Articles: opioid-analgesics.
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Randomized Controlled Trial Clinical Trial
Low-dose sufentanil as a supplement to halothane/N2O anaesthesia in infants and children.
Sufentanil as a supplement to halothane/N2O anaesthesia was evaluated in 32 unpremedicated infants and children age 6 months to 9 yr undergoing elective orthopaedic surgery. Patients were randomly assigned in a double-blind manner to receive one of four intravenous supplements: placebo, sufentanil 0.5, 1.0 or 1.5 micrograms.kg-1. Systolic arterial pressure (SAP), heart rate (HR) and end-tidal halothane concentration were recorded before and after induction, supplement administration, tracheal intubation, incision and every 15 min during the procedure. ⋯ One patient in the sufentanil 1.0 micrograms.kg-1 group whose surgical time was less than 45 min exhibited respiratory depression in the PACU requiring narcotic reversal. In conclusion, sufentanil 0.5 micrograms.kg-1 improved immediate postoperative pain relief and is acceptable as a supplement during halothane anasethesia in infants and children. The associated side effects of larger doses of sufentanil (1.0 and 1.5 micrograms.kg-1) make their use as a supplement to halothane anaesthesia unacceptable.
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Randomized Controlled Trial Clinical Trial
Analgesic and respiratory effects of epidural sufentanil in patients following thoracotomy.
Immediately following thoracotomy, 22 patients were entered into a randomized, double blind study comparing the effects of three lumbar epidural doses of sufentanil on postoperative pain and respiratory pattern. Patients were given either 30 micrograms (group I), 50 micrograms (group II), or 75 micrograms (group III) of epidural sufentanil in 20 ml N saline. Repeat doses were given on request for the 24-h study period. ⋯ Analgesia was not significantly prolonged by increasing the dose of sufentanil. SRR occurred in all four groups (group I: 2/9; group II: 2/6; group III: 7/7; group IV: 2/10 P less than 0.05 I, IV:II, I, IV:III, II:III). The number of episodes of SRR/hr was highest in group II (group I: 0.6 +/- 0.8, group II: 4.12 +/- 0.6, group III: 1.8 +/- 2.0, group IV: 0.5 +/- 0.2) (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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There is no uniform etiology of cancer pain. It is essential to understand the pathogenesis of pain as far as possible before a therapeutic modality can be conceived. The anatomical relation of the painproducing lesion to the site of pain perception should be clear (local, projected and referred pain). ⋯ Due consideration is given to neuroleptics and antidepressive drugs. Information about hormones (corticosteroids, calcitonin a. o.) in cancer pain therapy conclude this survey. Enormous differences of morphine use (Austria: 0.66 kg vs Denmark 16.59 kg per million people per year) indicate that there is a great demand for further professional education in this field.
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Comparative Study Clinical Trial
Relative analgesic potency of epidural fentanyl, alfentanil, and morphine in treatment of postoperative pain.