Articles: analgesia.
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Tidsskr. Nor. Laegeforen. · Jan 1999
Review[Should pethidine still be administered to women in labor?].
According to surveys from 1988, 1992 and 1996, Norwegian obstetric departments are still to a large extent using pethidine as birth analgesia. In this article we report recent knowledge of various pharmacological effects of pethidine in mothers and newborns. Pethidine has mainly a sedative effect, but very little analgesic effect in parturients. ⋯ As a result, breastfeeding is delayed and the mother-infant interaction is disturbed according to recent studies. There is concern about the more or less routine administration of pethidine in many hospitals. We conclude that obstetric departments should reconsider their use of pethidine.
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Paediatric anaesthesia · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialPatient controlled analgesia in children and adolescents: a randomized controlled trial.
In children, patient controlled analgesia (PCA) and continuous infusion (CI) of morphine are well established methods of relieving postoperative pain. This study was designed to assess the efficacy of PCA plus background infusion (BI) (15 microg x kg(-1) x h(-1) and bolus doses of 15 microg x kg(-1) with a lock-out interval of 10 min) with CI (20 to 40 microg x kg(-1) x h(-1)) in terms of analgesia, morphine needs and side-effects. A stratified randomized controlled trial was carried out. 47 children aged 5-18 years undergoing major elective lower/upper abdominal or spinal surgery were allocated. ⋯ Morphine consumption was significantly increased in the PCA group compared with the CI group. Moreover, morphine consumption was associated with SSS, independent of the technique of administration. There were no significant differences between groups in pain scores or in the incidence of side-effects.
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Paediatric anaesthesia · Jan 1999
Case ReportsExtrapyramidal side-effects from droperidol mixed with morphine for patient-controlled analgesia in two children.
We report two cases of extrapyramidal reactions occurring in children following the use of droperidol in combination with morphine for patient-controlled analgesia (PCA). Symptoms appeared 38 and 27 h, respectively, after commencement and after a total dose of 0.14 mg.kg-1 and 0.17 mg.kg-1, respectively. Although effective and safe in adult patients, we recommend caution with the use of droperidol-morphine mixtures for PCA in paediatric patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of clonidine 1 microgram kg-1 with morphine 30 micrograms kg-1 for post-operative caudal analgesia in children.
In a prospective randomized study in children, we compared caudal bupivacaine-clonidine with bupivacaine-morphine to evaluate whether clonidine can be used as an alternative to morphine in caudal anaesthesia. Caudal anaesthesia was administered in 36 children undergoing orchidopexy, hernia repair or circumcision, using 1.5 mL kg-1 bupivacaine 0.18% with either 1 microgram kg-1 clonidine (group 1) or 30 micrograms kg-1 morphine (group 2). Haemodynamic and respiratory parameters, anaesthetic requirements, recovery time and pain score were monitored for 24 h. ⋯ Recovery time after anaesthesia was significantly longer in group 1 (16.6 +/- 8.8 min) than in group 2 (11.5 +/- 4.7 min) (P < 0.05). We conclude that analgesia provided by 1 microgram kg-1 clonidine added to caudal bupivacaine is comparable with that provided by 30 micrograms kg-1 caudal morphine with bupivacaine. Clonidine at this low dose did not cause respiratory depression.