Articles: opioid-analgesics.
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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.
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Narcotic analgesics, although frequently used in adult patients, are at present relatively minor drugs in pediatric anesthesia. This review discusses indications, clinical applications, and side effects of opiates for pre-medication, induction and maintenance of anesthesia, and postoperative pain therapy in infants and children. Opiates do not represent the agents at first choice for preoperative anxiolysis or amnesia. ⋯ It has been shown, however, that opiate-supplemented general anesthesia can be used for pediatric surgery in an equally effective and safe manner. Finally, there is an essential need for more narcotic analgesics in the treatment of early postoperative pain, when antipyretic-antiphlogistic analgesics alone prove ineffective. It thus seems that in pediatric anesthesia today opiates are prescribed at the wrong time and withheld when they are most urgently needed.
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Opioids are given for acute intra- and postope-rative pain relief or for chronic cancer pain. In the literature there are only rare and contradictory reports on the oral administration of opioids for chronic non-malignant pain. However, there is no reason to withhold strong analgesics for patients with severe pain. ⋯ Side effects are controlled by additional medication. The principle of opioid administration is prophylaxis of pain -therefore, they should be given "by the clock". Opioids are not only indicated in malignant illness, but also according to severity of pain and by the failure of other measures to control pain.
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We reported the requirement of supplemental analgesics following epidural opioids including Opial 5mg and 10mg, and morphine HCl 2.5mg, for 24 hours in postoperative period after surgery of body surface, and lower and upper abdominal surgeries. Incidence of their side effects was also observed. Opial contains 50% morphine HCl and other opioids such as codeine, thebaine, papaverine, and noscapine etc. ⋯ Kinds and doses of opioids used, suggest that epidural administration of other opioids contained in Opial has some analgesic effect. After the surgery of body surface the opioid requirement may be influenced by the intraoperative anesthetic technics and the state of mind of the patient. Urinary retention was the most interesting side effect observed and our data suggest that papaverine contained in Opial may have favorable effect and morphine HCl may have adverse effects regarding its incidence.