Articles: analgesia.
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Regional anesthesia · Sep 1997
Randomized Controlled Trial Clinical TrialDoes metoclopramide supplement postoperative analgesia using patient-controlled analgesia with morphine in patients undergoing elective cesarean delivery?
Recent studies have shown that metoclopramide may decrease postoperative narcotic requirements in patients undergoing second-trimester induced abortions or prosthetic hip surgery. It is often used to decrease the incidence of nausea and vomiting in the patient undergoing cesarean delivery under regional anesthesia. If metoclopramide were found to be an analgesic adjunct in these patients, it would offer an additional impetus for its routine use. ⋯ This study demonstrates that metoclopramide decreases intraoperative nausea but does not supplement analgesia in patients undergoing elective cesarean delivery.
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Acta Anaesthesiol Scand · Sep 1997
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia after upper abdominal surgery using extradural administration of a fixed dose of buprenorphine in combination with lignocaine given at two infusion rates: a comparative study.
Extradural administration of combinations of local anaesthetics and opioids are frequently employed for postoperative pain relief. There is a scarcity of data on the analgesic effects of variations of the dose of local anaesthetic drug admixed to a fixed dose of opioid. ⋯ When added to a fixed dose of buprenorphine, continuous extradural infusion of 2% lignocaine at high rate provides better postoperative analgesia than when given at low rate without producing significant side effects.
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Regional anesthesia · Sep 1997
Case ReportsTrigger point injections for myofascial pain during epidural analgesia for labor.
Myofascial pain is the leading cause of chronic low back pain and in most cases can be successfully resolved with trigger point injections of local anesthetics. This type of pain can exist during pregnancy and exceed the analgesia provided by an epidural for labor. ⋯ Myofascial pain can be an etiology of back pain in the parturient. Trigger point injections, even when used concomitantly with a functioning epidural infusion, can be a valuable aid for the provision of complete analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Caudal tramadol for postoperative analgesia in pediatric hypospadias surgery.
Ninety boys, aged 13-53 months, undergoing repair of hypospadias, were allocated randomly to receive 0.8 ml kg-1 of one of three solutions into the caudal extradural space: group B received bupivacaine 2 mg kg-1, group T received tramadol 2 mg kg-1 in 0.9% saline and group BT a mixture of both. Postoperative pain was assessed hourly for 12 h after injection using a modified TPPPS pain score and additional analgesia was administered to those children whose pain scores were > 3/10. ⋯ There were no significant differences between the groups in mean ventilatory frequency, sedation scores, incidence of emesis, facial flushing or pruritus. We conclude that caudal tramadol had a slow onset of action and that the addition of tramadol to bupivacaine, when both drugs were administered caudally, did not significantly prolong the duration of action of bupivacaine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labor.
Reports indicate that the administration of epidural analgesia for pain relief during labor interferes with labor and increases cesarean deliveries. However, only a few controlled trials have assessed the effect of epidural analgesia on the incidence of cesarean delivery. The authors' primary purpose in this randomized study was to evaluate the effects of epidural analgesia on the rate of cesarean deliveries by providing a suitable alternative: patient-controlled intravenous analgesia. ⋯ Epidural analgesia was not associated with increased numbers of cesarean delivery when compared with a suitable alternative method of analgesia.