Articles: analgesics.
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Morphine and other strong opioids are very often needed for the treatment of severe pain. In the FRG the prescription of these analgesics is limited by law, especially for outpatients. Special prescriptions are needed for opioid medication. ⋯ Insufficient treatment of outpatients suffering from severe pain is obvious. The complex regulations in the FRG concerning the prescription of strong opioids are the main reason for insufficient treatment. It is necessary to liberalize these regulations in order to treat severe pain better.
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Review Randomized Controlled Trial Clinical Trial
Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men.
Postoperative use of as-needed intramuscular narcotics is potentially hazardous in frail elderly patients. Patient-controlled analgesia (PCA) allows patients to self-administer small boluses of narcotic, allowing better dose titration, enhanced responsiveness to variability in narcotic requirements, and reduction in serum narcotic level fluctuation. Although theoretically useful, this method has not bee well studied in the elderly or medically ill. ⋯ Patients who had previously received intramuscular injections reported that PCA was easier to use and provided better analgesia. Serum morphine levels showed significantly less variability on postoperative day 1 with PCA, compared with intramuscular injections. We conclude that PCA is an improved method of postoperative analgesia in high-risk elderly men with normal mental status, compared with as-needed intramuscular injections.
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The relief of pain is one of the most common reasons for seeking care in an emergency department. We conducted a retrospective chart review to see whether children received analgesic treatment similar to that of adults with the same acute, painful conditions. Charts of 112 pediatric patients from the Children's Hospital of Philadelphia ED and 156 patients from the Medical College of Pennsylvania ED were reviewed. ⋯ On discharge from the ED, 55% of all patients had no pain medications prescribed; and children were less likely than adults to receive analgesics at discharge (P less than .001). Pediatricians and emergency physicians are reluctant to use analgesics for children in pain. The data suggest that these physicians need additional education about management of acute pain.
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As previously stated in this paper, the therapeutic goal in the management of patients with chronic pain conditions in the face, head and neck is management and rehabilitation, striving for a 50 percent decrease in pain, a 50 percent increase in function and mobility, and a 50 percent decrease in medication with the elimination of agents with an addicting potential. These results will best be obtained through proper diagnosis and utilization of the aforementioned techniques in an interdisciplinary fashion as has been described.
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Vnitr̆ní lékar̆ství · Sep 1990
[Long-term pain therapy in malignancies using epidural administration of opiates].
The authors explain basic anatomical and pharmacological principles of epidural opiate analgesia. As to clinical aspects, the authors mention briefly the technique of epidural analgesia. They summarize, based on their own experience and data in the literature, the period of insertion of an epidural catheter, opiate dosage in morphine equivalents, the need of adjuvant treatment and complications. They mention briefly various techniques which can be used in epidural opiate analgesia with an outline on perspectives of this method.