Articles: pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Caudal block for postoperative analgesia in children.
A clinical trial was performed to compare the effects of intramuscular dihydrocodeine with caudal bupivacaine on postoperative pain and recovery in 181 children who had undergone either circumcision, inguinal herniotomy or orchidopexy performed under general anaesthesia. Linear analogues were used in assess level of consciousness and apparent pain. Recovery of consciousness was slower after caudal analgesia. For 90 minutes following circumcision there was significantly less pain and caudal analgesia, but better pain relief could not be demonstrated following inguinal herniotomy and orchidopexy.
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In a study to determine how children describe the experience of pain, we queried a convenience sample of 100 children in hospitals and 114 children in church and private schools who were between 9 and 12 years old. The questions were designed to seek correlations by age among boys and girls, and between hospitalized and non-hospitalized children that would aid health professionals in strategies that will identify and assist the child who is in pain. The preliminary results show that children clearly describe pain, that there are no appreciable differences by age groups, but that children who are hospitalized describe pain differently from children who are not.
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Subcutaneous administrations of naloxone and naltrexone have already been shown to enhance nociceptive reactions in mice. The present study was undertaken to examine the effects of N-methyl-naloxone and N-methylnaltrexone on nociception using the hot plate test (dose range: 0.3 to 30 mg kg-1s.c.). The latter compounds were selected to differentiate the central and peripheral components of hyperalgesia. ⋯ Further, N-methylnaloxone and N-methylnaltrexone were very weak in precipitating the signs of abstinence in mice rendered acutely dependent on morphine. Two factors, poorer penetration into the CNS and steric hindrance, might render the N-methylated antagonists weak. Hence, both these factors should be considered when interpreting the effects after quaternary derivatives of opioid antagonists.