Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal or systemic analgesia after extensive spinal surgery: comparison between intrathecal morphine and intravenous fentanyl plus clonidine.
To compare two different methods of postoperative analgesia after extensive spinal fusion. ⋯ This study shows that there is a major risk of respiratory depression with a single intrathecal dose of morphine 0.3 mg to control postoperative pain after scoliosis surgery. Systemic clonidine-fentanyl may be a possible approach to the postoperative pain treatment of this surgery.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialTramadol in labour pain in primiparous patients. A prospective comparative clinical trial.
The analgesic efficacy and safety of tramadol 50 mg, 100 mg and pethidine 75 mg, administered intramuscularly were compared in a randomized, double-blind clinical trial in 90 pregnant women with labour pain. Pain relief was measured by a 4-point verbal rating scale 10, 20, 30, 45 and 60 min after the administration of study drugs. ⋯ In comparison to both tramadol doses the administration of pethidine was associated with a significantly higher frequency of adverse events and a significantly lower respiratory rate in the neonates. The results indicate that tramadol 100 mg is as effective as pethidine 75 mg but has a superior safety profile.
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Randomized Controlled Trial Clinical Trial
Intrathecal sufentanil for labor analgesia. Effects of added epinephrine.
Intrathecal sufentanil has been found to provide profound analgesia during labor. Epinephrine, when added to various local anesthetic agents or opioids, may modify the analgesic profile and incidence of side effects. The authors sought to determine the effect of adding 0.2 mg epinephrine to 10 micrograms sufentanil when administered for analgesia during labor. ⋯ Intrathecal sufentanil 10 micrograms, both with and without epinephrine, provided rapid-onset, albeit short-duration, analgesia during labor. Epinephrine did not prolong the duration of intrathecal sufentanil analgesia. The addition of epinephrine increased the incidence of nausea and decreased the incidence and severity of pruritus.
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Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialEpidural clonidine decreases postoperative requirements for epidural fentanyl.
This study assesses the possibility that clonidine may decrease analgesic opioid demand in postoperative patients. ⋯ The combination of clonidine to epidural fentanyl allows a decrease in opioid requirements without impairing analgesia. Reduction of opioids administration may have beneficial effects on respiratory function in postoperative patients.
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Eur. J. Obstet. Gynecol. Reprod. Biol. · May 1993
ReviewUpdate on epidural analgesia during labor and delivery.
Properly administered epidural analgesia provides adequate pain relief during labor and delivery, shortens the first stage of labor, avoids adverse effects of narcotics, hypnotics, or inhalation drugs and it could be used as anesthesia in case a cesarean section is required. Epidural analgesia should be provided to all patients who need and ask for it with an exception of contraindications such as coagulation disorders, suspected infection or gross anatomic abnormality. ⋯ Supplementation of an opioid (mainly fentanyl) and introduction of the patient controlled epidural pump may not only serve this goal, but also reduce the demands on the time of obstetric anesthetists. We conclude that properly and skillfully administered epidural is the best form of pain relief during labor and delivery and we hope that more mothers could enjoy its benefits.