Articles: analgesia.
-
Patient controlled analgesia (PCA) is a proven method of administering analgesics via programmable infusion devices to relieve postoperative pain and pain associated with terminal illnesses. In mid-1989, a pain management service was started in the authors' hospital by the anesthesiology service. Since pharmacists had been previously involved in PCA postoperative pain management, it was decided they would continue in that capacity with the pain management service. ⋯ All subsequent programming including dose changes, rate changes, boluses, bag changes, and problem resolution are the responsibility of the staff pharmacists. Pharmacists are periodically certified in programming skills as part of the department's quality assurance program. In 1990, over 1800 patients received the benefits of this innovative service.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Patient controlled analgesia for extracorporeal shock wave lithotripsy of gallstones.
Sixty patients undergoing shock wave lithotripsy of gallbladder stones (ESWL) were randomly assigned to receive alfentanil either by infusion controlled by the attending anesthesiologist (standard treatment group, n = 31) or by analgesia controlled by the patient (PCA group, n = 29). Patients using PCA were allowed to self-administer 0.25 mg of alfentanil i.v. every minute as required. Data collected during treatment included the total dose of drug required, transcutaneous pCO2 values, verbal pain and sedation scores, visual analogue scale (VAS) patient satisfaction scores, and the incidence of nausea or vomiting. ⋯ No significant difference with regard to patient satisfaction with pain relief could be demonstrated. Self-administered alfentanil during ESWL of gallbladder stones provided adequate analgesia with minimal side effects and high patient satisfaction. ESWL may represent a new and useful indication for PCA.
-
Z Geburtshilfe Perinatol · Mar 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Effectiveness and tolerance of tramadol with or without an antiemetic and pethidine in obstetric analgesia].
The aim of this prospective, randomised, blind study was to investigate the analgesic potency and tolerance of intramuscular Tramadol compared to a standard obstetric analgesia with Pethidine. Triflupromazine was administrated in combination with the two tested analgesics in order to study its efficacy in alleviating the emetic side effects of the tested analgesics. 66 parturients were randomly assigned to three groups: group A: 100 mg Tramadol (Tramal), group B: 100 mg Tramadol (Tramal) and 10 mg Triflupromazine (Psyquil), group C: 50 mg Pethidine (Alodan) and 10 mg Triflupromazine (Psyquil). ⋯ In all three groups the analgesic effect was equally good. Combination of the analgesic with the antiemetic showed no reduction of the incidence and severity of side effects.
-
Twenty mothers who had requested regional analgesia during labour had a 32-gauge catheter inserted into the lumbar subarachnoid space. The mean time to place the catheters was 116 s (range 55-270 s) and there were no technical difficulties. Incremental diamorphine was given, up to a maximum initial dose of 0.5 mg. ⋯ Nine mothers were given hyperbaric 0.5% bupivacaine 1-2 ml during the second stage; all were pain free for the procedure. The maximum force needed to withdraw the catheters was 700 g; and all catheters were removed intact. There were no post-spinal headaches.
-
The use of intravenous (i.v.) patient-controlled fentanyl analgesia during labour in a parturient with unexplained thrombocytopenia (70 x 10(3).ml-1) is described. The patient self-administered boluses of 25 micrograms of fentanyl with a lock-out interval of ten min. In addition, a concurrent fentanyl infusion of 25 micrograms.hr-1 was given. ⋯ At birth, maternal total plasma fentanyl concentration was 1.11 ng.ml-1, whereas neonatal umbilical total plasma fentanyl concentration was 0.43 ng.ml-1. Newborn plasma protein binding of fentanyl was lower compared to the mother (63% vs 89%). Thus, free fentanyl concentrations (0.16 ng.ml-1) were identical in the mother and newborn at delivery.