Journal of opioid management
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Randomized Controlled Trial Comparative Study
A comparison of patient-controlled epidural pethidine vs. nurse-administered epidural pethidine for analgesia after caesarean section.
Patient-controlled epidural analgesia with pethidine for post-caesarean section patients has been shown to be efficacious. However, no studies to date have compared it with intermittent nurse-administered epiduralpethidine. The aim of this study was to compare the analgesia efficacy, pethidine requirement, side effects, and nurses' and patients' satisfaction with these two techniques in post-caesarean section patients. ⋯ Satisfaction scores of nurses caring for patients in group P were higher than for those in group N (median 100 mm, interquartile range [IQR] 90 to 100, vs. median 90 mm, IQR 80 to 90, p < 0.05). Patient-controlled epidural analgesia with pethidine improved patients' pain scores after caesarean section when compared with intermittent nurse-administered epiduralpethidine. Regarding the mode of delivery of postoperative analgesia, we noted a higher satisfaction score among nurses caring for group P than among those caring for group N.
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Transmucosal fentanyl is indicated for patients with cancer who are opioid tolerant, but it is also used for the treatment of noncancerous pain. The following is a survey study of the use of transmucosal fentanyl in 29 patients with noncancerous pain in an academic, community-based pain management practice. Transmucosal fentanyl was found to be safe and efficacious in the patients studied.
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Current pain treatment guidelines advise against providing analgesics for postoperative pain using intramuscular injections, as this generally provides poor pain relief. However, this route remains the most prevalent treatment method. Intravenous or epidural patient-controlled-analgesia methods reduce pain effectively but are expensive, labor intensive, and available to only a limited number of patients. ⋯ Nausea and vomiting, the most common adverse effects, were reported by 22 (23 percent) patients. Naloxone was not administered to any of the patients. Oral morphine given in the early postoperative time to patients after a variety of orthopedic surgeries was effective and safe.