Articles: analgesia.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Hydromorphone patient-controlled analgesia (PCA) after coronary artery bypass surgery.
We conducted a study to compare the effectiveness of patient-controlled analgesia (PCA) technique to conventional analgesic therapy (CAT) after coronary artery bypass graft (CABG). The PCA group received hydromorphone 0.1 mg.hr-1 basal infusion and bolus doses of 0.2 mg Q 5 min (maximum 1.2 mg.hr-1) while the CAT group received morphine 2.5 mg iv Q 30 min prn until extubation followed by prn meperidine 1 mg.kg-1 im Q 4 hr or acetaminophen 325 mg with codeine 30 mg po (1 or 2 tablets) when oral intake was possible. The degree of pain was assessed using a Visual Analogue Scale (VAS) starting after extubation and every 6-8 hr for the next 60 hr. ⋯ During the third postoperative day, the PCA group had a lower VAS pain score, a lower incidence of severe pain defined as a score > 5 on the VAS scale, and a reduced incidence of myocardial ischaemia (P < 0.01). However, there was no difference in the duration, severity, area under the curve (AUC), or heart rate during ischaemic events. Postoperative pulmonary function was abnormal in both groups (NS) with minimal recovery by the fourth day.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Randomized Controlled Trial Clinical Trial
Intravenous ketorolac as an adjuvant to pediatric patient-controlled analgesia with morphine.
To assess the effects of a single intraoperative dose of intravenous (i.v.) ketorolac on postoperative opioid dose requirements, quality of analgesia as assessed by the patient, and frequency of opioid-related side effects during pediatric patient-controlled analgesia (PCA) with morphine. ⋯ A single intraoperative dose of i.v. ketorolac appears to be opioid dose sharing, to provide superior analgesia, and to decrease the frequency of urinary retention during the first 12 hours of postoperative pediatric PCA with morphine.
-
Randomized Controlled Trial Clinical Trial
Anesthetic-postoperative morphine regimens for cesarean section and postoperative oxygen saturation monitored by a telemetric pulse oximetry network for 24 continuous hours.
To document the effects of compromised respiratory function on oxygen saturation (SpO2) after cesarean section via the telemetric pulse oximetry network (TPON) for 24 continuous hours. ⋯ All 3 regimens risked low SpO2, with the EA/EM regimen having the highest risk but the best analgesia. Neither general nor epidural anesthesia combined with postoperative parenteral morphine influenced SpO2 postoperatively. In this study, the TPON provided a feasible method of detecting hypoxemia early on in the general ward setting.
-
To examine the determinants of epidural analgesia in the active management of labor. To examine the association of epidural with instrumental delivery and cesarean section. ⋯ The use of oxytocin in active management of labor results in a high demand for epidural when this is available on demand. This, however, need not be associated with an increased incidence of operative delivery.
-
The present study examined the ability of a taste cue to serve as a conditioned stimulus (CS) for conditioning the analgesic effect of morphine. Rats were given three pairings of a taste CS with a morphine unconditioned stimulus (US). As expected, there was a decrease in CS intake across repeated pairings, indicating that a conditioned taste aversion was obtained. ⋯ Using 15 mg/kg morphine, however, both conditioned taste aversion and conditioned analgesia were present when the morphine US was given immediately following CS intake, but not when given 6 h following CS intake. In contrast to morphine, pairing a taste CS with lithium produced a conditioned taste aversion without any conditioned analgesic response. These results indicate that acquisition of an analgesic CR is not the result of stress induced by an aversion to the taste CS.