Articles: analgesia.
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To establish the effect of pain relief on maternal temperature during labour forty patients who went into spontaneous labour with a single fetus, had a normal temperature (less than 37.5 degrees C), and had no clinical evidence of infection were investigated prospectively. They were divided into two comparable groups--one receiving pethidine and the other epidural analgesia. Both groups had much the same temperatures at the beginning of labour and before any analgesic administration. ⋯ This rise was not related to any clinical evidence of infection. Patients receiving epidural analgesia during labour are at increased risk of developing pyrexia. This pyrexia may be the result of vascular and thermoregulatory modifications induced by epidural analgesia.
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The purpose of this study was to determine if patient-controlled analgesia (PCA) is an effective method of postoperative pain relief for children. Fifteen general surgery patients, aged 11 to 18 years, were treated for pain with PCA. ⋯ The average amount of medication administered by PCA was compared with the amount given to similar group of children treated by traditional administration; overall, the PCA group received less morphine than the traditional group. This study indicates that PCA is a valuable addition to pain management for the pediatric patient.
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Randomized Controlled Trial Comparative Study Clinical Trial
Controlled trial of extradural bupivacaine with fentanyl, morphine or placebo for pain relief in labour.
In a prospective, randomized double-blind study carried out on 255 parturients, fentanyl 80 micrograms (n = 81), morphine 4 mg (n = 83) or placebo (n = 85) was added to 0.25% bupivacaine administered extradurally for pain relief during labour. Fentanyl increased the mean duration of bupivacaine analgesia by 30% and did not reduce the rate of inadequate pain relief. Morphine did not increase the mean duration of bupivacaine analgesia significantly, but increased the rate of inadequate pain relief. It was concluded that morphine 4 mg added to extradural 0.25% bupivacaine was of no value.
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Twenty patients who underwent thoracotomy were given 2mg of epidural morphine postoperatively. Serum morphine concentrations were determined, analyzed pharmacokinetically, and compared with the degree of analgesia obtained. Excellent analgesia was attained in 11 patients and fair analgesia in the remaining 9 patients. ⋯ Maximal concentration (Cmax) was calculated to be 38.5 +/- 4.2 ng.ml-1 in the excellent analgesia group and 25.7 +/- 4.3 ng.ml-1 in the fair group. The area under the concentration-time curve (AUC) in the fair group was approximately 20% of that in the excellent group. It is concluded that serum morphine levels correlated with analgesic effect in patients receiving epidural morphine after thoracotomy.
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Fifty-eight patients undergoing cervical epidural injection of corticosteroids were followed for a 6-month period. Patients with 90% pain relief lasting 6 months were considered to have excellent results, those with greater than 50% pain relief lasting at least 6 weeks were considered to have good results, and all others were considered to have poor results. ⋯ Those patients with the diagnosis of cervical spondylosis and those with subacute cervical strain had statistically significantly (p less than 0.001, difference of proportions test) better results than patients with other diagnoses. The procedure of cervical epidural steroid injection may be most effective in patients with cervical degenerative joint disease as the etiology of their cervical pain.