Articles: analgesia.
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Cancer pain treatment is well established. The World Health Organization provides clinicians an "analgesic ladder" scheme to optimize cancer pain treatment. At the beginning of the pain treatment, oral analgesic administration is preferred. ⋯ Based on this experience, the generally accepted indications for the technique appeared to be justified. Concern about spinal infection is well considered, however. Three out of those patients developed meningitis, a complication rate that is far too high.
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J Pain Symptom Manage · Feb 1994
ReviewCognitive-behavioral interventions for children's distress during bone marrow aspirations and lumbar punctures: a critical review.
Children with cancer often have difficulty coping with the invasive medical procedures that are part of diagnosis and treatment. Bone marrow aspirations and lumbar punctures are painful and cause some children severe anxiety and distress. The increased risk and expense of general anesthesia and the relative ineffectiveness of sedatives and anxiolytics has prompted clinicians to examine nonpharmacologic methods for controlling pain and distress. This report critically examines intervention studies that focus on cognitive-behavioral strategies such as distraction, imagery, or hypnosis for reducing procedural distress in children with cancer.
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Pain is a major problem and primary concern of patients in the ICU. While nonintubated patients can verbalize their discomfort to healthcare providers, intubated patients cannot effectively communicate and are more at risk for inadequate analgesia. Mechanically ventilated, paralyzed patients are at even greater risk for inadequate control of pain. ⋯ A number of techniques are available, ranging from nonsteroidal anti-inflammatory drugs to other techniques and medications. However, analgesia usually requires the use of exogenous opioids. The most critically ill, mechanically ventilated patient receiving controlled alveolar minute ventilation is a candidate for continuous infusion of intravenous narcotics.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Feb 1994
Randomized Controlled Trial Clinical TrialAlfentanil or fentanyl during isoflurane-based anaesthesia for day-care knee arthroscopy?
Forty patients agreed to participate in a study to compare whether fentanyl or alfentanil used as analgesic is associated with quicker recovery following anaesthesia for outpatient arthroscopy procedure. Psychomotor tests including choice reaction time (CRT), perceptive accuracy test (PAT) and finger tapping test (FTT) were done prior to induction of anaesthesia with propofol (2-3 mg.kg-1). Patients were then divided into two groups: Group F (fentanyl) received 0.1 mg fentanyl prior to start of surgery and thereafter 0.05 mg every 30 min during the procedure. ⋯ Clinical recovery and time to discharge home ("home ready") were also significantly longer in Group F. There was no difference in recovery as seen in the PAT and CRT between the groups. Also, there was no difference in the incidence of side effects and the pain intensity (VAS) scores were similar in the two groups at all time periods.(ABSTRACT TRUNCATED AT 250 WORDS)