Articles: analgesia.
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Rev Esp Anestesiol Reanim · Jun 1996
Letter Case Reports[Evaluation of the blood patch using magnetic resonance].
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Intrapartum epidural analgesia has become increasingly popular because it is the most effective method of providing pain relief during labor. Much attention is given to its safety and efficacy, and many health care providers and consumers are unaware of its potential drawbacks. This article reviews the literature about the effects of epidural analgesia on the mother and infant. ⋯ Epidural analgesia is a safe and effective method of relieving pain in labor, but is associated with longer labor, more operative intervention, and increases in cost. It must remain an option; however, caregivers and consumers should be aware of associated risks. Women should be counseled about these risks and other pain-relieving options before the duress of labor.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural morphine vs hydromorphone in post-caesarean section patients.
The purpose of this randomized controlled double blind study was to compare the efficacy of pain relief and the side effects of epidural hydromorphone and morphine in post-Caesarean patients. ⋯ Hydromorphone provides no clinical benefit over epidural morphine for post operative analgesia following Caesarean section.
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Anesthesia and analgesia · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialDose-response study of intrathecal morphine versus intrathecal neostigmine, their combination, or placebo for postoperative analgesia in patients undergoing anterior and posterior vaginoplasty.
This study was designed to examine postoperative analgesia with intrathecal neostigmine in a randomized, blinded trial with morphine as the active control in patients undergoing anterior and posterior vaginoplasty. A secondary aim was to provide preliminary data on the interaction between these two drugs. The incidence of adverse effects was also assessed. ⋯ Increasing doses of intrathecal morphine (50 micrograms, 100 micrograms, and 200 micrograms) and intrathecal neostigmine (50 micrograms, 100 micrograms, and 200 micrograms) showed a dose-dependent pattern of analgesia (P < 0.001). The M50 + N50 combination resulted in a better analgesic effect with fewer side effects than M50, N50, and control groups. These preliminary data suggest that spinal neostigmine produces analgesia for vaginoplasty surgery similar in duration to spinal morphine and that the combination of morphine and neostigmine may allow a reduction in the dose of each component for postoperative analgesia.
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Randomized Controlled Trial Clinical Trial
Analgesia for day surgery. Evaluation of the effect of diclofenac given before or after surgery with or without bupivacaine infiltration.
One hundred patients undergoing breast lump excision using a standard anaesthetic technique in the Day Care Unit were randomly divided into five groups. Groups A and B received either saline or diclofenac in a double-blind fashion before and at the end of the procedure, with both groups receiving 10 ml of 0.5% bupivacaine infiltration at the end. Groups C and D also received saline or diclofenac before and after surgery but had no bupivacaine infiltration at the end. ⋯ Although not significant (p = 0.22), fewer patients required rescue medication when diclofenac was given before surgery (10%) rather than after surgery (22.5%). Fewer patients had a fair amount or a great deal of pain in the 48 h following surgery when diclofenac was injected before (7.5%) rather than after surgery (12.5%). The mean number of oral analgesics taken in the 48 h after surgery was also lower in those patients who had the diclofenac before the surgery rather than after.