Articles: analgesia.
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Randomized Controlled Trial Clinical Trial
Meperidine for patient-controlled analgesia after cesarean section. Intravenous versus epidural administration.
Although meperidine has been used for patient-controlled analgesia both intravenously (PCIA) and epidurally (PCEA), these routes have not been compared, and many studies have suggested that there is no advantage to the epidural route for administration of lipophilic opioids. ⋯ We conclude that after cesarean section, PCEA with meperidine produces high-quality pain relief with few side effects and has significant advantages over PCIA meperidine. With the caveat that neonatal effects in breast-feeding mothers have yet to be evaluated, it can be highly recommended in this population.
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Randomized Controlled Trial Clinical Trial
Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are in spontaneous labor?
Some studies suggest that epidural analgesia prolongs labor and increases the incidence of cesarean section, especially if it is administered before 5 cm cervical dilation. The purpose of the current study was to determine whether early administration of epidural analgesia affects obstetric outcome in nulliparous women who are in spontaneous labor. ⋯ Early administration of epidural analgesia did not prolong labor, increase the incidence of oxytocin augmentation, or increase the incidence of operative delivery, when compared with intravenous nalbuphine followed by late administration of epidural analgesia, in nulliparous women who were in spontaneous labor at term.
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Patients want safe and effective analgesia. Our goal is to prevent postoperative pain in an efficient and cost effective manner. For most patients, the pain can be managed using simple, non-invasive and inexpensive analgesic techniques. ⋯ There will be pressure to discharge patients as soon as they are able to take oral medications. Outpatient analgesia is the oldest and most widespread form of patient-controlled analgesia--We already have the knowledge and the analgesics necessary to prevent postoperative pain. What we need now is logical, rational, and universal application of this information.
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J Am Osteopath Assoc · Jun 1994
Intraspinal delivery of opiates by an implantable, programmable pump in patients with chronic, intractable pain of nonmalignant origin.
The use of intraspinal therapy for the management of intractable pain from nonmalignant causes has not been widely discussed. An implantable, externally programmable infusion pump was used for intraspinal delivery of morphine sulfate to 15 patients with intractable pain from reflex sympathetic dystrophy, arachnoiditis after spinal surgery, or an unknown cause. Dosage patterns were individualized. ⋯ Two patients chose to terminate therapy. Few complications occurred, but most patients needed increasingly larger doses over time to maintain pain relief. Intraspinal infusion of morphine sulfate by use of an implanted, externally programmable pump is safe and effective in selected patients with intractable pain of nonmalignant origin.
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Randomized Controlled Trial Clinical Trial
Analgesic effects of intraarticular bupivacaine after day-case arthroscopy.
A blind, prospective, randomized, controlled trial was conducted to assess the analgesic properties of intraarticular bupivacaine after day-case arthroscopy. Forty-eight patients undergoing routine arthroscopy were randomly allocated to receive 10 ml of 0.5% bupivacaine or 0.9% saline into the joint at the end of the procedure. The analgesic effects were assessed by visual analogue scales at discharge, on going to bed, and the following morning. Significant reduction in reported pain was found in the treatment groups on leaving the hospital and later the same evening, although no benefit was found the following day.