Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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Thoracic epidural anaesthesia is selected usually to provide adequate postoperative analgesia; however with administration of local anaesthetics to epidural space selective sympatolysis ensues. The effects of this transient sympathectomy on cardivascular, respiratory and other systems deserve certainly some interest as it may influence postoperative morbidity or mortality. Thoracic epidural anaesthesia has succesfully been used in cardiac, thoracic and major abdominal surgery. ⋯ Despite the superior quality of pain control, the beneficial aspect of thoracic epidural anaesthesia is not reflected on outcome in meta-analysis. Recent papers has still demonstrated positive effects on each system. So thoracic epidural anaesthesia is increasingly used and it seems that it will be discussed more in near future.
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Randomized Controlled Trial
Efficacy of lornoxicam in postoperative analgesia after total knee replacement surgery.
In total knee replacement operation, patients have a severe pain in the postoperative period. Because of side effects of opioids, multiple postoperative pain treatment regimens are more suitable in these elderly patients. In this double-blind, randomized, placebo controlled study, the effect of lornoxicam administration (32 mg/48 hour) on morphine consumption and drug-related side effects were investigated in elderly patients undergoing total knee replacement. ⋯ Incidence of side effects in Group M were 60% and 25% in Group L (p<0.05). In Group M, 8 patients (40%) experienced nausea and 3 (15%) patients experienced itching where as in Group L, 3 patients (15%) experienced nausea, 1 patient (5%) itching, 1 patient (5%) dry mouth. Lornoxicam administration in total knee replacement is associated with decreased morphine consumption for postoperative analgesia and fewer side effects.
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Randomized Controlled Trial
The effect of two different methods used during peripheral venous blood collection on pain reduction in neonates.
The purpose of the present study was to examine and compare the analgesic effects of breast feeding and sucrose solutions in reducing pain due to venipuncture in term neonates. 102 term infants requiring a venous blood sample for routine screening of phenylketonuria (n=26) and hyperbilirubinemia (n= 76) were included in the study. The participants were allocated into one of the sucrose, breast feeding, and control groups. Allocation of the infants into groups was performed due to mothers' wishes whereas the control group included the infants on whom routine procedures of the hospital were performed. ⋯ The mean heart rate did not significantly differ among three groups before, during and after procedure. During procedure, the mean oxygen saturation levels of sucrose group were found significantly higher than the control group, but no difference was observed between sucrose and breast feeding groups. This study has confirmed some well known information that breast feeding and oral sucrose solution have pain reducing effects in infants undergoing venipuncture.
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We investigated the effect of a new fixator made from a medication port of a intravenous fluid container on the migration of epidural catheter. Fifty patients were recruited to receive epidural analgesia and allocated to one of two groups. In the new fixator group (n=25) epidural catheter was advanced through a fixator then fixed with transparent adhesive dressing, in the standard dressing group (n=25), the catheter was fixed only with transparent adhesive dressing. ⋯ There was no movement in 13 cases in the standard dressing group compared with 23 of the new fixator group (p<0.05). The main reason for removal in the standard dressing group was the migration of the catheter whereas the catheter was removed on a regular basis at the end of therapy in the new fixator group. We concluded that the newly described fixation method for epidural catheter is an effective method in reducing catheter migration for short term usage.