Articles: analgesia.
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Randomized Controlled Trial Clinical Trial
[Effect of indomethacin as an adjunct to postoperative pain relief by continuous epidural infusion of bupivacaine and buprenorphine].
We examined the analgesic effects of indomethacin as an adjunct to postoperative epidural analgesia in 40 patients who underwent upper abdominal surgery. Twenty patients in control group were epidurally given 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine immediately after surgery and subsequently infused 15 micrograms buprenorphine in 1 ml of 0.25% bupivacaine at a rate of 1 ml.h-1 for 48 h. ⋯ The patients who did not need additional narcotics in the control and indomethacin groups were 45% and 80%, respectively (P < 0.05). In upper abdominal surgery, postoperative pain relief by epidural buprenorphine and bupivacaine plus rectal indomethacin was more effective than that by epidural buprenorphine and bupivacaine.
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Laboratory animal science · Oct 1994
Epidural catheter placement for testing of obstetrical analgesics in female guinea pigs.
The pregnant guinea pig may be a useful model for the study of drug effects in the newborn. A reliable technique for epidural catheterization in the guinea pig was developed to allow use of this model to evaluate the effects of epidural labor analgesics on neonates. Catheters were implanted in two open pilot animals and 19 time-dated pregnant animals on days 59 to 62 of gestation. ⋯ Failed catheters were either subdural, with one catheter found to be penetrating the spinal cord (intraspinal), or intramuscular. Response to epidurally administered bupivacaine was variable but was typically characterized by normal alertness and ability to use the forelimbs; depression of the panniculus reflex in the dorsal lumbar region; and hind limb motor impairment, with ataxia, loss of the placing reflex, and a tendency to drag the hind limbs. Subdural placement was associated with CNS depression, recumbency, shallow breathing, and sensory block ascending to the level of the ears.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anaesth Intensive Care · Oct 1994
Pharmacokinetics of bupivacaine enantiomers during interpleural infusion.
Interpleural infusions (24 hr) were given to 14 adults (29-81 yr) having surgery via right subcostal incisions. Patient-controlled analgesia with morphine was also available for 72 hours following surgery. An infusion of 0.25% bupivacaine with adrenaline 1/400,000 was commenced at 0.1 ml/kg/hr at the conclusion of surgery after an initial 20 ml bolus. ⋯ The total body clearance of each enantiomer was reduced during the 24 hours (P < 0.001). No relationship between pharmacokinetic parameters and weight, age or sex was found (P > 0.25 for each). Variation between patients was reduced when parameters were estimated for the free (unbound) bupivacaine (P < 0.001).