Articles: analgesia.
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Regional anesthesia · Mar 1997
Randomized Controlled Trial Clinical TrialAmbulatory combined spinal-epidural analgesia for labor. Influence of epinephrine on bupivacaine-sufentanil combination.
Subarachnoid sufentanil 5 micrograms during labor is known to have variable results. However, subarachnoid sufentanil 5 micrograms plus bupivacaine 1 mg provides good quality labor analgesia of 100 minutes' average duration. The objective of this study was to examine the effects of adding epinephrine 25 micrograms to this mixture. ⋯ This minimal bupivacaine-sufentanil-epinephrine mixture allows high-quality analgesia of 142 +/- 54.3 minutes' duration, with a low sensory block level and no motor block. However, hypotension can occur as a late side effect.
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Regional anesthesia · Mar 1997
Randomized Controlled Trial Comparative Study Clinical TrialContinuous spinal analgesia. Comparison between patient-controlled and bolus administration of plain bupivacaine for postoperative pain relief.
Adequate postoperative pain relief has been achieved in orthopedic patients by subarachnoid bolus administration of plain bupivacaine. This prospective randomized study compares bolus injections of bupivacaine with a patient controlled infusion via subarachnoid 28-gauge microcatheters for postoperative analgesia after elective hip replacement. ⋯ In spite of a higher incidence of technical problems, patient-controlled analgesia with a continuous background infusion via microspinal catheters provides more effective postoperative analgesia, without hemodynamic or respiratory side effects, than bolus administration.
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Regional anesthesia · Mar 1997
Randomized Controlled Trial Clinical TrialSubarachnoid meperidine-morphine combination. An effective perioperative analgesic adjunct for cesarean delivery.
Low-dose subarachnoid morphine provides effective perioperative analgesia but may be associated with a transient period of inadequate pain relief between the regression of local anesthetic block and the onset of morphine's analgesic effect. We hypothesized that this period of suboptimal analgesia could be avoided by adding meperidine, a rapid-acting, intermediate-duration opioid. ⋯ The subarachnoid combination of meperidine-morphine provided more uniform analgesia, higher satisfaction, and a lower requirement for intravenous narcotic supplementation than either morphine or meperidine alone in patients recovering from cesarean delivery.
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Regional anesthesia · Mar 1997
Randomized Controlled Trial Clinical TrialPreemptive analgesia in children. Does it exist?
Preemptive analgesia has been evident in animals, but few adult human studies exist demonstrating this concept exist, and there are fewer still in children. Caudal epidural blocks with local anesthetics are often placed for postoperative analgesia in children. This study evaluated whether these blocks are more effective when placed prior to surgical incision. ⋯ Although preemptive analgesia has been successfully demonstrated in some earlier clinical studies, our results indicate that pre- and postincisional caudal epidural blocks with 0.25% bupivacaine were equally effective in children.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of postoperative emesis, recovery profile, and analgesia in pediatric strabismus repair. Rectal acetaminophen versus intravenous fentanyl-droperidol.
Postoperative nausea and vomiting comprise significant morbidity in pediatric patients undergoing strabismus repair and can prolong hospitalization. Many authors recommend routine intraoperative opiate analgesia and prophylactic antiemetics. ⋯ Prophylactic fentanyl-droperidol prolongs the length-to-stay and recovery time and provides no discrete identifiable benefit over acetaminophen alone in this population. Cost-effectiveness analysis strongly favors use of acetaminophen over fentanyl-droperidol prophylaxis in children undergoing primary strabismus surgery.