Articles: postoperative-pain.
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J Obstet Gynaecol Can · Dec 2004
Comparative StudyEvaluation of postoperative pain control for women undergoing surgery for gynaecologic malignancies.
(1) To compare the benefits of epidural analgesia and patient-controlled analgesia (PCA) in the management of postoperative pain in women with gynaecologic malignancies,and (2) to understand issues related to the delivery of pain control strategies. ⋯ Postoperative pain management was excellent both in women who received PCA and in those who received epidural analgesia. Problems related to the delivery of pain control were more common in the epidural group.
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Paediatric anaesthesia · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of epidural vs intravenous analgesia for posterior spinal fusion surgery.
The study objective was to compare epidural vs intravenous postoperative analgesia in posterior spinal fusion surgery patients. ⋯ By evaluating morphine sulfate usage between groups, the analgesic effectiveness of continuous thoracic epidural analgesia bupivacaine and fentanyl doses used revealed no significant improvement over intravenous morphine sulfate analgesia alone in patients after posterior spinal fusion surgery.
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Anesthesia and analgesia · Dec 2004
Comparative StudyA comparison of postoperative pain control in patients after right lobe donor hepatectomy and major hepatic resection for tumor.
After initiating a living donor liver transplant program at our institution, we observed that donor patients experienced significant postoperative pain despite the use of thoracic patient-controlled epidural analgesia (PCEA) infusion catheters. We retrospectively compared patients who underwent right lobe donor hepatectomy (RLDH, n = 15) with patients who had undergone major hepatic resection for tumor (MHRT, n = 15) to elucidate the cause for this observation. All patients had preoperative thoracic epidural catheters placed, and both groups had similar surgical exposure. ⋯ There was no significant difference between patient groups for the amount of bupivacaine and volume of PCEA solution administered. These observations may be explained, in part, by the longer duration of surgery in the RLDH group. The possible role of preemptive analgesia via PCEA infusion and better perioperative teaching of PCEA use are discussed; these may lead to improved early postoperative pain control in RLDH patients.
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Plast. Reconstr. Surg. · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialLocally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients.
With recent developments in the field of analgesia, the question arises whether there is a role for placing local anesthetics, nonsteroidal anti-inflammatory drugs, or both into the breast implant pocket. The objective of this study was to test the effectiveness of locally administered intraoperative ketorolac and bupivacaine with epinephrine at reducing pain in the postoperative period. The study was a prospective, randomized, double-blind clinical trial. ⋯ There was a trend that the ketorolac and bupivacaine patients spent less time in the recovery room and used fewer analgesics postoperatively than the other patients. There were no hematomas requiring reoperation and no complications. Locally administered intraoperative ketorolac and bupivacaine with epinephrine significantly reduced pain in the postoperative period.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the analgesic efficacy and plasma concentrations of high-dose intra-articular and intramuscular morphine for knee arthroscopy.
It is important to provide good postoperative analgesia after discharge from day case surgery. The usefulness of intra-articular morphine for analgesia after day case knee arthroscopy remains controversial. A large dose of morphine intra-articularly may provide a good long-lasting analgesia, but its efficacy and pharmacokinetics are not known and may be no better than intramuscular morphine. We compared the effect of 10 mg intra-articular and intramuscular morphine for 24 h post-injection in a randomized double-blind study. ⋯ A large dose of intra-articular morphine provided better analgesia than the same dose of intramuscular morphine, low plasma morphine levels suggesting a peripheral mechanism.