Articles: analgesia.
-
J. Cardiothorac. Vasc. Anesth. · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialCoronary artery bypass grafting using two different anesthetic techniques: Part 3: Adrenergic responses.
Twenty patients were studied during and after coronary artery bypass grafting (CABG). The patients were randomly assigned to two groups. In 10 patients, intraoperative general anesthesia (GA) was based on a combination of intravenous (IV) sufentanil and midazolam. ⋯ It can be concluded that better hemodynamic stability during the prebypass and bypass periods was accompanied by less E and NE release during these periods. Co release in the TEA group was higher during the bypass period. Weaning from bypass was characterized by better hemodynamics in the TEA group.(ABSTRACT TRUNCATED AT 250 WORDS)
-
J. Cardiothorac. Vasc. Anesth. · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialCoronary artery bypass grafting using two different anesthetic techniques: Part 2: Postoperative outcome.
The aim of the present investigation was to study the effects of intraoperative and postoperative epidural pain management during and after coronary artery bypass grafting (CABG) on the recovery time, postoperative pulmonary and cardiac parameters, visual analog scale (VAS) scores, and sedation scores (SS) compared with patients anesthetized with general anesthesia (GA) whose postoperative pain was relieved with intermittent intravenous (IV) administration of nicomorphine. Fifty-four patients were studied postoperatively after uncomplicated CABG. In the thoracic epidural analgesia (TEA) group (n = 27), intraoperative analgesia was based on high TEA in combination with GA. ⋯ VAS score, SS, and postoperative PaO2 were significantly (P less than or equal to 0.01) better in the TEA group. The incidence of tachycardia (15 vs 2 patients) and postoperative myocardial ischemia (12 vs 4 patients) was higher in the GA group. It is concluded that intraoperative and postoperative pain treatment with epidurally administered bupivacaine plus sufentanil improved the recovery time, as well as pulmonary and cardiac outcome after CABG, when compared with IV postoperative pain treatment after intraoperative GA with sufentanil and midazolam.
-
J Pain Symptom Manage · Apr 1992
ReviewThe role of patient-controlled analgesia in the management of cancer pain.
The technology of patient-controlled analgesia (PCA) has gained wide acceptance for use in cancer pain management. Assessment of technological innovations is necessary in order to evaluate the most appropriate use from the perspective of the individual patient and broader health policy perspective. This paper reviews the literature related to PCA use in chronic cancer pain, appropriate and inappropriate uses of PCA, as well as several professional issues and directions for future PCA use. Professional dialogue regarding the standard of PCA care is necessary for optimum use of this technology for relief of chronic pain.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Extradural clonidine infusions for analgesia after total hip replacement.
We have examined the effectiveness of extradural clonidine infusions for postoperative analgesia and the effect of clonidine on extradural morphine. In a double-blind, controlled study, patients, undergoing total hip replacement were allocated randomly to receive one of two doses of extradural clonidine (25 micrograms h-1 or 50 micrograms h-1), low dose extradural morphine or a combination of morphine and clonidine. ⋯ Arterial pressure was reduced in the clonidine groups, although the incidence of clinical hypotension was low. There were no significant differences between the groups in emetic symptoms or urinary retention.