Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia.
In a randomised, placebo-controlled trial we have compared the efficacy of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia after orthopaedic surgery. One hundred and forty five patients, ASA 1 and 2, undergoing major orthopaedic surgery were anaesthetised using a standardised technique. They were randomly allocated to receive patient-controlled analgesia as morphine 1 mg.ml-1 alone; morphine as before plus a single dose of 1.25 mg droperidol together with 0.083 mg.ml-1 in the infusion syringe; or morphine as before plus 4 mg ondansetron and 0.13 mg.ml-1 in the syringe. ⋯ The number of patients suffering from nausea alone was not significantly different between the three groups, although those in the ondansetron group experienced less severe nausea (p < 0.05) when using a two point scale. The droperidol group had significantly higher sedation scores than the other two groups (p < 0.005). We conclude that ondansetron is superior to droperidol when used with patient-controlled analgesia and causes less sedation.
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Four infections were identified among 4,832 patients receiving epidural analgesia (an attack rate of 0.08%). The infections involved cesarean-section patients and occurred within a 9-month period. Findings suggest that the risk of infection is decreased by maintaining a closed system for the duration of the analgesia course.
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Postoperative analgesia inhibits the stress cascade with negative effects on whole organism. Therefore the spectrum of drugs used for soothing postoperative pain quickly widens. The epidural route appears as being logical, since due to the direct effect in the transmission and processing of pain it suffices with a lower dosage. The authors refer to a group of 30 patients postoperatively treated by a combination of tramadol and Clonidine administrated by means of an epidural catheter. 26 patients evaluated the induced analgesia as excellent or sufficient. (Tab. 3, Ref. 4).
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Letter Historical Article
Early French accounts of self-inhalation of ether and conscious analgesia.