Articles: analgesia.
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Intrathecal opioids and the combined spinal/epidural technique provide new tools for the obstetrical anesthesiologist. With intrathecal opioids, we can rapidly and safely relieve the pain of labor without maternal sedation or motor blockade. Intrathecal sufentanil 10 micrograms provides 1 to 2 hours of excellent analgesia during the first stage of labor. ⋯ Unless morphine is used, the side effects induced by intrathecal opioids are usually mild and easily treated. In our practice, combined spinal/epidural labor analgesia has rapidly gained wide acceptance by patients, nurses, obstetricians, and anesthesiologists. Continuous spinal analgesia, although theoretically appealing, requires further refinement.
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Randomized Controlled Trial Clinical Trial
Intravenous ketorolac as an adjunct to patient-controlled analgesia (PCA) for management of postgynecologic surgical pain.
To determine whether intravenous (IV) doses of ketorolac tromethamine provide safe and effective augmentation of postsurgical analgesia for patients using IV patient-controlled analgesia (PCA) with morphine. ⋯ IV ketorolac used as an analgesic adjunct provided safe and effective augmentation of PCA with morphine in patients recovering from intra-abdominal gynecologic surgery.
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Randomized Controlled Trial Clinical Trial
Use of ketorolac after lower abdominal surgery. Effect on analgesic requirement and surgical outcome.
Ketorolac is a nonsteroidal antiinflammatory agent with opioid-sparing properties. The effect of ketorolac on postoperative opioid analgesic requirement and surgical outcome was evaluated in 198 women after abdominal hysterectomy procedures using a double-blind protocol design. ⋯ The authors conclude that the opioid-sparing effects of ketorolac contributed few clinically significant advantages after abdominal hysterectomy procedures.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Clinical TrialSensory, motor, and sympathetic block during epidural analgesia with 0.5% and 0.75% ropivacaine with and without epinephrine.
Ropivacaine is a new long-acting local anesthetic, with vasoconstrictive properties. The purpose of this randomized, double-blind study was to evaluate sensory, motor, and sympathetic block following epidural anesthesia, and the influence of the addition of epinephrine. ⋯ Ropivacaine given epidurally provided adequate sensory anesthesia and motor block for transurethral surgery. Addition of epinephrine did not provide any significant prolongation of the sensory or motor block, nor any influence upon the sympathetic block.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural bupivacaine for aortic surgery. The effect of dilution on the quality of analgesia.
Twenty patients undergoing elective abdominal aortic aneurysm repair were randomly allocated to two groups and studied for 24 h following surgery. Postoperative analgesia was provided by epidural bupivacaine infusion and intravenous patient-controlled 0.05 mg boluses of alfentanil. ⋯ Patients receiving 7 ml.h-1 of epidural infusate required more doses of alfentanil (median 26.5, range 0-50) than the group receiving 25 ml.h-1 of the dilute infusion (median 3.0, range 0-16). It is concluded that 17.5 mg.h-1 of bupivacaine infused into the epidural space produces better analgesia when infused in a volume of 25 ml.h-1 (0.07%) than when given in a volume of 7 ml.h-1 of solution (0.25%).