Articles: pain.
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Randomized Controlled Trial Clinical Trial
Double-blind evaluation of a lignocaine-prilocaine cream (EMLA) in children. Effect on the pain associated with venous cannulation.
The effect of the topical application of a lignocaine-prilocaine cream (EMLA) on the pain of venous cannulation was tested in a double-blind manner. Sixty boys and girls between the ages of 4 and 10 yr who were to undergo surgery participated in the study. No analgesic premedication was given and the venous cannulation was performed during the preparation for general anaesthesia. ⋯ The effect of EMLA in the alleviation of the pain of venous cannulation was considered significantly better than placebo by both anaesthetist (P less than 0.001) and patient (P less than 0.05) (verbal scales). One conventional pictorial scale showed a statistically significant difference (P less than 0.05), but the other, based on facial expressions, did not. Local reactions to the cream were minor and transient in both groups.
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During a period of one year, 119 patients with chronic pain received injections of opioids via a catheter inserted in the lumbar epidural space. Twenty-three patients (19%) showed evidence of tolerance and were given droperidol 1.25-5.0 mg epidurally. ⋯ One patient given an accidental overdose of droperidol developed reversible Parkinsonism. It is concluded that epidural administration of the dopamine antagonist droperidol may be beneficial as supplementary medication to epidural opioids when tolerance develops.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of fentanyl and tramadol in pain therapy with an on-demand analgesia computer in the early postoperative phase].
17 patients undergoing cholecystectomy in non-opiate general anaesthesia received tramadol (n = 7) or fentanyl (n = 10) for immediate postoperative pain relief using the on-demand analgesia computer (ODAC). Heart rate, blood pressure, and respiratory rate were monitored at half-hourly intervals during the 6-h trial period. Arterial blood was withdrawn at hourly intervals for blood gas analyses and beta-endorphin plasma level assays. ⋯ Respiratory rate, which was elevated initially, dropped significantly in both groups. Arterial pO2 and pCO2 were within the normal range throughout the observation period, reflecting the absence of respiratory side effects. Opiate blood levels showed major inter- and intraindividual variations (minimal and maximal levels for fentanyl ranged from 0.44-3.44 ng/ml, for tramadol from 272-1,900 ng/ml) and were thus poor predictors of the quality of analgesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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Chronic pain in the perineum is a difficult neurosurgical problem. This article evaluates the effectiveness of sacrococcygeal rhizotomy in 28 patients who had cancer-related pain or coccydynia, underwent rhizotomy, and were followed for an average of 3 years. Good pain relief was obtained in 53% (10 of 19 patients) with malignant pain, as opposed to 22% (2 of 9 patients) with nonmalignant pain. Sacral rhizotomy is a reasonable treatment for cancer-related perineal pain, but it is ineffective for coccydynia and other benign perineal pain problems.
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Acta Anaesthesiol Scand · Nov 1986
Randomized Controlled Trial Clinical TrialLow-dose ketamine infusion for analgesia during postoperative ventilator treatment.
In a randomized, double-blind study with placebo, ketamine was used as an analgesic during ventilator treatment in the period of recovery after major abdominal surgery. Forty patients were orally intubated and ventilated by means of a volume-controlled ventilator. Twenty of them received an i.v. bolus of 30 mg of ketamine followed by an 8-h infusion of 1 mg per minute. ⋯ Dreams and hallucinations were recalled in three patients in the control group and five in the ketamine group. Only one control and two ketamine patients experienced these as unpleasant. In this investigation, ketamine infusion in a low dose appeared to offer satisfactory analgesia and to permit tolerance of the orotracheal tube.