Articles: analgesia.
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When local anesthetic is used to produce epidural anesthesia intraoperatively, epidural catheter placement is confirmed. However, when epidural catheters are placed intraoperatively only to provide postoperative opioid analgesia, correct catheter placement may not be confirmed by administration of a local anesthetic. The current study tests the hypothesis that the extent of sensory blockade produced by a 10-ml dose of 1.5% lidocaine can be used to predict the adequacy of epidural opioid analgesia. ⋯ Extensive sensory block from 10 ml 1.5% lidocaine was associated with excellent epidural opioid analgesia. Extent of analgesia after a 10-ml test dose of 1.5% lidocaine can be used to predict the adequacy of analgesia resulting from an epidural opioid infusion. The failure of a local anesthetic dose to produce sensory blockade does not necessarily predict a failure to produce analgesia from an epidural opioid infusion, as indicated by the presence of analgesia in several patients without detectable sensory block.
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Int J Obstet Anesth · Jul 1995
Sequential spinal epidural analgesia for pain relief in labour: an audit of 620 parturients.
This investigation was designed to evaluate sequential spinal epidural analgesia with a needle through needle technique for pain relief in labour. The spinal injection was made using a Becton Dickinson 29 gauge Quincke point needle. Bupivacaine 1 mg, sufentanil 5 microg and adrenaline 25 microg (2 ml) were injected intrathecally. ⋯ Of the 620 parturients in the investigation, 500 had a mean dose of 4.3 mg bupivacaine per hour. Hypotension and paresis were of no concern. Patient satisfaction was excellent, 85% of the parturients being very satisfied and 10% satisfied.
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Postoperative pain therapy often appears to be inadequate in children. The present study was a retrospective investigation of the administration of analgesics given to 133 children and adults following surgery for funnel chest between 1983 and 1994. ⋯ Children received smaller quantities of narcotics than adults when postoperative analgesia was performed with PRN administration. PCA led to delivery of larger quantities of narcotic drugs than PRN medication in children.
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Minerva anestesiologica · Jul 1995
Randomized Controlled Trial Comparative Study Clinical Trial[Patient-controlled postoperative analgesia in orthopedic surgery: epidural PCA versus intravenous PCA].
To evaluate both effectiveness and incidence of side effects of two techniques of postoperative pain treatment: intravenous and epidural PCA. ⋯ Our data show a better control of postoperative pain arising from total hip replacement during PCEA when compared to PCA. It should be emphasized that incident pain is far more decreased by PCEA, so that this technique is particularly indicated when an early postoperative mobilization is required.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of droperidol and cyclizine in the prevention of postoperative nausea and vomiting associated with patient-controlled analgesia.
Fifty ASA 1 or 2 patients scheduled to undergo major gynaecological surgery were allocated randomly to one of two groups. All patients received a standard anaesthetic regimen. Patients in group 1 received droperidol 1.25 mg given intravenously 20 min prior to the end of surgery and a patient-controlled analgesia infusion containing morphine 1 mg.ml-1 and droperidol 0.05 mg.ml-1. ⋯ Fifteen of 25 patients (60%) in group 1 and 18 (72%) of 25 in group 2 suffered no nausea or vomiting postoperatively. Two patients (8%) in group 1 and three (12%) in group 2 suffered severe postoperative nausea or vomiting. We conclude that cyclizine is as effective as droperidol in the prevention of postoperative nausea and vomiting when included in a patient-controlled analgesia infusion using morphine.