Journal of pain and symptom management
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J Pain Symptom Manage · Nov 1991
Case ReportsContinuous intrathecal fentanyl infusion for postoperative analgesia.
Following inadvertent dural puncture during epidural catheter placement, a 20 gauge polyethylene catheter was placed in the intrathecal space, and continuous spinal anesthesia with hyperbaric bupivacaine was administered intraoperatively to supplement general anesthesia. Following surgery, a continuous intrathecal fentanyl infusion (0.2 mcg/kg/hr) was administered to provide postoperative analgesia. The child was awake and comfortable throughout this time and required no supplemental analgesic agents. Although epidural catheters are still our preferred method of analgesia, intrathecal fentanyl infusion is one alternative when inadvertent dural puncture occurs.
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J Pain Symptom Manage · Nov 1991
Childbirth in Kuwait: the experiences of three groups of Arab mothers.
The aims of the present study were to characterize the childbirth experiences of three groups of Arab mothers delivering in Kuwait and to evaluate the use of visual analog scales (VAS) for assessing their pain (N = 301). Kuwaiti, Palestinian, and Bedouin women who were expected to have an uncomplicated vaginal delivery were studied. 73% of the women described their maximum labor pain as "unbearably painful," and more than one-half reported that they were "very frightened" or "terrified." The deliveries of Bedouin mothers were remarkable for the absence of pain behaviors; yet their VAS reports indicated that they experienced no less pain. Painful menstruation and fear of childbirth emerged as risk factors for a painful labor. Among the issues discussed are the validity of the VAS data, the difficulties of managing Bedouin mothers' pain, and the importance of excluding physical factors before cultural differences in pain perception are assumed.