British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia.
Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing arthroscopic knee surgery might shift the analgesic dose-response curve of intra-articular (i.a.) morphine. ⋯ The dose-response relationship of i.a. morphine analgesia is not shifted by enhanced inflammation and END expression within synovial tissue. Thus, the presence of END within inflamed synovial tissue does not seem to interfere with i.a. morphine analgesia.
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Randomized Controlled Trial Clinical Trial
Epidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia for knee arthroplasty.
Peripheral neural blockade appears to provide effective analgesia with potentially less morbidity than central neuraxial techniques. We compared the relative benefits of combined femoral (3-in-1) and sciatic nerve block with epidural blockade for postoperative knee arthroplasty analgesia. ⋯ Combined femoral (3-in-1) and sciatic blocks offer a practical alternative to epidural analgesia for unilateral knee replacements.
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Randomized Controlled Trial Clinical Trial
Effect of pre-emptive ketamine on sensory changes and postoperative pain after thoracotomy: comparison of epidural and intramuscular routes.
In this study we have evaluated the efficacy of ketamine via i.m. and epidural routes for the control of post-thoracotomy pain. ⋯ The results of the present study demonstrate that pre-emptive epidural ketamine is effective in reducing intra- and postoperative analgesic requirements, hyperalgesia and touch allodynia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular changes following insertion of oropharyngeal and nasopharyngeal airways.
The cardiovascular responses following the insertion of oropharyngeal airways in anaesthetized patients have been found to be of little consequence. However, those following the insertion of nasopharyngeal airways have not been studied. The aim of this investigation was to compare the cardiovascular responses to the insertion of oropharyngeal and nasopharyngeal airways in anaesthetized patients. ⋯ The pressor response following the insertion of nasopharyngeal airways in anaesthetized patients is significantly greater than that following the insertion of oropharyngeal airways. However, the mean rise in arterial pressure does not exceed pre-induction level, and thus the response is less severe than that likely to be associated with orotracheal or nasotracheal intubation.