Articles: analgesia.
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Anaesth Intensive Care · Feb 1997
Randomized Controlled Trial Comparative Study Clinical TrialThe antinociceptive effect of epidural lignocaine and fentanyl during lithotripsy.
To determine the antinociceptive effect of combining epidural fentanyl with lignocaine during non-immersion lithotripsy, 56 healthy patients were enrolled into a prospective, randomized, double-blind study. Epidural anaesthesia was induced with either lignocaine 300 mg alone, or lignocaine 300 mg, or 200 mg in combination with fentanyl 100 micrograms. Throughout the procedure analgesia was assessed by comparing the incidence of (a) spontaneous complaints of pain, (b) patients' attempts to withdraw from the painful stimulus, (c) supplemental epidural lignocaine requirements, (d) the haemodynamic response to lithotripsy and (e) the time to first postoperative pain. ⋯ No difference was found in the time to the first complaint of postoperative pain. Similarly, discharge times were unaffected by treatment modality. We conclude that despite the addition of fentanyl, adequate analgesia during lithotripsy is dependent upon the dose of local anaesthetic administered.
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Acta Anaesthesiol Scand · Feb 1997
Randomized Controlled Trial Clinical TrialIntraperitoneal bupivacaine for analgesia after laparoscopic cholecystectomy.
The effects of intraperitoneal administration of bupivacaine on pain after laparoscopic cholecystectomy were studied in a prospective, double-blind, randomised trial. ⋯ We conclude that reducing pain with intraperitoneal bupivacaine is effective, easy to administer, and without side-effects.
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Anesthesia and analgesia · Feb 1997
Randomized Controlled Trial Clinical TrialIntrathecal sufentanil for labor analgesia: do sensory changes predict better analgesia and greater hypotension?
Sensory changes and hypotension occur after intrathecal sufentanil (ITS) is given during labor. The goal of this study was to determine whether sensory changes are predictive of hemodynamic changes or duration of pain relief. We also examined whether sensory and hemodynamic changes relate to the concentration of ITS administered. ⋯ Systolic blood pressure decreased 23 +/- 2 mm Hg (P < 0.05) during the first 30 min after ITS, and six patients were given ephedrine. The magnitude of blood pressure change was not affected by the diluent volume or the presence of sensory changes. Because sensory changes were not predictive of the duration or quality of analgesia or the degree of hemodynamic change, we conclude that analgesia with ITS is predominantly mediated via spinal cord opioid receptors rather than by a local anesthetic-type conduction blockade.
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Acta Anaesthesiol Scand · Feb 1997
Wound infiltration with liposomal bupivacaine prolongs analgesia in rats.
Wound infiltration with local anesthetics does not reliably produce satisfactory postoperative analgesia, and the dose of local anesthetic which may be safely administered is limited by the potential for systemic toxicity. This study evaluated the efficacy of a slow-release liposomal bupivacaine formulation on duration of wound analgesia. ⋯ The 8-fold increase in duration of wound analgesia and the lower plasma levels seen with the liposomal formulation are explained by gradual drug release from the liposomal depot. These results may have important implications for achieving safe and effective analgesia with wound infiltration techniques in humans.