Articles: analgesia.
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Br J Clin Pharmacol · Nov 1990
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind, placebo controlled, cross-over comparison of the analgesic effect of ibuprofen 400 mg and 800 mg on laser-induced pain.
1. The analgesic efficacy of single oral doses (400 mg, 800 mg) of ibuprofen on argon laser-induced pain was studied in a double-blind, placebo controlled, three way cross-over comparison. Ten healthy volunteers participated. 2. ⋯ Comparing total analgesic effect (area under effect curve), both active medications were superior to placebo (P less than 0.01-0.05), and 400 mg was superior to 800 mg (P less than 0.05). 5. Peak plasma concentrations of S- and R-ibuprofen occurred between 1.2 and 1.5 h. Concentrations after the 800 mg dose were higher than those after the 400 mg dose at all times.
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Regional anesthesia · Nov 1990
Continuous spinal anesthesia after unintentional dural puncture in parturients.
Headache after unintentional dural puncture with 17- or 18-gauge needles represents a significant source of anesthetic-induced maternal morbidity. We performed this study to determine whether inserting a catheter into the subarachnoid space after dural puncture can significantly alter the incidence of headache. Thirty-five women, requesting labor analgesia, suffered a dural puncture during attempts to identify the epidural space using an 18-gauge Hustead needle (bevel oriented parallel to the longitudinal axis of the back). ⋯ Neither the incidence of headache nor the need for therapeutic blood patch differed significantly between the two groups of women. No other anesthetic related complications ensued. Continuous spinal anesthesia after unintentional dural puncture does not decrease the incidence of headache in parturients.
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Rev Esp Anestesiol Reanim · Nov 1990
Comparative Study[Treatment of chronic pain of oncologic origin with epidural or intrathecal morphine administered by continuous or programmable flow implanted pumps].
We have treated a total of 40 patients who presented chronic pain secondary to a neoplastic condition; the patients were treated with morphine in a continuous perfusion by means of an implanted perfusion pump. The route used was the epidural route in seven patients and the intrathecal route in the remaining 33 patients. ⋯ Main complications were displacement of the catheter and rejection of perfusion system. Despite its high prize, we believe that such treatment system should be considered because of the quality of life improvement of the patients.
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In 1988, the American College of Obstetricians and gynecologists (ACOG) decided that vaginal delivery after a previous cesarean delivery (trial of labor, TOL) was an acceptable alternative to elective repeat cesarean delivery. ACOG stated that there appears to be no absolute contraindication to epidural anesthesia for labor during TOL. The concern is that should there be a uterine rupture, would the epidural anesthesia mask the abdominal pain? The incidence of complete rupture with trial of labor is reported to be 0.3-0.5%. ⋯ There have been no reports of epidural anesthesia delaying the diagnosis of uterine rupture. In the review of 10,967 patients undergoing TOL, there were no maternal deaths and only nine fetal deaths secondary to complete uterine rupture. The literature strongly suggests that epidural anesthesia is safe in TOL even when oxytocin is used for augmentation of labor.
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Anaesth Intensive Care · Nov 1990
Randomized Controlled Trial Comparative Study Clinical TrialThe addition of fentanyl to epidural bupivacaine in first stage labour.
Epidural analgesia was studied in 100 healthy Chinese women with uncomplicated pregnancies in first stage labour. Patients were randomly allocated to receive 8 ml of one of the following five solutions: bupivacaine 0.125% with fentanyl 50 micrograms or fentanyl 100 micrograms, bupivacaine 0.25% plain, bupivacaine 0.25% with fentanyl 50 micrograms or fentanyl 100 micrograms. ⋯ There was no difference in method of delivery or neonatal Apgar scores. The least concentrated mixture providing good quality analgesia for the first stage of labour was the combination of bupivacaine 0.125% with fentanyl 50 micrograms.