Articles: analgesia.
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Randomized Controlled Trial Clinical Trial
Preemptive opioid analgesia does not influence pain after abdominal hysterectomy.
Opioid administration before surgical stimulus may reduce or prevent subsequent pain. We studied the effect of timing of opioid administration on the pain-related behaviour after abdominal hysterectomy. Eighty-five patients scheduled for abdominal hysterectomy were blindly randomized to receive fentanyl 10 micrograms.kg-1 before induction of anaesthesia (FA), after peritoneal incision (FB) or after removal of the uterus (FC), or sufentanil 1 micrograms.kg-1 before induction of anaesthesia (SA) or after peritoneal incision (SB) respectively. ⋯ The times from skin closure to the first analgesic request did not differ among the five groups. The VAS scores using the two-way ANOVA with repeated measurements differed among the five groups (F = 4.046, df = 4, 213, P < 0.005). The VAS scores with one-way ANOVA differed among the five groups 30 min postoperatively (F = 4.542, df = 4, 58, P < 0.003), being higher in the FA (6.5 +/- 1.8) and SA (5.9 +/- 2.1) groups than in the FC (3.2 +/- 2.5) group, and at 120 min postoperatively (F = 3.217, df = 4, 18, P < 0.05), being higher in the FA than in the FB group (6.1 +/- 1.5 and 2.6 +/- 1.9 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Feb 1995
Randomized Controlled Trial Clinical TrialDesflurane analgesia for vaginal delivery.
The use of subanaesthetic concentration of inhalational anaesthetic for vaginal delivery offers many advantages to the mother and newborn. Desflurane, with the characteristics of rapid onset and minimal metabolism, may provide better analgesia and safety for labour pain control. Eighty healthy parturients were randomly assigned to receive either desflurane 1.0-4.5% and oxygen (n = 40) or nitrous oxide 30-60% in oxygen (n = 40). ⋯ Blood loss did not differ significantly, 364 ml for the desflurane group and 335 ml for the nitrous oxide group. There were no significant differences for neonatal Apgar score at 1 min or at 5 min or the NACS at 2 hr or 24 hr between the two groups. We conclude that desflurane in subanaesthetic doses is safe and effective inhalation agent for normal delivery but might be associated with amnesia.
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Clinical Trial
[Postoperative pain relief by patient controlled analgesia using intravenous pentazocine].
Patient controlled analgesia (PCA) by intravenous pentazocine was performed to determine its efficacy and the dose required for the pain relief after gynecological or obstetric operations. After obtaining informed consent, studies were performed on 28 female patients (ASA I, II: Mean age 38.1 years: Mean weight, 53.8 kg) who had received gynecological or obstetric operations with lower abdominal incision. Anesthesia given was nitrous oxide and isoflurane combined with epidural anesthesia with 1% mepivacaine used only during the operation. ⋯ Evaluation of PCA by the patients after the procedure showed excellent (13 patients) good (12) and passable (3) analgesia. No significant complication was observed except temporary nausea in two patients. Satisfactory postoperative pain relief could be obtained by relatively small doses of pentazocine and adverse reactions related especially to sigma receptor could be avoided.
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patient-controlled analgesia PCA is a rapidly spreading approach to the management of post-operative pain. The suitability of this method for the morbidly obese patient undergoing bariatric surgery has not yet been determined. ⋯ use of PCA in patients undergoing bariatric surgery has obvious advantages and appears to be a safe procedure.
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Acta Anaesthesiol Scand · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialIntramuscular ketorolac following total hip replacement with spinal anaesthesia and intrathecal morphine.
We have studied the analgesic and morphine sparing effect of ketorolac tromethamine in 60 patients after total hip replacement under spinal anesthesia. In this double blind study 30 patients received ketorolac 30 mg IM 6 hourly postoperatively and the control group received saline. Analgesia was assessed by visual analogue pain scores (VAS) and morphine consumption by patient controlled analgesia (PCA). ⋯ Although there was a trend for lower VAS on the first postoperative night this was only significant at 10 hours postoperatively and the next morning at 08:00 hr. The incidence of side effects (emetic sequelae, pruritus and headache) were similar in both groups. It is concluded that ketorolac reduces the consumption of additional morphine in conjunction with intrathecal morphine but had no effects on the side effects.