Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of continuous paravertebral and extradural infusions of bupivacaine for pain relief after thoracotomy.
Pain was controlled in 20 post-thoracotomy patients using a continuous infusion of 0.25% bupivacaine through an extradural or para-vertebral catheter. Both techniques provided good analgesia. Hypotension and urine retention occurred significantly less frequently in the paravertebral than in the extradural group.
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Acta Anaesthesiol Scand · Feb 1989
Randomized Controlled Trial Comparative Study Clinical TrialEffects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomy.
A comparison was made of the effects of continuous epidural analgesia with bupivacaine and intermittent epidural morphine on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. ⋯ The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the epidural bupivacaine group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the epidural morphine group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when epidural bupivacaine is given for postoperative pain relief than when this is achieved by epidural morphine.
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Comparative Study
Effects of instructional set on attributions of nonvolition during hypnotic and nonhypnotic analgesia.
Fifty highly hypnotizable subjects were assigned to four treatment groups or a no-treatment control group and then underwent two pain stimulation trials. Half the treated subjects were administered hypnotic analgesia, half waking analgesia. ⋯ Both hypnotic and nonhypnotic subjects given passive instructions rated their pain reduction as occurring involuntarily, whereas those given active instructions reported that their pain was reduced through their active use of coping strategies. These findings support sociocognitive formulations of hypnotic responding that view ratings of involuntariness as reflecting contextually guided interpretations of behavior.
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Regional anesthesia · Jan 1989
Randomized Controlled Trial Comparative Study Clinical TrialThe treatment of patients with multiple rib fractures using continuous thoracic epidural narcotic infusion.
The incidence of tracheostomy, length of intensive care unit (ICU) and total hospital stay, and duration of ventilatory support were evaluated prospectively in 28 patients who had multiple rib fractures. The patients were randomly divided into two groups: 13 patients were given standard morphine parenteral analgesia and constituted the control group (Group 1), and 15 patients had thoracic epidural catheter placement within 72 hours from the time of admission to the ICU (Group 2). ⋯ Group 2 patients also had a lower incidence of tracheostomy versus control patients (6.7 +/- 6.7% vs. 38.5 +/- 14.0%, p less than 0.05). The authors believe that continuous thoracic epidural morphine analgesia may provide distinct pulmonary and economic advantages in patients with multiple rib fractures.