Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Clinical Trial Controlled Clinical Trial
Naloxone infusion after prophylactic epidural morphine: effects on incidence of postoperative side-effects and quality of analgesia.
There have been conflicting reports of the value of naloxone infusions to prevent the side-effects associated with epidural morphine. In our study, 29 patients undergoing thoracotomies for pulmonary surgery received epidural morphine (0.1 mg.kg-1) shortly after induction of anaesthesia. ⋯ In addition, side-effects occurred in all groups. We conclude that prophylactic naloxone, used in this manner, is not an appropriate technique for the prevention of side-effects associated with epidural morphine used for the prevention of pain after thoracotomy.
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Randomized Controlled Trial Clinical Trial
Intravenous meperidine for control of shivering during caesarean section under epidural anaesthesia.
To determine the efficacy of meperidine in controlling shivering during epidural anaesthesia for Caesarean section, forty-six parturients were studied. After delivery of the infant, shivering patients received either a single dose of intravenous meperidine 50 mg, or saline in a randomized double-blind fashion. Shivering was classified on a scale of 0 to 3 (grade 0 = none, grade 3 = severe shivering that was distressing to the patient and interfered with monitoring). ⋯ The incidence of nausea was similar, although patients receiving meperidine were more drowsy at two and five minutes following injection (p less than 0.01) compared with patients in the saline group. There were no differences in level of consciousness at the later intervals. The mechanism of action of meperidine on shivering remains to be elucidated.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia with a bupivacaine-fentanyl mixture in obstetrics: comparison of repeated injections and continuous infusion.
We compared the efficacy and side-effects of continuous infusion versus repeated injections of epidural bupivacaine-fentanyl during labour. Forty-four parturients were randomly distributed into two groups balanced for population size, morphology and parity. Analgesia was begun at the same stage of labour with a mixture of 20 ml 0.25 per cent plain bupivacaine and 2 ml (100 micrograms) fentanyl. ⋯ The course of labour, and maternal and neonatal status were comparable in the two groups. Assays showed no difference in bupivacaine blood concentrations between the two groups nor signs of drug accumulation. The constant infusion technique is advantageous since it provides a more regular degree of analgesia with lower doses than those required for patients having repeated injections.
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Comparative Study Clinical Trial Controlled Clinical Trial
Pharmacokinetics and clinical efficacy of intrarectal solution of acetaminophen.
Acetaminophen is frequently administered orally to children for its analgesic properties, although its potency has never been clearly evaluated in this population. In certain situations (patients vomiting or unconscious), acetaminophen has to be given rectally. However, the rectal absorption of suppositories is frequently erratic. ⋯ The absorption of acetaminophen was incomplete (peak serum concentration: 70.8 mumol. L-1) and delayed. We conclude that the rectal administration of acetaminophen at the induction of anesthesia results in incomplete and delayed absorption and does not prevent the occurrence of immediate postoperative pain in children undergoing adeno-tonsillectomy.