Articles: analgesia.
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Paediatric anaesthesia · Jan 1996
Patient controlled analgesia (PCA) in paediatric surgery: a prospective study following laparoscopic and open appendicectomy.
Patient controlled analgesia (PCA) has not yet gained universal acceptance for the management of postoperative pain in paediatric surgery. In a prospective study we evaluated feasibility and complications of PCA following 90 cases of laparoscopic or open appendicectomy. ⋯ Assessment of application protocols showed, that the consumption of analgesics was significantly reduced following laparoscopic appendicectomy (P < 0.05). PCA is a safe and feasible method for the management of postoperative pain in children and PCA recording provides an excellent insight into the consumptional behaviour of patients, enabling staff to evaluate postoperative pain for various procedures.
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Int J Obstet Anesth · Jan 1996
Unexpected postpartum seizures associated with post-dural puncture headache treated with caffeine.
This report describes a case of isolated postpartum seizures, in an apparently healthy woman who had suffered an accidental dural puncture during epidural analgesia for labour, and was on caffeine for relief of post-dural puncture headache. Investigation failed to determine the aetiology of the seizures. The possible contribution of dural puncture and caffeine toxicity are discussed.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of morphine, pethidine and fentanyl in the postsurgical patient-controlled analgesia environment.
This study was designed to evaluate whether there is any scientific basis for clinicians' preferences for selecting opioids for use in patient-controlled analgesia (PCA) and to determine whether there are any patients' preferences for being treated with any of these opioids. Results were obtained for 55 postoperative patients recruited to investigate putatively equivalent doses of 3 commonly used opioids--morphine, pethidine and fentanyl--when self-administered postoperatively. No significant differences in the incidence of side effects between groups were found with the exception of more pruritus reported in the group given morphine. ⋯ The majority of patients reported being very satisfied with their postoperative pain management and with PCA, with no differences in satisfaction between the 3 opioid-treated groups. A senior consultant anaesthetist, when asked to make a judgement, was not able to identify which agent each patient was receiving with a better than chance accuracy. These findings suggest that while there may be subtle differences in patient response to these 3 commonly used opioids, none was obviously superior when used for postoperative PCA.
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Acta neurochirurgica · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialIntra-operative epidural morphine, fentanyl, and droperidol for control of pain after spinal surgery. A prospective, randomized, placebo-controlled, and double-blind trial.
The present study was conducted to investigate the analgesic effects of intra-operatively administered epidural morphine in patients undergoing surgery for lumbar disc disease. Three treatment groups were constituted: one with 5.0 mg morphine and 2.5 mg dehydrobenzperidol (DHB) in 10 ml physiological saline, one with 5.0 mg morphine and 0.1 mg fentanyl in the same amount of saline, and one placebo group with saline only. The test solution was injected epidurally via catheter after haemostasis and before closure of the wound. ⋯ It was shown that additional epidural fentanyl offers no significant improvement of postoperative analgesia. No significant reduction of adverse effects could be found in the morphine/droperidol group compared to the morphine/fentanyl group. In conclusion, the intra-operative epidural application of morphine is a safe, effective and simple method for achieving sufficient analgesia in the first 24 hours after lumbar spinal surgery for disc disease.