Anaesthesia
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Comparative Study
Longterm treatment with epidural opioids. A retrospective study comprising 150 patients treated with morphine chloride and buprenorphine.
During a 2-year period, 150 patients were treated with epidural opioids for more than 7 days; 89 received morphine and 61 buprenorphine. In 16 cases, medication was changed from morphine to buprenorphine, and in 6 from buprenorphine to morphine. In 19 patients in each group, the disease process was benign. ⋯ Side effects were reported in 46% of patients given morphine and 20% given buprenorphine. Seventy-one patients were treated on an outpatient basis. In these cases, buprenorphine was administered for 89% of the total duration of treatment and morphine chloride for 52%.
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Femoral and lateral cutaneous nerve of the thigh blocks have been performed in a group of 50 children; the method has not previously been described in paediatric practice. The technique was judged to have been successful in 48 (96%) of the children. There were no early or late complications. It is concluded that these blocks are easy to perform, even in small children and infants, and that they can produce reliable postoperative analgesia for a variety of orthopaedic and plastic procedures.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural buprenorphine for postoperative analgesia. A controlled comparison with epidural morphine.
In a double-blind controlled study, epidural buprenorphine 0.3 mg was compared with 4 mg of epidural morphine for postoperative pain relief the first 24 hours after major orthopaedic surgery. The degree of analgesia was equal and satisfactory in both groups. ⋯ The only serious side effects were recorded in the morphine group, with two patients complaining of pruritus and five of urinary retention. In conclusion, epidural buprenorphine did not offer any advantages in preference to morphine for postoperative pain relief following orthopaedic surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intramuscular midazolam premedication in small children. A comparison with papaveretum and hyoscine.
Midazolam 0.2 mg/kg was compared as an intramuscular premedication in small children with papaveretum and hyoscine 0.4 and 0.008 mg/kg. Midazolam produced satisfactory sedation and anxiolysis and in the early postoperative period patients were significantly more awake (p less than 0.05).
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Randomized Controlled Trial Clinical Trial
Cryoanalgesia for pain after herniorrhaphy.
The effect of freezing the ilioinguinal nerve on postoperative pain relief was examined in a double blind study in 36 patients undergoing herniorrhaphy, randomly allocated into two groups. Patients in the experimental group had their ilioinguinal nerves frozen during surgery and were compared with the patients in the control group who did not have cryoanalgesia. Pain relief was assessed over a 48-hour period in three ways, namely the linear analogue pain scale, peak expiratory flow rates and the amount of analgesic drugs required by patients in the two groups. We conclude that cryoanalgesia of the ilioinguinal nerve alone does not produce significant early post herniorrhaphy pain relief.