Articles: analgesia.
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Despite its efficacy, bupivacaine has never been considered to be the most suitable agent for achieving anaesthesia and analgesia in the obstetric patient. Ropivacaine is less cardiotoxic than bupivacaine and, at low concentrations, can produce analgesia with minimal motor block, attributes which make it potentially very suitable for use in obstetrics. However, further research is required to ultimately establish ropivacaine's place in obstetric anaesthesia and analgesia. Levobupivacaine, the L isomer of bupivacaine, is of similar potency to bupivacaine but has the advantage of being significantly less cardiotoxic than racemic bupivacaine, which suggests that it might ultimately replace racemic bupivacaine in obstetric practice.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison between epidural infusion of fentanyl/bupivacaine and morphine/bupivacaine after orthopaedic surgery.
To compare epidural infusions of bupivacaine-fentanyl and bupivacaine-morphine mixtures for postoperative pain relief after total hip replacement. ⋯ Continuous epidural infusion of bupivacaine-morphine or bupivacaine-fentanyl mixtures provided similar pain relief. Patients receiving morphine showed a more marked decrease in SpO2 than those receiving fentanyl. However, the average SpO2 remained > 90% in both groups.
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The Journal of pediatrics · Jun 1998
Randomized Controlled Trial Clinical TrialPhysiological, hormonal, and behavioral responses to a single fentanyl dose in intubated and ventilated preterm neonates.
To study the responses of ventilated preterm neonates to a single dose of opioid. ⋯ Single doses of fentanyl analgesia can reduce the physiologic/behavioral measures of pain and stress associated with mechanical ventilation in preterm infants.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative hypoxaemia: continuous extradural infusion of bupivacaine and morphine vs patient-controlled analgesia with intravenous morphine.
We carried out a randomized prospective study in 60 patients who had undergone major abdominal surgery for cancer. For postoperative pain control, 30 patients received continuous extradural infusion of 0.125% bupivacaine 12.5 mg h-1 and morphine 0.25 mg h-1 (EXI group) and 30 received patient-controlled analgesia (PCA) with intravenous morphine (1 mg bolus, 5-min lock-out and maximum dose 20 mg 4h-1). Both groups had general anaesthesia. ⋯ Episodes of moderate desaturation (90% > SpO2 85%) were more frequent in the EXI group than in the PCA group (P < 0.05). Pain scores were lower in the EXI group compared with the PCA group at rest and while coughing (P < 0.05). No significant difference was found for patient sedation and satisfaction.
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Randomized Controlled Trial Clinical Trial
Treatment of incomplete analgesia after placement of an epidural catheter and administration of local anesthetic for women in labor.
Approximately 15% of women still have pain after placement of an epidural catheter and administration of local anesthetic for labor analgesia. Two techniques frequently used to treat this pain were compared: (1) withdrawal of the catheter 1 cm and repeated dosing with additional local anesthetic, and (2) repeated dosing with additional local anesthetic without any catheter manipulation. ⋯ Administration of additional local anesthetic without first withdrawing the epidural catheter will effectively treat most women for whom analgesia is incomplete after the placement of an epidural catheter during labor.