Articles: analgesia.
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Opiates remain the most common form of analgesic therapy in the burn patient today. Because of increased opiate requirements, optimal relief of burn pain continues to be a problem for these patients. The purpose of this article is to summarize those alternative pain control methods that appear in the literature. ⋯ Ketamine has been extensively used during burn dressing changes but its psychological side-effects have limited its use. Clonidine, however, has shown promise in reducing pain without causing pruritus or respiratory depression. Other forms such as transcutaneous electrical nerve stimulation (TENS), psychological techniques, topical and systemic local anaesthetics are also useful adjuncts.
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Randomized Controlled Trial Comparative Study Clinical Trial
Peri-operative multimodal pain therapy for caesarean section: analgesia and fitness for discharge.
To compare, the efficacy of a multi-modal analgesic regimen and single drug therapy with iv PCA morphine alter Caesarean delivery with spinal anaesthesia. ⋯ Multi-modal pain therapy resulted in improved early post-operative analgesia during the first 24 hr after Caesarean delivery. Patients receiving iv PCA morphine followed by acetaminophen+codeine po were more likely to develop decreased bowel mobility. All patients, with one exception, achieved discharge criteria (eating solid food, absence of nausea, normal lochia, dry incision and DVAPS < 4) at 48 hr after spinal injection.
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Anesthesia and analgesia · Aug 1997
Biography Historical ArticleAnesthesia & Analgesia: seventy-five years of publication.
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Patient-controlled analgesia (PCA) is the use of a portable infusion pump activated by the patient to inject an analgesic drug intravenously, subcutaneously or epidurally. PCA permits a patient to deliver a small bolus of opioid to achieve prompt relief without over sedation. Use of PCA for pain management is increasing in hospitals and home settings, largely because it can provide equivalent or better analgesia than conventional methods, and patients are more satisfied with its use. ⋯ Also, researchers do not include the full scope of costs associated with the use of PCA in comparison with conventional drug delivery methods and some do not measure the level of pain relief achieved. Of the few complete and well designed published studies found, PCA was reported to produce superior analgesia at a higher cost than conventional intramuscular therapy in 3 studies, but to be more costly and produce less pain relief than intramuscular therapy in 1 study. There is a pressing need for cost-effectiveness, cost-utility and cost-benefit analyses to determine the appropriate clinical and cost circumstances for the use of PCA.