Articles: pain.
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Anasth Intensivther Notfallmed · Feb 1982
[Epidural fentanyl analgesia for the relief of postoperative pain (author's transl)].
The results are reviewed which were obtained with epidural administration of fentanyl for the relief of pain in 134 patients who had undergone abdominal surgery or had sustained multiple fractures of the ribs. Single doses of 0.1 mg of fentanyl were given epidurally via an indwelling catheter inserted between L1/L2 or L2/L3 or, in the case of 7 patients with multiple rib fractures, between Th8/Th9. The results were satisfactory to excellent. ⋯ Epidural injections caused a steeper rise in concentration than did intramuscular administration. Although none of the patients developed respiratory depression the possibility of respiratory failure should be taken into account when employing epidural fentanyl analgesia. The method is very effective in intensive therapy for relieving postoperative or post-traumatic pain, but is unsuitable for the relief of chronic pain because the analgesic effect is comparatively short-lived.
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Gan To Kagaku Ryoho · Feb 1982
Comparative Study Clinical Trial Controlled Clinical Trial[Effect of a long-acting analgesic, buprenorphine on cancer pain--a single-blind crossover comparison with pentazocine].
The therapeutic value of buprenorphine was investigated in 31 patients suffering from moderate to severe cancer pain by intramuscular administration at the single doses of 0.2 mg and 0.3 mg in comparison with pentazocine 30 mg. Analgesic effect of buprenorphine 0.3 mg was significantly superior to buprenorphine 0.2 mg and pentazocine 30 mg. The duration of analgesia with buprenorphine was 9 hours at 0.2 mg and 11 hours at 0.3 mg, which were markedly longer than pentazocine's 6 hours. ⋯ Blood pressure, heart rate and respiratory rate did not change appreciably, thereby suggesting a little effect of buprenorphine on the respiratory and cardiovascular systems. Buprenorphine was found a useful or extremely useful in 58% at 0.2 mg and 87.5% at 0.3 mg. As the result it was concluded that buprenorphine could be valuable as an analgesic for cancer pain.
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Randomized Controlled Trial Clinical Trial
Intercostal nerve block with thoracoabdominal and flank incisions.
A double-blind study was done in 90 patients undergoing a rib-resecting thoracoabdominal incision for testicular cancer or a flank incision for renal surgery to determine the effect of intraoperative intercostal nerve block with bupivacaine hydrochloride on postoperative pain and complications, day of ambulation, and day of oral fluid intake. In the patients treated with bupivacaine, we found a significant reduction in the amount of postoperative analgesia required, but no difference in the day of ambulation or fluid intake. Ten of 45 patients given a placebo nerve block experienced postoperative atelectasis, whereas only 4 of 45 patients in the treated group experienced this complication. We believe that intercostal nerve block is a valuable postoperative adjuvant in patients undergoing flank surgery to reduce the postoperative analgesic requirements and incidence of atelectasis.