Articles: analgesia.
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Tidsskr. Nor. Laegeforen. · May 1991
Clinical Trial Controlled Clinical Trial[Sterile water papulae for analgesia during labor].
In a group of Scandinavian women in labour, application of sterile water wheals intradermally was compared with a "dry needling" technique as a way of treating labour pain. 101 women received intradermal wheals, 50 were "dry needled" and 117 served as a control group for perinatal complications. 57.6% of the women in the wheal group experienced more than 50% relief of pain compared with 18% in the dry needling group (p less than 0.0001). Mean duration of pain relief was 79 +/- 15 min. (SD) in the wheal group and only 19 +/- 15 min. in the dry needling group. ⋯ Judged by the mean Apgar scores one and five minutes after delivery, the method did not seem to have any side effects, either on the mother or on the foetus. It was impossible to carry out the study double blind, but it still strongly indicates that application of small amounts of sterile water intradermally during labour is an efficient and safe way of reducing pain in labour.
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Randomized Controlled Trial Clinical Trial
Wound infiltration of local anaesthetic after lower segment caesarean section.
The analgesic efficacy of subcutaneous wound infiltration with 20 ml of 0.5% bupivacaine after elective lower segment section Caesarean section was studied in 28 patients in a double-blind randomised controlled manner using a patient-controlled analgesia system. The mean 24-hour morphine consumption of the placebo group and the bupivacaine group was similar (76 mg and 68 mg respectively). ⋯ However, on a weight-adjusted basis statistically significant differences in morphine consumption were demonstrated, although these may not be clinically important. Subjective experiences of pain, nausea and drowsiness assessed by linear analogue scoring were similar in both groups.
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Anesthesia and analgesia · May 1991
Comparative StudyComparison of intravenous sedative-analgesic techniques for outpatient immersion lithotripsy.
Fifty-three unpremedicated outpatients undergoing elective extracorporeal shock wave lithotripsy using an unmodified Dornier HM-3 lithotriptor received one of two different intravenous sedation-analgesia techniques. Both intravenous midazolam-alfentanil and fentanyl-propofol techniques produced conditions comparable to those achieved with epidural anesthesia during immersion lithotripsy. ⋯ Compared with a standard epidural anesthesia technique, the mean anesthesia and recovery times were significantly shorter with the two intravenous sedation-analgesia techniques (57-62 min vs 105 min and 143-147 min vs 199 min, respectively). These data suggest that combinations of either midazolam and alfentanil or fentanyl and propofol are viable alternatives to epidural anesthesia for outpatient immersion lithotripsy.
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Randomized Controlled Trial Clinical Trial
Epidural fentanyl does not influence intravenous PCA requirements in the post-caesarean patient.
Forty ASA physical status I or II patients scheduled for elective Caesarean delivery were studied to determine the effect of epidural fentanyl on post-Caesarean delivery analgesic requirements as administered by intravenous patient-controlled analgesia (PCA). Following delivery of the infant, under epidural anaesthesia with lidocaine 2% with 1/200,000 epinephrine, patients were randomly assigned to receive either 10 ml of preservative-free normal saline via the epidural catheter or 100 micrograms of fentanyl with 8 ml preservative-free normal saline in a double-blinded fashion. ⋯ No differences were observed in any values between the groups. It is concluded that a single bolus of epidural fentanyl does not provide an advantage for postoperative pain relief in this patient population.