Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Dose requirements, efficacy and side effects of morphine and pethidine delivered by patient-controlled analgesia after gynaecological surgery.
We have compared the dose requirements and side effects of morphine with those of pethidine when administered by patient-controlled analgesia in 40 patients (ASA I-II, 20-65 yr) after elective total abdominal hysterectomy. Patients were allocated randomly, in a double-blind manner, to receive either morphine (bolus dose 2 mg, lockout time 10 min) or pethidine (bolus dose 20 mg, lockout time 10 min) for postoperative pain relief. ⋯ Four patients receiving pethidine were withdrawn because of postoperative confusion and one receiving morphine because of intractable nausea and vomiting. The 95% confidence interval for this difference between the groups for VAS scores of sedation, nausea and pain were approximately 30 mm.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative cognitive impairment in the elderly. Choice of patient-controlled analgesia opioid.
This study evaluated the safety and cognitive impact of patient-controlled analgesia with fentanyl compared to patient-controlled analgesia with morphine among elderly postoperative patients. In addition, two screening tests for cognitive impairment, the Mini Mental Status Exam and the Short Portable Mental Status Questionnaire, were compared. Ninety-six elderly patients were randomly allocated to receive patient-controlled analgesia with either fentanyl or morphine following hip or knee arthroplasty. ⋯ Fentanyl patients used more opioid based on a dose ratio of 100:1 suggesting that this dose ratio is inadequate. The incidence of urinary retention was lower in the fentanyl group. A poor agreement between the two tests of cognitive impairment mandates caution when peri-operative cognitive function is compared using different tests.
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Clinical Trial Controlled Clinical Trial
Pharmacokinetics and analgesic effect of ropivacaine during continuous epidural infusion for postoperative pain relief.
The pharmacokinetics and clinical efficacy of ropivacaine (2.5 mg/ml) during a 24-h continuous epidural infusion for postoperative pain relief in 20 patients scheduled for abdominal hysterectomy were characterized using an open-label, increasing-dose design. ⋯ The pharmacokinetics of ropivacaine were independent of dose, but total clearance decreased with time over 24 h. The consistent increase in total plasma concentration during the postoperative epidural infusion contrasted to much less variation in the unbound plasma concentrations of ropivacaine.