Anesthesia and analgesia
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Anesthesia and analgesia · Feb 1993
Randomized Controlled Trial Clinical TrialEffects of epidural morphine and intramuscular diclofenac combination in postcesarean analgesia: a dose-range study.
To assess the efficacy of combinations of epidural morphine and intramuscular diclofenac in postcesarean analgesia, a double-blind, randomized study was conducted. Epidural anesthesia was administered to 120 parturients who were randomly allocated into six treatment groups; these groups, A, B, C, D, and E, received 0.5, 1, 2, 3, and 4 mg of epidural morphine in 10 mL of normal saline solution, respectively, and 75 mg (3 mL) of diclofenac intramuscularly (IM). Group F received 4 mg of epidural morphine in 10 mL of normal saline solution and 3 mL of normal saline solution IM. ⋯ The incidence of nausea or vomiting or both, pruritus, and bleeding was similar. There was no evident relationship between severity of pruritus and morphine doses. No bradyspnea was observed during the study period.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Feb 1993
Randomized Controlled Trial Clinical TrialInfluence of different glucose-insulin-potassium regimes on glucose homeostasis and hormonal response in cardiac surgery patients .
Intravenous infusion of glucose/insulin in combination with potassium (GIK) is an often used technique to improve myocardial preservation in cardiac surgery. In a randomized study in 50 patients undergoing elective aortocoronary bypass grafting with good ventricular function, the influence on glucose homeostasis and hormonal response to four different glucose/insulin regimes were compared to an untreated control: 1) 50 g of glucose mixed with 100 U of human insulin (HI/100); 2) 50 g of glucose mixed with 100 U of bovine insulin (BI/100); 3) 50 g of glucose mixed with 50 U of human insulin (HI/50); and 4) 50 g of glucose mixed with 50 U of bovine insulin (BI/50) [corrected]. Glucose/insulin were given in combination with 70 mmol of potassium 40 min before beginning the operation. ⋯ Blood glucose levels showed no differences among all GIK groups (groups 1-4) but were significantly higher than in the control patients. The incidence of severely reduced (< 50 mg/dL) or elevated blood glucose level (> 300 mg/dL) did not differ between HI- and BI-treated patients but was significantly lower in the untreated control. Insulin plasma level increased significantly after infusion of GIK with higher levels in HI- than BI-treated patients (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Feb 1993
Randomized Controlled Trial Clinical TrialIntraarticular analgesia following knee arthroscopy.
A randomized, double-blind, controlled study was conducted in patients undergoing elective knee arthroscopy to assess the analgesic effect of intraarticular morphine and bupivacaine, alone and in combination. Patients in group 1 (n = 10) received 5 mg of morphine in 25 mL of saline; patients in group 2 (n = 10) received 25 mL of 0.25% bupivacaine (62.5 mg); patients in group 3 (n = 10) received a combination of 5 mg of morphine and 62.5 mg of bupivacaine in 25 mL dilution; and patients in group 4 (n = 10) received 25 mL of saline. All the drugs were injected intraarticularly. ⋯ These low pain scores were associated with lower requirements of supplementary analgesics. The patients in group 4 showed the highest pain scores and analgesic requirements. We conclude that intraarticular morphine significantly reduces postoperative pain following knee arthroscopy and that there is no advantage of combining bupivacaine with morphine.