Articles: analgesia.
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Anesthesia and analgesia · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of multiport and uniport epidural catheters in laboring patients.
The relative incidence of technical difficulties associated with multiport (three lateral ports) and uniport (single distal port) epidural catheters remains controversial. As part of a continuing institutional evaluation of epidural catheter insertion, 500 parturients were randomized to have either a multiport or a uniport epidural catheter inserted 6 cm into the epidural space. ⋯ No multiport epidural catheter was associated with multicompartment placement. We conclude that multiport epidural catheters are preferable for use in laboring patients since they reduce the incidence of inadequate epidural analgesia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Double-blind comparison of epidural ropivacaine 0.25% and bupivacaine 0.25%, for the relief of childbirth pain.
To evaluate the efficacy of ropivacaine 0.25% when administered epidurally for relief of labour pain and to compare it with bupivacaine 0.25%. ⋯ Ropivacaine 0.25%, when administered epidurally by intermittent top-ups for labour analgesia, was equally efficacious as bupivacaine 0.25%.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Continuous extradural infusion of ropivacaine 2 mg ml-1 for pain relief during labour.
We have assessed the dose-response relationship of a solution of ropivacaine 2 mg ml-1, given as a continuous extradural infusion to women in labour. A total of 133 parturients were allocated randomly to one of four groups to receive a fixed rate ropivacaine infusion of 4, 6, 8 or 10 ml h-1 with additional bolus doses as necessary. ⋯ There were no significant differences between groups in terms of obstetric or neonatal outcome. We conclude that ropivacaine 2 mg ml-1 was effective and well tolerated when given as a continuous extradural infusion at 6-8 ml h-1 and may be used as the sole analgesic during labour.
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Progress in neurobiology · Jun 1997
ReviewThe neurobiology of placebo analgesia: from endogenous opioids to cholecystokinin.
Placebo is a widespread phenomenon in medicine and biology and its mechanisms are understood only partially. Most of our understanding of placebo comes from studies on pain. In particular, placebo analgesia represents a situation where the administration of a substance known to be non-analgesic produces an analgesic response when the subject is told that it is a pain killer. ⋯ This claim comes from the observation that the opioid antagonist naloxone can reverse placebo analgesia. On the basis of the discovery of the anti-opioid action of the neuropeptide cholecystokinin, recent studies demonstrate that the blockade of cholecystokinin receptors potentiates the placebo analgesic response, thus suggesting an inhibitory role of cholecystokinin in placebo analgesia. Thus, by antagonizing the anti-opioid action of cholecystokinin during a placebo procedure, a potentiation of the endogenous opioid systems can be obtained.
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Randomized Controlled Trial Comparative Study Clinical Trial
Is wound infiltration with anesthetic effective as pre-emptive analgesia? A clinical trial in appendectomy patients.
To assess the efficacy of wound infiltration with local anesthetic in reducing postoperative pain after a muscle-splitting incision for appendectomy. ⋯ Infiltration with local anesthetic before incision does not pre-empt postoperative pain from a muscle-splitting incision used for appendectomy.