Articles: analgesia.
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Randomized Controlled Trial Clinical Trial
Combining propofol with morphine in patient-controlled analgesia to prevent postoperative nausea and vomiting.
We have studied the antiemetic effects of propofol when mixed with morphine in a patient-controlled analgesia (PCA) pump after major gynaecological surgery. In a double-blind, randomized, controlled study, 50 women, ASA I or II, received a standardized anaesthetic comprising thiopental, morphine, atracurium, nitrous oxide and oxygen with enflurane, and received postoperative PCA with morphine mixed with either 1% propofol or lvelip. The PCA bolus was morphine 1 mg with propofol 5 mg or lvelip 0.5 ml, with a lockout time of 5 min. ⋯ There were no significant differences between the two groups in any of the study measurements of PONV. There were, no side effects after propofol. Propofol, when mixed with morphine in this dose combination for PCA, did not decrease the incidence of nausea and vomiting in women undergoing major gynaecological surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
The dose-response relation of intrathecal fentanyl for labor analgesia.
This study determined the dose-response relation of intrathecal fentanyl for labor analgesia and described the onset, duration, and quality of analgesia when used as the sole analgesic. ⋯ Intrathecal fentanyl produces rapid, profound labor analgesia with minimal side effects. These data indicate that there is little benefit to increasing the dose beyond 25 microg when it is used as the sole agent for intrathecal labor analgesia.
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Randomized Controlled Trial Clinical Trial
Pre-emptive effect of multimodal analgesia in thoracic surgery.
Thirty subjects undergoing posterolateral thoracotomy were allocated randomly to receive one of two analgesic regimens: group Pre received i.v. morphine, i.m. diclofenac and intercostal nerve blocks from T2 to T11, 20 min before operation and placebo injections after operation. Group Post received placebo injections before operation, and i.v. morphine, i.m. diclofenac and intercostal nerve blocks from T2 to T11 at the end of surgery, before discontinuation of anaesthesia. ⋯ During the first 48 h after operation there were lower pain scores in group Pre when taking a vital capacity breath but there were no significant differences between the groups in any other measure. The effects of pre-emptive analgesia given before surgery appeared to be relatively modest in terms of analgesia, analgesic consumption and long-term outcome and were of limited clinical significance.
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Comparative Study
A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease.
Recently, patient controlled analgesia (PCA) has gained prominence in the treatment of pain for children suffering from vaso-occlusive crisis associated with sickle cell disease. Because there are several different regimens that can be used for PCA, the purpose of this study was to compare and contrast two regimens of patient controlled analgesia (PCA) in terms of safety, efficacy, and cost for the treatment of vaso-occlusive pain associated with sickle cell disease. In this study a retrospective chart review was conducted. ⋯ Patients were grouped according to the type of PCA regimen they received: high dose PCA/low basal infusion (HPCA/LBI) or low dose PCA/high basal infusion (LPCA/HBI). Children in Group 1 (HPCA/LBI) used significantly less morphine during their hospitalization, were hospitalized fewer days, and reported lower pain scores on day 2. There were considerable cost savings due to decreased length of stay, less morphine consumed overall, and fewer days required for rental of the PCA pump.