Articles: analgesia.
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Acta Anaesthesiol Scand · Feb 1996
Randomized Controlled Trial Clinical TrialBalanced analgesia improves recovery and outcome after outpatient tubal ligation.
Outpatient surgery benefits patients only if postoperative sequelae are effectively treated. After laparoscopic tubal ligation (TL) intense pain and consequent postoperative nausea and vomiting (PONV) has been a problem delaying recovery and resulting in hospital admission. Ninety patients were randomised to this double-blind study, the aim being to evaluate the effect of balanced analgesia on postoperative pain and recovery after sterilization. ⋯ Postoperative pain and analgesic requirements, incidence of PONV and need for antiemetic medication were all significantly lower in the balanced analgesia group. Home readiness was consistently achieved 70-90 min sooner in the balanced analgesia group compared to the other groups (P < 0.01 between the balanced analgesia and the placebo group), and the patients were able to return to normal activity sooner (cumulatively 93% of the patients in the balanced analgesia group vs. 60% in the other two groups (P < 0.01 between the balanced analgesia and the other groups) had returned to normal activity on the 2nd postoperative day). It is concluded that in patients undergoing laparoscopic TL the combination of analgesic regimens with different mechanisms of action offer a simple and efficient way of postoperative pain relief, as well as an improvement of quality (i.e. less PONV) and speed of recovery.
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Acta Anaesthesiol Scand · Feb 1996
No additional metal particle formation using the needle-through-needle combined epidural/spinal technique.
Combined epidural/spinal analgesia utilizing a needle-through-needle technique has become very popular in anesthesia. However, findings of concave deformities at the orifice of Tuohy needles after spinal needle passage have raised concerns that metal fragments might be deposited within the epidural space. This study was proposed to investigate whether the needle-through-needle technique does produce metallic flecks. ⋯ Metallic particles are not produced by the needle-through-needle technique. However, metal particles are an apparent contaminant of all epidural needles and are probably routinely introduced into patients when the needle is placed.
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Critical care medicine · Feb 1996
Comment Letter Comparative StudyPractice parameters for intravenous analgesia and sedation.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of tunnelling on epidural catheter migration.
A prospective, randomised study of 82 patients having postoperative epidural analgesia was performed to determine whether the tunnelling of an epidural catheter influences its migration. Tunnelling of the catheter subcutaneously for a distance of 5 cm reduced the incidence of inward migration of 1 cm or more (p < 0.01) compared to a standard method of fixation with a transparent adhesive dressing. ⋯ Sixty two percent (n = 26) of tunnelled catheters remained within 0.5 cm of their original position compared to 38% (n = 16) of non-tunnelled catheters, although this difference was not statistically significant. Outward catheter migration was not reduced by subcutaneous tunnelling.
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Anaesth Intensive Care · Feb 1996
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia for acute musculoskeletal trauma: low-dose subcutaneous infusion of ketamine.
Low-dose ketamine by subcutaneous infusion (0.1 mg/kg/h) was compared in double-blind fashion with intermittent morphine (0.1 mg/kg intravenously, four-hourly) as analgesic regimen in 40 ASA-I adults after acute musculoskeletal trauma. Pain was assessed using visual analogue scales and sedation was graded on a four point rank drowsiness score. Objective cardiovascular and respiratory parameters and patient acceptability in terms of supplementary analgesia and early mobilization were also recorded. ⋯ None of the patients in ketamine group required supplementary analgesia (P < 0.001) and the patients could be easily mobilized for traction/splintage as compared with patients in the control group (P < 0.001). The incidence of nausea and vomiting in the morphine group was high (P < 0.01). The study shows that subcutaneous infusion of ketamine provides safe and effective analgesia in acute musculoskeletal trauma.