Articles: analgesia.
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Am. J. Obstet. Gynecol. · Sep 1995
Randomized Controlled Trial Clinical TrialThe effect of topical 20% benzocaine on pain during loop electrosurgical excision of the cervix.
Our purpose was to evaluate the effect of cervical application of 20% benzocaine on the pain associated with subsequent cervical injection of local anesthetic and tissue excision during the loop electrosurgical excision procedure of the cervix. ⋯ Preoperative cervical application of 20% benzocaine does not appear to reduce the pain associated with either subsequent local anesthetic injection or tissue excision during the loop electrosurgical excision procedure of the cervix.
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Clinical Trial
A pharmacokinetic approach to resolving spinal and systemic contributions to epidural alfentanil analgesia and side-effects.
A pilot study was conducted in 7 normal volunteers to demonstrate the feasibility of employing pharmacokinetic tailoring to achieve matching plasma opioid concentration-time curves after epidural (e.p.) and intravenous (i.v.) alfentanil administration. Each subject participated in 1 pretest and 2 test sessions. Our pain model was cutaneous electrical stimulation of the finger and toe, adjusted to produce a baseline pain report of 5 (strong pain on a 0-5 scale). ⋯ Onset of pain relief was rapid, and duration was approximately 1.5 h with e.p. and 1 h with i.v. alfentanil. There were no differences in pupil size, ETCO2, or subjective side effects between e.p. versus i.v. administration. We conclude that systemic redistribution from the epidural space appears to account for most, but not all, of the analgesia.
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Randomized Controlled Trial Clinical Trial
Epidural scopolamine administration in preventing nausea after epidural morphine.
To determine the effectiveness of epidural scopolamine in preventing nausea and vomiting in patients receiving epidural morphine. ⋯ Epidural scopolamine can be used as an adjunct to epidural morphine in effectively reducing the incidence of postoperative nausea and vomiting.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialPain relief for thoracotomy. Comparison of morphine requirements using an extrapleural infusion of bupivacaine.
The effectiveness of a continuous infusion of extrapleural bupivacaine for relief of postoperative pain was assessed in patients undergoing posterolateral thoracotomy under general anesthesia by comparing morphine requirements. ⋯ Continuous extrapleural infusion of bupivacaine through unkinkable catheters sited during thoracotomy resulted in decreased intravenous patient-controlled analgesia use and decreased verbal categoric pain scores at rest and during movement.
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Critical care medicine · Sep 1995
Practice Guideline GuidelinePractice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit: an executive summary. Society of Critical Care Medicine.
The development of practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit (ICU) setting for the purpose of guiding clinical practice. ⋯ A consensus of experts provided six recommendations with supporting data for intravenous analgesia and sedation in the ICU setting: a) morphine sulfate is the preferred analgesic agent for critically ill patients; b) fentanyl is the preferred analgesic agent for critically ill patients with hemodynamic instability, for patients manifesting symptoms of histamine release with morphine, or morphine allergy; c) hydromorphone can serve as an acceptable alternative to morphine; d) midazolam or propofol are the preferred agents only for the short-term (< 24 hrs) treatment of anxiety in the critically ill adult; e) lorazepam is the preferred agent for the prolonged treatment of anxiety in the critically ill adult; f) haloperidol is the preferred agent for the treatment of delirium in the critically ill adult. This executive summary selectively presents supporting information and is not intended as a substitute for the complete document.