Articles: analgesia.
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Acta Anaesthesiol Scand · Jan 1995
Multicenter StudyMaternal expectations and experiences of labour pain--options of 1091 Finnish parturients.
A prospective survey of 1091 Finnish parturients was conducted in order to ascertain mothers' expectations for labour pain relief, to measure the actual pain during all three stages of labour and to question their satisfaction and the adequacy of pain relief on the third day following delivery. Antenatal expectations for pain relief were surveyed. Mothers were questioned on pain levels in the delivery room and 3 days after giving birth. ⋯ In the delivery room over 80% of all parturients described their pain as very severe to intolerable, only 4% of the multiparous had low pain scores (0-2). After pain treatment 50% of multiparous women still had pain scores from 8 to 10, which reflects a lack of effective pain relief. Dissatisfaction with the childbirth experience was very low, and was associated with instrumental deliveries, but not with the usage of analgesia. 51% of all parturients complained of inadequate pain relief during childbirth, which, in multiparous women, was significantly associated with the second stage of labour.
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Paediatric anaesthesia · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialA comparison between ilioinguinal-iliohypogastric nerve block performed by anaesthetist or surgeon for postoperative analgesia following groin surgery in children.
A study was performed to compare postoperative analgesia in children undergoing groin surgery. Patients were randomly allocated to receive ilioinguinal-iliohypogastric (I-I) nerve blocks using 0.25% plain bupivicaine (0.5 ml.kg-1) performed either percutaneously by the anaesthetist after the induction of general anaesthesia, before surgery commenced, or intraoperatively, under direct vision, by the surgeon. ⋯ Statistical analysis of the results revealed no difference in pain score between groups treated either by anaesthetist or surgeon. However, children under two years of age had significantly higher pain scores than those over two.
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Paediatric anaesthesia · Jan 1995
Comparative StudyIntrathecal morphine (ITM) for postoperative pain control in children: a comparison with nalbuphine patient controlled analgesia (PCA).
This is a retrospective study covering the ten-year period 1984-1993. Single shot spinal morphine (ITM) is compared with PCA nalbuphine for postoperative pain relief in children having abdominal or thoracic procedures. The records of 52 patients meeting selection criteria were examined. ⋯ No difference in duration of hospital stay or ICU stay could be demonstrated. We conclude that ITM provides better pain relief, without more serious complications, than PCA nalbuphine. We recommend it as a safe, effective technique to treat postoperative pain in children following thoracic or upper abdominal procedures.
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A new regimen for postoperative analgesia after thoracic surgery is proposed. Eight children received an interpleural infusion using bupivacaine 0.1% in a regimen from 0.5 ml.kg-1.h-1 up to 1 ml.kg-1.h-1, for 48 h according to the pain scores. The plasma levels after 24 h and 48 h were measured as well as the pleural level and in two patients the free fraction of plasma bupivacaine and the plasma PPX (a metabolite of bupivacaine) and one patient the orosomucoid (main plasma protein involved in bupivacaine protein binding) were also measured pre and postoperatively. The results shows the safety of such a regimen, for two days of postoperative analgesia.
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Paediatric anaesthesia · Jan 1995
The safety of continuous pleural lignocaine after thoracotomy in children and adolescents.
Several studies have proven pleural bupivacaine effectively provides postthoracotomy analgesia for both children and adults. When 0.25% bupivacaine is administered as a continuous infusion or repeated bolus, serum bupivacaine levels frequently approach the toxic range. The hazards of bupivacaine toxicity are more difficult to monitor, especially in children who may not report symptoms of local anaesthetic toxicity. ⋯ Seven patients had lignocaine levels that exceeded 5 micrograms.ml-1 and no patient manifested symptoms of systemic toxicity. This study shows that the administration of pleural lignocaine is a safe method of providing postthoracotomy analgesia. Lignocaine infusions in the dosage range of 20 to 40 micrograms.kg-1.min-1 rarely produce toxic levels, and monitoring of lignocaine levels every 12 h is an effective method of screening for toxicity.