Articles: analgesia.
-
Journal of anesthesia · Jul 1993
Differences in the assessment of postoperative pain when evaluated by patients and doctors.
This study was undertaken to compare the assessment of pain intensity by 59 patients and by their doctors according to a visual analogue scale (VAS) at rest and when coughing at 5 and 20 hr after major abdominal surgery. The rating given by the patients, who received epidural analgesia to relieve postoperative pain, was significantly above, and moreover, significantly correlated with that given by the doctors at any time or under any condition of the assessment. ⋯ Our findings indicate that the assessment of postoperative pain may be associated with some unreliability, especially during early periods, when using the subjective or objective-rated VAS at rest separately, and thus requires the combined use or the concomitant use of the VAS when coughing. Substitutional use of the objective-rated VAS for the subjective-rated VAS is not advised.
-
Rev Esp Anestesiol Reanim · Jul 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Treatment of postoperative pain with intravenous PCA system. Comparison with morphine, metamizole, and buprenorphine].
To evaluate the postoperative analgesic efficacy, side effects and acceptance by patients and nurses of intravenous "patient-controlled analgesia" (PCA) with morphine, metamizole and buprenorphine. ⋯ Intravenous postoperative PCA was effective with all three drugs studied. Patient and nurse acceptance was good and side effects were few in the three groups. The lower rate of side effects for metamizole makes it the drug of choice.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Combined spinal epidural block versus spinal and epidural block for orthopaedic surgery.
In a controlled study a single segment combined spinal epidural (CSE) block was compared with spinal or epidural block for major orthopaedic surgery. Seventy-five patients, age 52-86 yr, were randomly assigned to receive one of the three blocks. Bupivacaine 0.5% was used for surgical analgesia. ⋯ Perioperative sedatives and concomitant analgesics were required more frequently and in larger doses by the patients undergoing surgery with epidural block (P < 0.05) than with CSE or spinal block. Our study demonstrated that the analgesia after surgery provided by 0.2 and 0.4 mg morphine administered intrathecally was comparable to that provided by 4.0 mg of epidural morphine. It is concluded that the analgesia and surgical conditions provided by the spinal and CSE blocks were similar and were superior to those provided by an epidural block.
-
J Vasc Interv Radiol · Jul 1993
Randomized Controlled Trial Clinical TrialRandomized double-blind clinical trial of celiac plexus block for percutaneous biliary drainage.
This study was undertaken to determine the efficacy of celiac plexus block (CPB) as a method of providing analgesia for percutaneous biliary drainage (PBD). ⋯ This study indicates that CPB is not an effective means of providing additional visceral pain relief over and above that which can be accomplished with self-administered intravenous medication for patients who undergo PBD.
-
Anesthesia and analgesia · Jul 1993
Laboratory evaluation of the Baxter Patient-Controlled Analgesia Infusor System: a disposable patient-controlled analgesia device.
The purpose of this study was to determine the accuracy of bolus-demand volumes obtained from the Baxter Patient-Controlled Analgesia Infusor System, a disposable patient-controlled analgesia device. An automated system was used to make demands in a pattern designed to simulate those made by a patient in the first 24 postoperative hours. Following this, a pattern of varying short interdemand intervals was used to evaluate performance of the device when demands were made near the nominal lockout interval of 6 min. ⋯ Evaluation near the nominal lockout interval revealed a departure of delivered volume from nominal (worst = 73.9% at an interdemand interval of 6 min). As the reservoir became exhausted, delivery increased to a maximum value, ranging from 118% to 137% of nominal, before falling to zero. In general, the devices performed consistently and the departures from nominal delivery were not considered to be of clinical significance.