Articles: analgesia.
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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.
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Acta Anaesthesiol Scand · May 1994
Comparative StudyDiclofenac sodium versus fentanyl for analgesia in laparoscopic sterilization.
The effectiveness of an anaesthetic technique employing diclofenac sodium as an analgesic given preoperatively by intramuscular injection was compared against one employing intravenous fentanyl in patients undergoing laparoscopic sterilization. Postoperative pain was marked and both drugs provided partial relief only. ⋯ These findings suggest that neither drug provides sufficient analgesia for laparoscopic sterilization when given as a sole analgesic. Investigation of a combined analgesic technique employing morphine and a non-steroidal anti-inflammatory drug is warranted.
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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.
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This self-directed learning module highlights advances in therapeutic options in pain management. It is part of the chapter on pain rehabilitation for the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This section discusses pharmacologic agents, modalities, behavioral strategies, and invasive techniques in pain management, with case studies illustrating pain management approaches in clinical practice. Advances that are covered include use of opioid receptors, receptor-specific categories of drugs used in painful conditions, components of behavioral programming for chronic pain, and the limitations of invasive techniques in chronic pain patients.
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AJR Am J Roentgenol · May 1994
Anodyne imagery: an alternative to i.v. sedation in interventional radiology.
Pain and anxiety are to be expected in patients undergoing interventional procedures, and they are usually treated by IV conscious sedation. Insufficient treatment of pain and anxiety can cause cardiovascular strain and restlessness, which may jeopardize the success of the procedure. On the other hand, pharmacologic oversedation can provoke respiratory and cardiovascular depression, thereby increasing the procedural risks and delaying the patient's recovery. We therefore evaluated a nonpharmacologic method, which we call anodyne imagery (anodyne: able to soothe or relieve pain; soothing the feelings; relaxing), as an alternative to the use of drugs in interventional radiology. ⋯ Patients having interventional radiologic procedures frequently experience intense and frightening imagery related to the procedure. Our initial experience with anodyne imagery suggests that this alternative method of analgesia can mitigate patients' anxiety and fears and reduce the amount of drugs used during interventional radiologic procedures, and thereby has the potential to improve procedural safety and increase the speed of recovery.