Articles: analgesia.
-
Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialSubarachnoid and intravenous PCA versus bolus administration for postoperative pain relief in orthopaedic patients.
Patient-controlled analgesia (PCA) with intravenous piritramide and subarachnoid bupivacaine was studied during postoperative pain management in comparison with nurse-administered bolus injections. ⋯ PCA with CSA was more effective than nurse-administered bolus-administration of bupivacaine, while the present study failed to show superiority of i.v. PCA over i.v. bolus-administration of piritramide. PCA using the subarachnoid route is a promising concept for treatment of postoperative pain in orthopaedic patients, while the PCA piritramide regime of this study warrants improvement.
-
Some cancer patients require invasive techniques for control of chronic cancer pain. Many patients have benefited from local administration of opioids and anesthetics through an epidural catheter. However, epidural abscess and meningitis are side effects of epidural catheters that have serious morbidity and mortality. ⋯ Deep infection is a frequent complication of epidural analgesia and is associated with a high morbidity and mortality. Only cancer patients with a short life expectancy (< or =3 months) should be treated with epidural analgesia.
-
Berl Munch Tierarztl · Nov 1998
[Evaluation of the antinociceptive effect of systemic and epidurally applied xylazine in general anesthesia with isoflurane in dogs and the effect of atipamezole infection on postoperative analgesia].
The alpha 2-selective adrenergic agonist xylazine has a long lasting antinociceptive effect (> 4 hours) after lumbosacral injection in dogs (Rector, 1996). The present study was performed to find out if epidurally administered xylazine acts locally as well as systemically. In a clinical investigation 30 dogs anesthetized with isoflurane in oxygen (1.9 Vol.% ET) were examined before and after epidural and intramuscular injection of xylazine (0.25 mg/kg) during surgery and over a 240-minute postoperative period. ⋯ However, sufficient analgesic plasma xylazine concentrations could only be detected in group II up to 180 minutes after injection. After this time period, an analgesic effect could not be expected anyway, even without antagonization. It can be concluded that the epidural administration of xylazine offers advantages in contrast to a systemic administration, as a longer lasting analgesic effect can be observed (after the epidural application), and systemic side effects can be reversed without effecting spinal analgesia.
-
Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative evaluation of four different infusion rates of ropivacaine (2 mg/mL) for epidural labor analgesia.
Previous studies have reported comparable efficacy for ropivacaine and bupivacaine when used for labor analgesia at concentrations of 2.5 mg/mL. In this multicenter study, we assessed ropivacaine at the commercially available concentration of 2 mg/mL (0.2%) for labor pain management. ⋯ The 2 mg/mL of ropivacaine produces satisfactory labor analgesia at epidural infusion rates of 4, 6, 8, and 10 mL/hour, provided supplemental bolus dosages are available. Clinically, a rate of 6 mL/hour may be the lowest effective rate that provides the best combination of pain relief, motor block, and rebolusing, although rates of 8 and 10 mL/hour produced similar results.
-
Reg Anesth Pain Med · Nov 1998
Letter Case Reports Randomized Controlled Trial Clinical TrialIntrathecal ropivacaine in cancer pain.