Articles: analgesia.
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Comparative Study
[Anesthesia procedure and postoperative ADH secretion].
44 patients undergoing major abdominal and thoracic surgery received different anaesthetic treatment and different pain therapy during the postoperative period (4 groups). Analysis of plasma vasopressin was performed in all patients pre-, intra- and five days postoperatively. ⋯ During the postoperative period pain relief was provided by giving fentanyl epidurally (group B and D) or with systemic administration of piritramide (group A and C). During the investigation period vasopressin secretion in patients under epidural opiate therapy was significantly less pronounced as in patients under systemic opiate therapy.
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Anaesth Intensive Care · Feb 1983
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia for haemorrhoid surgery.
Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p less than 0.05) and morphine-lignocaine (p less than 0.05) groups. ⋯ In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p less than 0.01), morphine-lignocaine (637 min, p less than 0.05) and morphine (665 min, p less than 0.0). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia.
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We investigated pain relief following 1-2 mg morphine intrathecally applied in 7 patients with cancer pains and in 5 patients with multiple rib fractures (group 1). For postoperative pain relief (group 2) we applied 1-2 mg morphine intrathecally in 26 patients immediately before the induction of the anaesthesia. In 30 patients we applied 4 mg morphine epidurally in 10-20 ml saline solution for postoperative pain relief (group 3). ⋯ In the second group a respiratory depression occurred in 3 cases and was successfully treated with naloxon. In the third group a bladder disorder occurred in two cases. Because of the risk of respiratory depression following intrathecally applied morphine, we recommend the epidural way of application.