Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antiemetic efficacy of a droperidol-morphine combination in patient-controlled analgesia.
To evaluate the antiemetic effectiveness and side effects of adding low-dose droperidol to morphine delivered via a patient-controlled analgesia (PCA) device. ⋯ An intermittent intake of low-dose droperidol with morphine given via a PCA delivery system in two treatment groups gave evidence for a dose-response relation between the amount of droperidol added and the proportion of patients needing a rescue antiemetic. The same result applied to the proportion of patients having an emetic episode and the number of times a rescue antiemetic had to be administered. There was no evidence that the low dose of droperidol added to morphine delivered via a PCA device increased unwanted side effects.
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Regional anesthesia · Mar 1995
Comparative Study Clinical TrialPostoperative myocardial ischemia: epidural versus intravenous patient-controlled analgesia. A pilot project.
Continuous postoperative epidural analgesia with bupivacaine (BUP) and morphine (MS) may be associated with a decreased incidence of postoperative myocardial ischemia (ISCH) and infarction (MI). This study evaluated the incidence of ISCH and MI in patients with two or more risk factors for coronary artery disease (CAD) who were admitted to the ICU after upper abdominal surgery for cancer. ⋯ These preliminary results suggest that epidural anesthesia and analgesia may decrease the incidence of postoperative tachycardia, ischemia, and possibly infarction in patients undergoing upper abdominal procedures.
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Adjuvant analgesics are drugs that are not primarily used as analgesics but can produce analgesia in certain types of pain. Adjuvant analgesics can be administered together with non-opioid and opioid analgesics on each step of the WHO analgesic ladder. They should be given when an additional or specific indication exists, but should not be used as a substitute for a thorough treatment with opioids and nonopioids. ⋯ Biphosphonates (etidronate, clodronate, pamidronate derivates) also produce analgesic effects in patients with bone metastases. However, differences among the various compounds have not been clearly evaluated yet. Potent and specific radioisotopes are still under development and the use of calcitonin in bone pain is considered controversial.
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Comparative Study Clinical Trial Controlled Clinical Trial
Psychological characteristics and the effectiveness of patient-controlled analgesia.
We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping style as predictors of the effectiveness of patient-controlled analgesia (PCA) in 110 patients undergoing total abdominal hysterectomy. After operation patients were allocated to receive pain control with either PCA or i.m. injections (IMI). Pain was assessed using the short form McGill pain questionnaire at 6, 18 and 24 h after operation, and by recording the amount of analgesic consumed in the first 24 h after surgery. ⋯ Patients using PCA experienced significantly better pain control than those receiving IMI. However, it was those with high levels of state anxiety who experienced the greatest reduction in pain with PCA. In addition to achieving better pain control, patients who received PCA used significantly less analgesia and were discharged earlier than patients who received IMI.
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Anesthesia and analgesia · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia after lumbar laminectomy: epidural fentanyl infusion versus patient-controlled intravenous morphine.
We compared the efficacy and safety of continuous epidural fentanyl infusion with intravenous morphine via a patient-controlled analgesia system (IV-PCA) in the management of postoperative pain after lumbar laminectomy. Twenty patients undergoing elective lumbar laminectomy were randomly allocated to one of two groups. The epidural group (n = 10) received an epidural fentanyl infusion (2 micrograms/mL at 4-10 mL/h) while the IV-PCA group (n = 10) received IV morphine through a PCA system. ⋯ Although more patients in the IV-PCA group required urinary catheterization and had somnolence than the epidural group, there was no difference in the incidence of vomiting or pruritus. No patient developed respiratory depression or wound infection. We conclude that continuous epidural infusion of fentanyl is superior to IV-PCA morphine in the management of pain after lumbar laminectomy.