Articles: analgesia.
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Regional anesthesia · Jan 1993
Randomized Controlled Trial Comparative Study Clinical TrialThoracic epidural bupivacaine plus sufentanil: high concentration/low volume versus low concentration/high volume.
To compare the postoperative analgesic and side effects of a continuous epidural infusion of bupivacaine with sufentanil: high concentration/low volume versus low concentration/high volume. ⋯ With the thoracic epidural administration of bupivacaine and sufentanil for postoperative analgesia, the total dose is more important than the concentration or the volume of the solution.
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Randomized Controlled Trial Clinical Trial
Analgesic onset time as a measure of topical anesthetic efficacy in spontaneous toothache pain: a pilot study.
The purpose of this pilot investigation was to determine the usefulness of analgesic onset time as a measure of topical anesthetic efficacy in patients with spontaneous toothache pain. Under blinded conditions, 20 patients with spontaneous toothache pain from an open tooth cavity were randomly assigned to receive either 20% benzocaine or placebo (80% polyethylene glycol). The medication was applied directly to the open cavity in a volume of 3 drops. ⋯ In the benzocaine group, 90% of the patients reported some pain relief, while a surprisingly high 60% reported some pain relief in the placebo group. The results of this study suggest that in the spontaneous toothache pain model, analgesic onset time is a valuable measure of topical anesthetic efficacy. In addition, polyethylene glycol at a concentration of 80% may not be a totally inactive vehicle.
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Eur J Cardiothorac Surg · Jan 1993
Comparative StudyIntercostal nerve block, interpleural analgesia, thoracic epidural block or systemic opioid application for pain relief after thoracotomy?
The purpose of this study was to investigate the effect of different pain-relief methods (regional and systemic) following thoracotomies on the cardiovascular system, pulmonary gas exchange, various endocrine parameters and subjective perception. A further aspect was to evaluate the benefits of interpleural analgesia as a new regional technique against already established regional techniques, such as intercostal nerve block and thoracic epidural block. All postoperative pain methods led to a significant time-dependent reduction of the adrenaline concentrations in plasma while the noradrenaline concentrations did not change significantly. ⋯ The plasma concentrations of the "stress metabolites", such as glucose, free fatty acids and lactate, as well as the haemodynamic (mean arterial pressure, heart rate) and pulmonary parameters (blood gas analyses), showed no significant differences among groups. In contrast to the other pain-relieving methods, interpleural analgesia did not lead to sufficient pain relief in that 7 out of 10 patients needed supplementary systemic opioid therapy. Therefore, interpleural analgesia for pain relief following thoracotomies cannot be recommended.
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Cahiers d'anesthésiologie · Jan 1993
Review[Is there an advantage to using opioid combinations by the peridural route?].
Epidural opioids provide a potent analgesia not devoided of side effects. In addition, epidural administration of lipid soluble opioids has no clear advantage over the IV route. Combination of epidural opioids with other analgesics may strengthen analgesia and may decrease the incidence of side effects because of a reduction in the amount of opioid administered. ⋯ Clonidine, which is a selective alpha-2-adrenergic agonist has been demonstrated to improve and to prolong analgesia produced by opioids in postoperative patients. Clonidine administration induces side effects, like sedation, bradycardia and hypotension, but allows to highly reduce the opioid dose. None of the combined techniques of analgesia implies that monitoring of the side effects of opioids has to be reduced.