Articles: analgesia.
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The practice of obstetric anaesthesia can be highly rewarding. The clinician prepared with an understanding of maternal-fetal physiology (obstetric requirements), systemic narcotics, and regional anaesthesia can be highly effective at relieving pain and bringing about a successful delivery. While alternative techniques should always be considered, particularly those that stress childbirth education, continuous lumbar analgesia remains the most flexible and satisfactory approach. While there is new equipment (fine needles and smaller catheters) on the horizon, it remains to be demonstrated if they can match the success and safety record of present lumbar epidural practice.
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Regional anesthesia · May 1992
Randomized Controlled Trial Clinical TrialEffect of epidural analgesia on colorectal anastomotic healing and colonic motility.
To examine the effect of epidural local anesthetic and narcotic agents on colonic anastomotic healing. ⋯ These findings suggest in this model that postoperative epidural analgesia is a safe technique after colorectal resection and anastomosis.
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Numerous postoperative analgesic therapies are continuing to develop as interest increases in the control of acute pain, particularly within the specialty of anaesthesia. Further progress will be made in the near future in relation to preemptive analgesia and reduction of postoperative pain by controlling spinal cord plasticity.(41,42) The concept of multimodal or balanced analgesia(43) in which the combined use of specific agents blocking specific segments of the pain pathway is another area which may provide improvements in postoperative analgesia.
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Randomized Controlled Trial Clinical Trial
Epidural pethidine and bupivacaine in labour.
A double-blind randomised study was performed to assess the value of the addition of pethidine 50 mg to the initial dose of bupivacaine given for epidural analgesia in labour. Forty-nine patients received either 1 ml of saline (n = 24), or 50 mg of pethidine (n = 25), added to 9 ml of 0.25% bupivacaine as an initial injection for intrapartum epidural analgesia. There was a significant increase in the mean duration of analgesia in the pethidine group. However, pethidine did not increase the speed of onset of analgesia, or improve the quality of analgesia.