Articles: analgesics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of the extradural administration of lofentanil, buprenorphine or saline in the management of postoperative pain. A double-blind study.
Sixty postoperative orthopaedic patients were randomly assigned to three equal groups to study, in a double-blind fashion, the analgesic effects, durations of action and side effects of the extradural administration of lofentanil 5 micrograms, buprenorphine 0.3 mg or physiological saline. No systemic analgesics were given before, during or after surgery, and all the patients had operations on the lower extremities under extradural analgesia (lignocaine and bupivacaine). ⋯ We observed a long duration of action and a marked analgesic effect with lofentanil, a shorter duration of action and less pain suppression with buprenorphine and a rather marked placebo effect after saline. The only side effect noticed in this study was drowsiness in three patients in the lofentanil group and in two patients in the buprenorphine group.
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Anesthesia and analgesia · Sep 1985
Comparative Study Clinical Trial Controlled Clinical TrialComparison of morphine, meperidine, fentanyl, and sufentanil in balanced anesthesia: a double-blind study.
A double-blind study comparing four narcotic analgesics of different potencies, meperidine, morphine, fentanyl, and sufentanil, was performed on consenting patients undergoing general or orthopedic surgery under balanced anesthesia. Blood pressure, measured through an indwelling arterial catheter, was recorded continuously, as were ECG and heart rates. The narcotics, made up in equipotent concentrations, were given as indicated by hemodynamic and clinical signs. ⋯ Side effects, including histamine release accompanied by tachycardia and hypotension, were most frequent and most severe in patients who received meperidine. After extubation, marked increases in heart rate, blood pressure, and plasma norepinephrine and epinephrine occurred in some patients in each group. The incidence of postoperative respiratory depression was greatest in patients given morphine (mean dose of naloxone 8.6 micrograms/kg) and least with sufentanil (mean dose of naloxone 1.8 micrograms/kg) and fentanyl (3.2 micrograms/kg naloxone).
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Anesthesia and analgesia · Sep 1985
Analgetic contribution of sufentanil during halothane anesthesia: a mechanism involving serotonin.
Catecholamine and serotonin concentrations in the cord, medulla, and hypothalamus were measured in rats after saline, after sufentanil sufficient to reduce the minimum alveolar concentration (MAC) of halothane by 30% or less, or after sufentanil sufficient to reduce the MAC of halothane by 80% or more. In the cord, high doses of sufentanil resulted in a 13.4% reduction (P less than 0.05) in serotonin concentration compared to saline control and a 17.4% reduction (P less than 0.05) in serotonin concentration compared to low dosages of sufentanil. ⋯ No other significant differences were found in catecholamine content. The experimental results support the hypothesis that sufentanil may contribute to an analgetic component of general anesthesia by modulating nociception via the release of 5-HT.
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The Journal of urology · Sep 1985
Comparative Study Clinical Trial Controlled Clinical TrialA double-blind comparison of dezocine and morphine in patients with acute renal and ureteral colic.
The safety and analgesic efficacy of dezocine and morphine in the treatment of acute renal or ureteral colic due to calculi were evaluated in 2 multicenter, double-blind studies, comparing 10 mg. dezocine and 10 mg. morphine in 88 patients, and 15 mg. dezocine and 10 mg. morphine in 61 patients. All patients received an intramuscular injection of the test drug, and pain intensity and pain relief were evaluated through 4 hours after drug administration. Vital signs, degree of sedation and adverse effects also were recorded. ⋯ More morphine-treated than dezocine-treated patients withdrew from each study because of inadequate pain relief. The frequency of adverse effects was not significantly different between groups in either study and none of the patients had clinically significant changes in vital signs. These results indicate that dezocine is a safe and effective analgesic for the treatment of renal and ureteral colic due to calculi, and 15 mg. dezocine were more effective than 10 mg. morphine in this pain model.
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The influence of total hip replacement (THR) on pain and use of analgesics was evaluated in 511 patients with McKee-Farrar and Brunswik prostheses. The mean age of the patients was 63.8 years and the mean follow-up time 4.2 years. The average grade of pain decreased from 1.8 to 4.9 as evaluated according to Charnley. ⋯ Postoperatively those with previous hip operations, McKee-Farrar prosthesis, one hip replaced, reapplications and removal of the prosthesis gave inferior results with respect to pain than those without previous surgery, with Brunswik prosthesis, both hips replaced and with the original prosthesis in situ. In addition to previous THR operations, type of the hip prosthesis, bilateral or unilateral surgery, primary or secondary coxarthrosis and reapplication of the prosthesis influenced the use of drugs. THR, however, brought a marked drop in the use of analgesics and this effect should be taken into account when assessing the costs and benefits of THR.