Articles: analgesics.
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Acta Anaesthesiol Scand Suppl · Jan 1982
Multiple dose kinetics of ketobemidone in surgical patients.
Twelve patients scheduled for major abdominal surgery were selected for a study of the kinetics of ketobemidone during the day of surgery and in a follow-up study 3-5 days after surgery. In six patients ketobemidone was administered as ketobemidone plain and in the other six, it was given as Ketogin, a combination formula containing a spasmolytic substance in addition to ketobemidone. Plasma samples were collected for approximately 24 h following induction of anesthesia, during which time multiple doses of ketobemidone were administered. ⋯ Plasma clearance did not change significantly between the two periods of study, being 18.0 +/- 4.4 ml . kg-1 . min-1 peroperatively and 21.7 +/- 7.6 ml . kg-1 . min-1 postoperatively. Peroperative Vd area was significantly larger than post-operative Vd area, 5.84 +/- 2.62 l . kg-1 and 3.63 +/- 0.38 l . kg-1, respectively. T1/2 terminal decreased from 3.84 +/- 1.6 h peroperatively to 2.06 +/- 0.44 h postoperatively.
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Like other investigators, we have found that the postoperative period is characterized by high energy expenditure, pain, high plasma catecholamines and decreased arterial oxygen tension, and also glycogenolysis, lipolysis, proteolysis and a low turn-over rate of glucose. Regional anaesthesia has often been supposed to counteract some of these phenomena without causing ventilatory depression. During the past few years a number of studies have been carried out in our department with the aim of elucidating possible differences between the effects of systemic analgesics and different regional anaesthetic blockades. ⋯ Adequately administered regional anaesthesia and systemic analgesic therapy both relieve postoperative pain, the former without interfering with normal ventilatory function. In addition, regional anaesthetic techniques cause less mental confusion, fewer bowel problems and possibly less postoperative lung complications. Moreover, high spinal blockades seem to be the only means of reducing the post-traumatic metabolic stress reaction.
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Clinical Trial Controlled Clinical Trial
Analgesic efficacy of zomepirac sodium in patients with pain due to cancer.
In a single-dose, a double-blind crossover study in 40 patients with chronic pain due to advanced cancer, zomepirac sodium (Zomax), a new, single-entity, non-narcotic analgesic, was compared to oxycodone with APC (Percodan) and placebo. Both a verbal and a curvilinear visual analog scale were used in the study, and the results obtained were comparable. ⋯ Zomepirac sodium, 100 mg, appears to be an acceptable alternative to narcotic combinations such as oxycodone with APC in the management of moderate to severe cancer pain. The visual analog scale presented appears to be useful in the evaluation of analgesic efficacy and appears to be acceptable as an alternative to the more conventional verbal scale.