Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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For years pediatric pain management has been practiced without clear rational use of analgesic therapy. The recent improved understanding of anatomical and physiological pathways of pain perceptions, and opioid and local anesthetic pharmacology in infants and children has led to the development of formal analgesic regimens for the management of pain. Also modifying the anatomical approach for children, studying new agents and combinations of agents, technological developments have made regional anesthetics techniques more accessible to children. ⋯ Regional anesthetic techniques have a significant but limited place in the practice of pain management in infants and children. However regional anesthetic techniques presumably afford many of the same advantages for the pediatric patients as it does in the adult patients. In this review, we discuss regional and topical anesthetic techniques available to clinicians who care for this population.
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Randomized Controlled Trial Clinical Trial
[Is epidural preemptive analgesia effective in lower abdominal surgery?].
In this study, we aimed to investigate the preemptive analgesic efficacy of epidural application of fentanly-bupivacaine combination. A total of 60 patients admitted for total abdominal hysterectomy were included in this study after the approval of the ethic committee, and the patients were randomly classified into three groups. An epidural catheter was inserted to all patients through L2-3 or L3-4 space before general anesthesia induction. 2 micrograms/kg fentanyl in 0.25% bupivacaine in 10 ml serum saline was applied to the preemptive analgesia group (Group P) 20 minutes before the incision, and to the post-incisional analgesia group (Group E) 20 minutes after the incision, whereas control group received 10 ml serum saline 20 minutes before the incision through the epidural catheter. ⋯ First analgesic requirement time was also significantly prolonged in Group P (p < 0.001). Total analgesic consumption in Group P was significantly lower than the other two groups (p < 0.05). As a result we observed that preemptive administration of epidural fentanyl-bupivacaine combination reduces the postoperative pain and analgesic consumption in lower abdominal surgery.
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Epidural analgesia (EA) is one of the most commonly used techniques in obstetric analgesia. Our objective was to evaluate patients who experienced EA during labour as well as to find out their knowledge, attitude and behaviour in this matter, prospectively. Between 1997 and 2002, a questionnaire, "patient evaluation form for EA", was delivered to 190 obstetric patients. ⋯ With these information about EA, 30% and 40% of the patients in Group I were found out to be worried about neural paralysis and some possible disorders related to their babies, respectively. However, 40% of the patients in Grup II worried about back pain and headache (p < 0.01). As a result, considering the mother candidates' high information rate from someone who experienced EA before (60%), interest to the labour analgesia will increase as the mothers are satisfied with the results of EA.