Articles: analgesia.
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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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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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Anaesth Intensive Care · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled analgesia: a comparison with nurse-controlled intravenous opioid infusions.
Patient-controlled analgesia (PCA) with intravenous pethidine was compared with nurse-controlled pethidine infusions for pain relief in 200 patients after major abdominal or thoracic surgery. Pain, level of sedation, nausea and presence of other adverse effects, in addition to cumulative pethidine requirement, were measured for the first 24 hours after surgery. Both groups were similar for age, weight and type of surgery. ⋯ The frequency and severity of adverse effects was also similar. The cumulative pethidine dose administered to both groups was identical. It is concluded that nurse-controlled opioid infusions are as effective as PCA and may be used as an alternative to PCA where this is either unavailable or unsuitable.
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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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Randomized Controlled Trial Comparative Study Clinical Trial
Post-circumcision analgesia: comparison of topical analgesia with dorsal nerve block using the midline and lateral approaches.
Forty-five patients undergoing circumcision were allocated randomly to one of three study groups to compare topical analgesia with dorsal nerve block using the midline or lateral approach. Pain scores, side effects and analgesic requirements were recorded after surgery. ⋯ Fentanyl requirements and pain scores were similar in patients who received a dorsal nerve block using either the midline or lateral approach. The incidence of side effects after surgery was similar in all three groups.