Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of single, end-holed and multi-orifice extradural catheters when used for continuous infusion of local anaesthetic during labour.
Single, end-holed and multi-orifice extradural catheters were compared in terms of efficacy and complications when used for infusion of 0.1% bupivacaine during labour. In this study of 364 patients there was no difference in unilateral block after an initial bolus dose (18 (11.5%) for single, end-holed and 16 (10.9%) for multi-orifice catheters). Unilateral block recurred with seven (4.0%) single, end-holed and with eight (4.8%) multi-orifice catheters. Unilateral blocks, arising for the first time during infusion of local anaesthetic, occurred significantly more frequently when single, end-holed catheters were used (29 (16.4%)) compared with multi-orifice catheters (14 (8.4%)) (P < 0.05).
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Many anaesthetists believe that informed consent for epidural analgesia during labour is inadequate. Patients are perceived to be poorly informed and unable to cope with the information given during labour for informed consent. We reviewed these two hypotheses: A) to define complications for which patients want clear information: B) to quantify the influence of pain, anxiety, opioid premedication, and the importance of level of education, on a patient's level of satisfaction with regard to the consent process: and C) to assess how satisfactory epidural pain relief correlates with satisfaction with the consent process. ⋯ Patients indicated they should be informed of all possible complications associated with epidural analgesia, regardless of severity or risk. In contrast to reports in the literature, non disclosure of serious risks during labour was not acceptable to parturients.
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Acta Anaesthesiol. Sin. · Sep 1997
Case ReportsTruncal rigidity as a result of epidural sufentanil--a case report.
It is well known that intravenous opioids may cause truncal rigidity. To the best of our knowledge truncal rigidity induced by epidural opioid has never been reported. Recently, we came across an accident of truncal rigidity following epidural sufentanil. ⋯ She stayed in the recovery room for 24 h and returned to ward in satisfactory condition. The incidence disclosed that epidural sufentanil even with a dose as small as 50 micrograms could cause truncal rigidity. Thus when epidural sufentanil is applied for post-operative pain control constant vigilance is necessary in order to avoid accident.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Evaluation of the safety and efficacy of ketorolac versus morphine by patient-controlled analgesia for postoperative pain.
To compare ketorolac tromethamine with morphine for pain management after major abdominal surgery. ⋯ Ketorolac may be effective when administered by PCA device, and has a clear morphine-sparing effect.