Articles: analgesia.
-
Rev Esp Anestesiol Reanim · May 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison between fentanyl and a fentanyl-bupivacaine combination using epidural PCA for postoperative analgesia after thoracotomy].
The association of opioids and local anesthetics for spinal analgesia appears to have a synergistic++ effect. ⋯ The analgesic effect obtained with epidural fentanyl or fentanyl/bupivacaine is similar and adequate, and the association of fentanyl and bupivacaine can be considered safe.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of patient-controlled analgesia in children by i.v. and s.c. routes of administration.
Sixty children undergoing appendicectomy were allocated randomly to receive one of two PCA regimens with morphine. Group IV received standard i.v. PCA with a bolus dose of morphine 20 micrograms kg-1 and a background infusion of 4 micrograms kg-1 h-1 while group SC received PCA by the s.c. route with a bolus dose of morphine 20 micrograms kg-1 and a background infusion of 5 micrograms kg-1 h-1. ⋯ PCA. By giving patients feedback on the occurrence of valid demands for analgesia, s.c. PCA may produce more appropriate and effective use of PCA.
-
Acta Anaesthesiol Scand · May 1994
Randomized Controlled Trial Clinical TrialThe effect of balanced analgesia on early convalescence after major orthopaedic surgery.
Forty-two patients scheduled for total knee arthroplasty (n = 20) or hip arthroplasty (n = 22) were randomly allocated to receive either continuous epidural bupivacaine/morphine for 48 h postoperatively plus oral piroxicam, or general anaesthesia followed by a conventional intramuscular opioid and acetaminophen regimen. Patients undergoing knee- or hip arthroplasty treated with epidural analgesia had significantly lower pain scores during mobilization under the 48 h epidural infusion compared with patients receiving conventional treatment, while no important differences were observed after cessation of the epidural regimen. ⋯ Late postoperative pain, fatigue and conservative attitudes and routines in the postoperative care, were the most important reasons limiting mobilization and activity. We conclude that effective early (48 h) postoperative pain relief with balanced analgesia does not per se lead to important improvements in convalescence and hospital stay.
-
Regional anesthesia · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of patient-assisted epidural analgesia with continuous-infusion epidural analgesia for postoperative patients.
Patient-assisted epidural analgesia, a mode of epidural analgesic delivery in which self-administered epidural boluses supplement a baseline continuous epidural infusion, was compared to continuous epidural infusion in 62 postsurgical patients. ⋯ Patient-assisted epidural analgesia can provide superior pain control as compared to continuous epidural infusions while also reducing opioid dosages. Despite the reduction in total analgesic administered no reduction in side effects was seen with this mode of administration.
-
Acta Anaesthesiol Scand · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural infusion of morphine/bupivacaine with fentanyl/bupivacaine for postoperative pain relief.
The efficacy and safety of postoperative analgesia with continuous epidural infusion of either morphine or fentanyl in combination with bupivacaine were evaluated in 85 patients, ASA physical status I or II, undergoing thoracic and/or upper abdominal surgery. Patients were treated with one of the combinations for 48 h after surgery. The morphine/bupivacaine group (MB; n = 45) received morphine at the rate of 0.2 mg.h-1, and bupivacaine at the rate of 10 mg.h-1 for the first 24 h or 5 mg.h-1 for the second 24 h; the fentanyl/bupivacaine group (FB; n = 40) received fentanyl at the rate of 20 micrograms.h-1, and bupivacaine at the rate of 10 mg.h-1 for the first 24 h or 5 mg.h-1 for the second 24 h. ⋯ No significant differences were observed between the groups in assessment of pain. The incidence of hypotension (P < 0.05) and pruritus (P < 0.05) was higher in group MB than in group FB. None of the patients developed respiratory depression in either group.