Articles: pain.
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Comparative Study
Postoperative analgesia in major orthopaedic surgery. Epidural and intrathecal opiates.
Sixty-two patients were given morphine 2 mg and 69 patients were given diamorphine 0.5 mg by either the epidural or intrathecal route. All had undergone either total hip replacement or spinal disc surgery. ⋯ Headache, pruritus, urinary retention and nausea and vomiting were recorded, the incidence of the latter being unacceptably high, particularly when the drugs were administered by the intrathecal route: one patient required resuscitation. It is suggested that previously reported respiratory depression using these techniques is associated with the administration of other analgesics contemporaneously; that dosage should be limited to one-fifth of the estimation intramuscular dose; and that patients should be observed in a recovery ward for 24 hours.
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Words related to pain were collected by asking 59 students and 18 patients to create a list by free association. Each subject was then given a dictionary-derived Finnish version of the McGill Pain Questionnaire (MPQ) with the words arranged in alphabetical order and was asked to place his own words among the dictionary-derive words which appeared most appropriate. Simultaneously, each word was allocated on a visual analogue scale (VAS) in order of increasing intensity. ⋯ Those words were chosen for the pain vocabulary which reflected a statistically significant intensity change and were most often to be found in the word-list. The same method is applicable irrespective of language. Words are replaceable by numerical values so that follow-up and renewed investigations become statistically comparable.
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Anasth Intensivther Notfallmed · Oct 1981
Clinical Trial Controlled Clinical Trial[Epidural application of opiates in chronic pain due to malignoma (author's transl)].
In 75 patients epidural opiates were applied for relief of chronic cancer pain. In order to avoid local infection during long-term therapy part of the catheter was placed subcutaneously. Different opiates were used separately or in combination with local anaesthetics to define the degree and duration of pain relief after epidural opiate application. ⋯ Epidural opiate application cause a long-lasting reduction of pain, which may become restricted during long-term or repeated use, especially after a period of systemic opiate therapy. Side-effects, for example slight respiratory depression in the first hour after injection, indicate an initial phase of resorption beeing followed by a long-lasting reduction of pain without attendant symptoms. Keeping in mind certain precautions epidural opiate therapy is superior to systemic opiate application.