and prolonged analgesia postoperatively, although the quality of analgesia does not differ from when conventional routes are used. The different opioids differ only in the speed of onset and duration of action, and in the incidence of side-effects. 'Minor' complications such as nausea, vomiting, pruritus and retention of urine are relatively common. ⋯ It is commoner after morphine and after intrathecal administration, and is also associated with advanced age, concomitant use of other central depressant drugs, respiratory disease and large doses. Because of the potentially lethal nature of this complication, it is recommended that the epidural and intrathecal routes of administration are used only when patients can be closely and constantly observed postoperatively.
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The effect of stimulus area and adaptation temperature on warm and heat pain threshold were studied in healthy human subjects using a contact thermal stimulator. The stimulus area was varied in the range of 1.3 to 11.8 cm. Both the warm and heat pain thresholds decreased with increasing stimulus surface. ⋯ The adapting temperature was varied in the range 25-35 degrees C, and warm thresholds were elevated with increasing adaptation temperature. The change of heat pain thresholds with increasing adapting temperature was not significant. Thus, there are both differences and similarities concerning how the different stimulus conditions affect heat pain and warm thresholds.
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Int J Oral Maxillofac Surg · Feb 1987
Randomized Controlled Trial Comparative Study Clinical TrialSuprofen versus paracetamol after oral surgery.
A randomized double-blind trial was performed to evaluate efficacy and tolerability of suprofen 200 mg (Suprocil) in comparison to paracetamol 500 mg after surgical extraction of a wisdom tooth. The study lasted 4 days per patient at the longest. Pain intensity and pain relief were evaluated by the patients using a visual analog scale. ⋯ No significant differences between the 2 treatments was seen. Tolerability was rated good by all but 1 patient in each treatment group; with suprofen, 1 result was moderate, while with paracetamol, 1 result was poor. Adverse reactions occurred in 3 patients on suprofen and in 2 patients on paracetamol, though these reactions could not be related to the use of the drug itself.
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Acta Anaesthesiol Scand · Feb 1987
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of bupivacaine and morphine on pain and bowel function after colonic surgery.
Sixty patients scheduled for colonic surgery were randomly allocated to four groups according to postoperative pain medication: I. Control group, the patients received oxycodone intramuscularly (0.15 mg kg-1) on request. II. ⋯ Pain intensity (visual analogue scale) was lower in Groups II and III at 3 h and in Group IV at 24 h compared to the control Group I. All the epidurally treated groups needed less additional analgesics than the control Group I. Postoperatively bowel movements occurred on the second day in Group II (bupivacaine) as compared to the fourth day in all other groups (P less than 0.05).
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous intercostal blockade after cardiac surgery.
The provision of analgesia using continuous bilateral intercostal blockade was compared with that provided by conventional i.v. narcotics for the first 48 h after cardiac surgery. The subjective quality of analgesia was significantly superior with the regional technique. However, pulmonary function tests, gas exchange, lung volume, and radiological and clinical evidence of pulmonary complications were not improved. The failure to reduce morbidity and the potential for complications such as pneumothorax, makes it difficult to recommend the regional analgesia technique in this situation.