Articles: analgesia.
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The epidural route of administration can be used safely for acute and chronic pain control. Although most frequently used in the obstetrical setting, the epidural route has been used more recently for pain control in general surgical and oncology patients. Nursing policies, physician order sets and nursing documentation provide a consistent approach to patients receiving epidural analgesia. Continuous quality improvement helps to assure patient satisfaction and program quality.
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Acta Anaesthesiol Scand · Oct 1993
Case ReportsEpidural morphine for postoperative pain relief in children.
Epidural morphine for postoperative pain relief is in general use, and has proved to be very efficient in adults. The epidural technique and the use of epidural morphine are much less frequent in children. For 2 years we have prospectively followed 76 children who had epidural morphine for postoperative pain relief after major abdominal surgery. ⋯ In conclusion, the use of epidural morphine in children for postoperative pain relief is very efficient. The minimal effective dose has not been established as yet, but 50 micrograms/kg every 8 h, supplemented with small doses of bupivacaine, provides excellent analgesia in the immediate postoperative period after major abdominal surgery. The side effects are few, but the risk of respiratory depression is always present and observation in the intensive care unit or recovery for the first 24 h is strongly recommended.
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Comparative Study
Evaluation of patient controlled sedation and analgesia for ESWL.
This study was designed to evaluate the quality of sedation/analgesia and patient cooperation provided by Patient Controlled Sedation & Analgesia (PCSA) using propofol and fentanyl (Group II) when compared with anesthetist administered propofol/fentanyl (Group I) in 32 ASA I & II patients undergoing ESWL of renal or ureteric stones. Demographics of the patients and the duration of ESWL were similar in both groups. ⋯ PCSA provided a marginally higher degree of patient and surgeon satisfaction scores as compared to anesthetist administered propofol/fentanyl. Quick recovery was more consistent in the PCSA group as compared to group I patients.
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Patient-controlled analgesia (PCA) is rarely used on surgical wards despite described advantages of this method as compared to conventional techniques. Uncertainties in patient selection and insufficient evaluation of this technique may explain these circumstances. The aim of our study was to evaluate PCA on general surgery and traumatology wards by means of standardized criteria for technology assessment (i.e. safety, practicability, benefit for patients and medical staff) and the efficacy of pain relief. ⋯ A mean postoperative pain level of 55 visual analogue scale points (0-100 point scale) was achieved with tramadol/metamizol. PCA was stopped in 16% of the patients due to the occurrence of nausea or vomiting and in two patients due to insufficient pain relief. The use of piritramid in phase II led to lower pain levels and no interruptions of PCA because of ineffectivity or nausea/vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)