Articles: opioid-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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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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Since the use of narcotics was initially advocated 28 years ago, serious adverse reactions, including fatalities, have been reported. At least four factors appear to contribute to these reactions: multiple drug administration, excessive dosage, inadequate monitoring, and ineffectual emergency care. Because of the relatively high incidence of life-threatening reactions and the complexity of the required emergency care, the routine use of pediatric sedation techniques that require large doses of narcotics cannot be advocated for use in the private office.