Articles: analgesia.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative analgesia with transdermal fentanyl following lower abdominal surgery.
In a randomised, placebo-controlled, double-blind study involving 81 patients undergoing total abdominal hysterectomy, the postoperative analgesia provided by transdermal fentanyl given at 25, 50, or 75 micrograms.h-1 for 72 h was compared with a placebo group. The efficacy of the Transdermal Therapeutic System was related to the rate of fentanyl delivery, higher rates being associated with significantly lower visual analogue pain scores (24, 20, 17 and 13, for placebo, 25, 50 and 75 micrograms.h-1 respectively) and reduced patient controlled analgesia morphine requirements (44, 38, 33 and 31 mg respectively). Patients' overall sedation scores were not increased by transdermal fentanyl, but respiratory rates decreased with higher transdermal fentanyl dosage.
-
Pediatric emergency care · Apr 1995
Randomized Controlled Trial Clinical TrialEfficacy of oral ketamine for providing sedation and analgesia to children requiring laceration repair.
A prospective, double-blind, placebo-controlled, randomized clinical trial was conducted to study the efficacy of oral ketamine for providing sedation and analgesia to children during laceration repair. Thirty children between the ages of one and seven years with lacerations that required suturing were randomly assigned to receive either oral ketamine (10 mg/kg) or an identically flavored placebo syrup prior to suturing. Patients were assessed by means of a tolerance score reflecting behavioral correlates of perceived pain at the time of both lidocaine injection and suturing. ⋯ The ketamine-treated group also achieved a significantly greater degree of sedation (P = 0.012). No significant respiratory or circulatory adverse effects were seen in either group, although 26% of patients who received ketamine experienced minor, transient adverse effects. We conclude that oral ketamine in a dose of 10 mg/kg provides effective sedation and analgesia to young children undergoing wound repair.
-
Randomized Controlled Trial Clinical Trial
Self-administered intranasal meperidine for postoperative pain management.
Recent studies have demonstrated that intranasal is comparable to intravenous opioid titration in its pain-relieving effect. In these studies, however, the intranasal opioid titration was performed by the investigator, and the treatment period was two hours or less. The purpose of this randomized, prospective study was to investigate whether intranasal opioid administration by the patients themselves for a prolonged postoperative period may be regarded as a therapeutic alternative for postoperative pain management. ⋯ The meperidine requirement was 112.9 +/- 81.3 mg in the nasal and 103.4 +/- 41.5 mg in the sc group (NS). Two patients in each group complained of nausea and vomiting. Thirteen of the 21 nasal and nine of the 15 sc patients who completed the final questionnaire rated the pain management as excellent or good (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Clinical Trial
Analgesia after caesarean section. The use of rectal diclofenac as an adjunct to spinal morphine.
A double-blind placebo-controlled study was performed to assess the analgesic effect of rectal sodium diclofenac 100 mg after Caesarean section using subarachnoid hyperbaric bupivacaine 0.5% and morphine 0.2 mg. During the 48 h follow-up period, both placebo and diclofenac groups had comparable analgesia as measured by visual analogue scores (VAS) at rest and on movement. However, diclofenac prolonged the mean time to first analgesia by more than 5 h from 13 h 45 min in the placebo group to 18 h 58 min (p < 0.03). The incidence of side effects (nausea, vomiting, itching, excessive lochia loss and the need for additional analgesia) were comparable in each group.
-
Clinical Trial
Transdermal fentanyl in combination with initial intravenous dose titration by patient-controlled analgesia.
Two studies including a total of 70 patients evaluated the efficacy and side effects of a combination of initial patient-controlled analgesia (PCA) for dose finding with transdermal fentanyl administration. Patients, requiring strong opioids for severe cancer pain, received intravenous (i.v.) fentanyl on an on-demand basis over a 24 h period. The amount of fentanyl administered was then used for selecting a suitable transdermal therapeutic system (TTS), which remained in place for 72 h. ⋯ A respiratory rate below 8 per minute was observed in three patients. Due to adequate symptomatic treatment, other moderate and severe symptoms were relatively rare. TTS fentanyl was shown to be an effective, safe and simple method for long-term pain relief in cancer patients and presents an interesting novel option in the treatment of cancer pain.