Articles: analgesia.
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Helvetica chirurgica acta · Mar 1992
Randomized Controlled Trial Clinical Trial[Effect of continuous postoperative analgesia with peridural bupivacaine on intestinal motility following colorectal resection].
In a prospective randomized trial the effects of continuous peridural analgesia on gastrointestinal motility and the postoperative course was studied in 48 consecutive patients with elective colorectal resections. 24 patients had peridural analgesia (PDA) with bupivacaine while 24 patients received intravenous analgesia (IVA) with pentazocine. With PDA the first passage of flatus and faeces was significantly accelerated. PDA was not associated with an increased rate of anastomotic breakdown and there were no respiratory complications in the PDA group.
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To review current and potential analgesic techniques in day surgery, with particular regard to their pharmacology. ⋯ Combination analgesia therapy is the best approach for postoperative analgesia for day surgery. The usefulness of preoperative blockade of the pain sensation which limits activation of the central pain pathway and decreases analgesic requirements, is also emphasised. Examples of measures for relief of mild, moderate and severe pain are given.
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Anaesth Intensive Care · Feb 1992
Randomized Controlled Trial Comparative Study Clinical TrialPatient-controlled epidural analgesia in labour--is a continuous infusion of benefit?
A randomised, single-blind study was conducted among 52 gravida in active labour, to investigate two variants of patient-controlled epidural analgesia--bolus only versus bolus plus infusion. Patient-controlled analgesia variables, using an epidural solution of 0.125% bupivacaine plus fentanyl 3 mcg per ml, were a 4 ml incremental bolus with 15 minute lockout, plus or minus a 4 ml per hour infusion. ⋯ Both groups had high quality analgesia, low rates of bupivacaine usage and were highly satisfied. However, under the conditions of the study, the addition of a continuous background infusion to self-administration conferred no benefit.
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Anaesth Intensive Care · Feb 1992
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind randomised trial comparing postoperative analgesia after perioperative loading doses of methadone or morphine.
This double-blind randomised study compared postoperative analgesia after a loading regimen of methadone or morphine in thirty women undergoing abdominal hysterectomy. Methadone or morphine, 0.25 mg.kg-1, was given intravenously at induction of anaesthesia with further increments in the recovery room for analgesia if required. The mean (SD) total doses of methadone and morphine required were 0.43 (0.13) mg.kg-1 and 0.45 (0.15) mg.kg-1 respectively. ⋯ Ten patients in the methadone group did not request any further opioid analgesics while all patients in the morphine group made at least two requests for opioids. The overall postoperative course was remembered as less painful by patients in the methadone group (P less than 0.001). There was no significant respiratory depression or excessive sedation in either group.
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Anaesth Intensive Care · Feb 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison of epidural and intravenous opioid analgesia after elective caesarean section.
Patient acceptance is a particularly relevant method of assessing currently employed epidural and intravenous techniques of opioid analgesia after elective caesarean section. We have prospectively studied 71 such patients, randomised postoperatively to receive epidural morphine, intravenous morphine or intravenous pethidine. When compared with either intravenous opioid, epidural morphine provided twofold better average or excellent analgesia with 30% less drowsiness but with about 50% more pruritus. In spite of this troublesome complication, more patients (83% vs 74%) preferred epidural to intravenous opioid analgesia.