Articles: analgesia.
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This article examines the extent to which pain contributes to pulmonary dysfunction in burns, trauma, a variety of acute abdominal diseases, and postoperatively. Also discussed are the options available to attenuate the extent of this contribution.
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Rev Esp Anestesiol Reanim · Jan 1999
Historical Article[Obstetric anesthesia/analgesia in Spain. Study notes on its historical evolution during the 1st half of this century].
This historical review of obstetric analgesia-anesthesia in Spain covers the first half of the twentieth century. Following usual practice for researching medical history, we have performed an exhaustive review of Spanish medical literature published during the study period, followed by classification, study and critical analysis. We found that the first half of the century saw considerable change in the application of analgesic-anesthetic techniques for childbirth and obstetric procedures, indicating that practitioners were far from apathetic as had been obstetricians of the second half of the nineteenth century, who generally rejected any type of analgesia for use during labor and birth. The numerous techniques in vogue during that period under study are described, although analgesia-anesthesia by inhaled ether and chloroform was undoubtedly the most widely used by obstetricians until well into the 1950's.
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Patient-controlled analgesia has been proven to be an effective technique in postoperative pain management. The aim of our study was to evaluate PCA on general surgery wards. 311 patients and their nurses were questioned about their experiences in using PCA for postoperative pain management. Satisfaction with pain relief judged by both patients and nursing staff, incidence of negative side effects and technical problems were studied. ⋯ Most of the patients coped very well with operating their PCA-pumps. We conclude that PCA is a safe and effective method in postoperative pain management on surgical wards. Under the condition of regular monitoring of pain intensity, of analgesic consumption, level of sedation and of side effects by trained medical and nursing staff, monitoring of respiration and vigilance is not necessary for the PCA regimen we used.
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To establish an effective method of continuous quality control of acute pain service, a retrospective study on incident reporting during postoperative analgesia period was conducted. Incidents were reported and analyzed in 1507 patients who received epidural postoperative analgesia, and the results of satisfaction of pain relief was compared with those of incident analysis. In this study, an incident was defined as any factor that might or had affected patient's safety during analgesia period. ⋯ There was a very significant difference between the satisfaction of the patients who suffered from incidents and who did not (P < 0.001). It is concluded that incidents affect the satisfaction of the patients who received postoperative pain relief. Incident reporting is a more effective method for quality control of acute pain service.
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Acta Anaesthesiol Belg · Jan 1999
Case ReportsTreatment for postdural puncture headache associated with late postpartum eclampsia.
Postdural puncture headache (PDPH) is the most common complication of accidental or deliberate dural puncture. It also occurs after epidural or spinal analgesia for labor and delivery. ⋯ Definitive treatment can be accomplished with an epidural blood patch (EBP). We present a case of postpartum convulsions which were temporally related to a caffeine infusion and an EBP.