Articles: analgesics.
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Research has indicated that approximately three-quarters of patients in acute care hospitals experience moderate to severe pain. It is thought that inadequately controlled pain is the result of poor clinical performance on the part of nurses and physicians. Faculty knowledge about pain mechanisms and pharmacology have been targeted as the source of their poor performance. ⋯ This study examined some of the misconceptions nurses have about addiction and pain management. A number of fallacies were identified. These included a very strong opiophobia or fallacy about addiction liability of narcotics even under conditions of normal hospital use.
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Intensive care nursing · Jun 1990
Use of patient controlled analgesia in postoperative cardiac surgical patients--a survey of ward staff attitudes.
Staff who worked regularly on a postoperative cardiac surgical ward were asked to complete a questionnaire regarding the use of patient controlled analgesia, which had recently been introduced to the ward. Fifty-five per cent found that the machines reduced their workload, mainly by relieving them of the task of checking and administering controlled drugs. The benefits noted were increased patient confidence (noted by 74%) and improved analgesia (41%). However it was felt by 61% that some postoperative cardiac patients seemed reluctant to use the machines properly or did not fully understand the technique.
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A retrospective study was carried out to determine analgesic requirements in a group of orthopaedic outpatients (n = 145) and oral surgery inpatients (n = 172). The orthopaedic patients received a codeine-paracetamol premedication, an opioid during operation, or no analgesic. ⋯ In the patients undergoing oral surgery, ibuprofen administered before operation significantly reduced analgesic requirement, without unwanted side effects. The use of codeine-paracetamol or a non-steroidal anti-inflammatory agent before body surface surgery appeared to be advantageous in reducing postoperative analgesic needs, without causing problems associated with the stronger opioids.
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Randomized Controlled Trial Clinical Trial
Parturition pain treated by intracutaneous injections of sterile water.
Forty-five pregnant women in the first stage of labour presenting with lower back pain were randomized into 2 groups. One group received intracutaneous injections of sterile water in the lumbosacral region, while the other group was given corresponding subcutaneous injections of isotonic saline, regarded as a placebo treatment. ⋯ However, the requirement of pethidine (meperidine) was similar in the 2 groups. The analgesic method presented was found to be an effective treatment against lower back pain during the first stage of labour and it is speculated that the mode of action resembles acupuncture.
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Epidural sufentanil was administered to 57 women after Caesarean section, under epidural anaesthesia, to provide postoperative analgesia. Each patient received a 30 micrograms dose at the first complaint of pain and this dose was repeated when pain recurred. Epinephrine (1:200,000) was added to the local anaesthetic, sufentanil, both, or neither. ⋯ Respiratory depression, as defined by a respiratory rate less than 10 bpm, was not observed. A number of patients noted a transient period of euphoria 5-8 min after administration of the epidural sufentanil. The authors feel that epidural sufentanil provides satisfactory analgesia after Caesarean section, but the brief duration of action and the high incidence of drowsiness limit its acceptability for routine use in obstetric patients.