Articles: analgesia.
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Many patients suffering from trauma or acute illness are in need of pain treatment in the prehospital phase, a treatment they seldom receive. In Denmark, it has been considered whether ambulance personnel should be allowed to administer pain treatment. Inhalation of 50% nitrous oxide and 50% oxygen has been administered for many years by non-physicians around the world. ⋯ The few available controlled studies conducted inside the hospital have not shown significant pain-relieving effects of nitrous oxide for patients suffering from pain of acute medical of surgical origin when compared to other methods of pain treatment. Controlled studies of the effects of prehospital treatment with nitrous oxide need to be done. Technical problems and problems concerning indications, side effects, complications, pollution and possible addiction remain to be fully elucidated before prehospital treatment with nitrous oxide can be recommended for routine use in the Danish ambulances.
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J. Cardiothorac. Vasc. Anesth. · Oct 1994
Early extubation after cardiac surgery using combined intrathecal sufentanil and morphine.
The records of 10 patients who had well-preserved respiratory and ventricular function and had received 50 micrograms of sufentanil and 0.5 mg of morphine intrathecally before induction of anesthesia for cardiopulmonary bypass surgery were reviewed. Anesthesia was maintained with isoflurane and no patient received intravenous narcotics intraoperatively. ⋯ No patient required naloxone, reintubation, or treatment for respiratory depression. Combined intrathecal sufentanil and morphine provided conditions that allowed successful early extubation in 8 of 10 of these selected cardiac surgery patients.
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Int J Obstet Anesth · Oct 1994
Effect of preoperative skin infiltration with 0.5% bupivacaine on postoperative pain following cesarean section under spinal anesthesia.
Recent work suggests that preoperative skin infiltration with local anesthetic may lead to reduced postoperative pain. We have studied this in a randomised, prospective, double-blind trial of 40 women having cesarean section under spinal anesthesia. After establishment of the spinal block, the incision line was infiltrated in 20 women with 30 ml 0.5% bupivacaine and in 20 with 30 ml normal saline. There was no difference in pain scores between the 2 groups on any of the 3 postoperative days, perhaps due to the high quality analgesia provided by supplemental subarachnoid morphine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pre-emptive analgesia: comparison of preoperative with postoperative caudal block on postoperative pain in children.
We have compared in 25 children the effect of preoperative with postoperative caudal block on pain after circumcision in a double-blind, randomized study. After induction of anaesthesia, patients were allocated randomly to receive a caudal block either before (n = 14) or immediately after (n = 11) surgery. Postoperative pain was rated on a paediatric pain scale. ⋯ Using the Mann-Whitney U test (significance < or = 0.05) there was no significant difference in cumulative postoperative analgesic requirements within the first 48 h and in times to first analgesic administration between the groups. Cumulative pain score, assessed every 30 min for the first 8 h after operation, was significantly lower for those patients who received caudal anaesthesia after operation. Thus we could not demonstrate any advantage in performing caudal block before compared with after surgery.
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Am. J. Obstet. Gynecol. · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialDouble-blind comparison of intravenous butorphanol (Stadol) and fentanyl (Sublimaze) for analgesia during labor.
Our purpose was to compare the analgesic properties, effect on labor, and maternal-fetal side effects of intravenous butorphanol and fentanyl. ⋯ Both drugs were equally safe and without effect on active labor. Butorphanol provided better initial analgesia than fentanyl with fewer patient requests for more medication or epidural analgesia.