Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative patient-controlled epidural analgesia with opioid bupivacaine mixtures.
To determine the efficacy and safety of patient-controlled epidural analgesia of morphine or fentanyl in combination with bupivacaine for postoperative pain relief. ⋯ Both methods were effective in the prevention of pain but, because of fewer side effects, fentanyl may be preferable to morphine.
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Seminars in perinatology · Oct 1998
ReviewPractical approach to analgesia and sedation in the neonatal intensive care unit.
The anatomic and physiological bases for nociception are present even in very preterm neonates. Neonates show the same behavioral, endocrine, and metabolic responses to noxious stimuli as older subjects. Preterm infants appear to be more sensitive to painful stimuli and have heightened responses to successive stimuli. ⋯ A pure sedative agent can provide physiological stability in settings in which there are less acutely painful stimuli or when there are adverse effects from, or tolerance to, opiates. Local anesthesia of skin and mucous membranes is helpful for invasive procedures. Antipyretic analgesics such as acetaminophen have a role in inflammatory pain.
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Case Reports Randomized Controlled Trial Clinical Trial
The effect of the addition of adrenaline to pethidine for patient-controlled epidural analgesia after caesarean section.
We have investigated the addition of adrenaline to pethidine for patient-controlled epidural analgesia after elective Caesarean section. In a randomised, double-blind study, patients received patient-controlled epidural analgesia for 24 h using pethidine 5 mg.ml-1 with adrenaline 5 micrograms.ml-1 (adrenaline group, n = 40) or pethidine 5 mg.ml-1 without adrenaline (plain group, n = 38). ⋯ Patients in the adrenaline group had higher visual analogue scale scores for nausea at 2 h and 24 h and higher scores for pruritus at 2 h compared with the plain group. Addition of adrenaline to pethidine for patient-controlled epidural analgesia does not appear to have significant clinical advantages.
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Local and regional anesthetic techniques have a significant but limited place in the practice of infant pain control. In certain clinical circumstances, regional anesthetic techniques presumably afford many of the same advantages for the pediatric patient as in the adult patient. However, there are few controlled clinical trials on the advantages and adverse effects compared with conventional analgesic strategies. This article discusses the clinical application, effectiveness, safety, and outcomes of the available local and regional anesthetic techniques for control of postoperative and procedure-related pain in neonates and infants.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · Oct 1998
Case ReportsIntracranial subdural haematoma complicates accidental dural tap during labour.
A 19-year-old, healthy nulliparous woman developed an intracranial subdural haematoma after unintentional dural puncture in connection with epidural analgesia for labour pain. The haematoma was evacuated and the patient recovered completely. Anaesthesiologists and obstetricians should be aware of this rare but potentially dangerous complication to epidural analgesia.