Articles: analgesia.
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Circumcision in children is followed by severe pain. This study analysed retrospectively anesthetic techniques of 110 children from 17 months to 14 years old who had undergone ambulatory of 24 h stay circumcision. There were two groups of patients: one being operated on under locoregional techniques combined with general anesthesia (53.6%), the other one under general anesthesia alone (46.4%). ⋯ In the first group, dorsal nerves block of the penis (DNBP) was performed on 47 children (79.8% of the locoregional techniques), caudal block on 10 patients and ring block on 2 patients. Regional techniques offered a satisfactory, safe and reliably effective post circumcision analgesia. DNBP should be used systematically in order to shorten duration of day circumcision stay.
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Int Anesthesiol Clin · Jan 1990
ReviewContinuous infusions of local anesthetics and narcotics for epidural analgesia in the management of labor.
It appears that complete analgesia for labor using epidural and subarachnoid opiates alone, with a minimum of side effects, remains an unfulfilled goal. However, the combination of extremely small doses of local anesthetics and opiate drugs seems to provide excellent analgesia with a minimum of side effects. ⋯ These drugs include catecholamines, clonidine, GABA agonists, substance P antagonists, prostaglandin synthetase inhibitors, and many other drugs capable of altering neural transmission in such a way that analgesia results. Obviously, labor analgesia is one area in which these combinations will be explored extensively, and the next few years should be very exciting ones.
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Inadequate pain relief remains a problem for many patients with cancer. Narcotic administration by the epidural or subarachnoid route is a relatively recent innovation and is indicated when pain is poorly controlled with high doses of systemic narcotics, or when patients experience limiting narcotic side effects. ⋯ Epidural and intrathecal administration of narcotics is an alternative when oral narcotics are ineffective. In this report the term "intraspinal" refers to epidural and/or subarachnoid placement of catheters and drugs.
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Randomized Controlled Trial Clinical Trial
Objective assessment of clonidine analgesia in man and influence of naloxone.
Experimental data indicate that clonidine can induce marked analgesia. We characterized this effect in healthy volunteers and investigated possible links with the opioid peptide system by means of naloxone antagonism. According to a cross-over, double-blind, placebo-controlled design, 10 subjects received oral and i.v. placebo or clonidine (0.2 mg p.o.) or clonidine and naloxone (2.8 mg i.v. in 5 h). ⋯ Oral clonidine alone or with naloxone increased subjective and objective pain thresholds for at least 4 hours (p less than 0.01, ANOVA). Naloxone tended to reinforce clonidine analgesia. Only moderate and well tolerated side-effects were observed.
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Acta Anaesthesiol Belg · Jan 1990
Randomized Controlled Trial Clinical TrialSurgical analgesia for knee arthroscopy with epidural lignocaine and sufentanil--effect of varying sufentanil doses.
In a double blind trial the additional analgesic effect of the combination of epidural lignocaine 2% + epinephrine 1/200,000 with varying epidural Sufentanil doses was studied per- and postoperatively in patients undergoing arthroscopy of the knee. Fifty patients were randomly divided into five groups. They received epidural lignocaine 2% + epinephrine 1/200,000 in addition with respectively 0, 20, 30, 40 or 50 micrograms Sufentanil. ⋯ On the other hand, at 40 and 50 micrograms of Sufentanil significantly more patients demonstrated respiratory depression and pronounced sedation during surgery as compared to lignocaine alone. Patients in these groups had better postoperative analgesia. In addition nausea, vomiting and pruritus were seen in some patients at all doses of Sufentanil.