Articles: postoperative-pain.
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Thoracic surgery clinics · Nov 2004
ReviewPain management strategies for patients undergoing extrapleural pneumonectomy.
The role of anesthetic or analgesic technique in outcome remains controversial. The choice of anesthetic and postoperative analgesic plan plays a small, albeit important, role in perioperative care and a multimodal rehabilitation program. Pulmonary complications are the most important cause of morbidity and mortality after EPP. There is increasing evidence that TEA with local anesthetic agents and opioids is superior for the control of dynamic pain, plays a key role in early extubation and mobilization, reduces postoperative pulmonary complications, and has the potential to decrease the incidence of PTPS.
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Letter Randomized Controlled Trial Clinical Trial
Small-dose ketamine decreases postoperative morphine requirements.
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The ability to communicate the presence of pain by means of verbal and nonverbal communication is crucial to facilitate the assessment of pain. Patients with communication impairment (CI) are limited in their ability to verbally report their pain and, consequently, mechanisms to elicit information about the pain experience must incorporate simple and valid methods to accomplish this goal. Pain measurement and the impact of the pain experience in older adults with CI are areas that have been studied on a limited basis in nursing. ⋯ The highest correlation coefficients between pain measurement tools were identified during the third time when the pain measurement tools were used to rate pain intensity. Subjects identified the Numeric Rating Scale as the preferred method to rate pain intensity. Canonical correlation analysis demonstrated that among the demographic variables evaluated in the study, education explained the largest variance in composite of the pain measurement scales.
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Di Yi Jun Yi Da Xue Xue Bao · Nov 2004
Randomized Controlled Trial Clinical Trial[Effects of fentanyl on EC50 of ropivacaine for postoperative epidural analgesia after gynecological surgery].
To determine the effect of fentanyl on 50% effective concentration (EC50) of ropivacaine for postoperative epidural analgesia following gynecological surgery. ⋯ EC50 of ropivacaine for postoperative epidural analgesia determined by up-down sequential allocation is 0.098%, which can be decreased by the use of fentanyl.
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Because of its subjective nature, the assessment of pain requires the use of comprehensive practices that accurately reflect a patient's experiences of pain. The purpose of this study was to determine how nurses make decisions in their assessment of patients' pain in the postoperative clinical setting. An observational design was chosen as the means of examining pain activities in two surgical units of a metropolitan teaching hospital in Melbourne, Australia. ⋯ In total, 316 pain activities were determined. Five themes relating to assessment were identified from the data analysis: simple questioning, use of a pain scale, complex assessment, the lack of pain assessment, and physical examination for pain. The study identified how nurses' prioritization of work demands created barriers in conducting timely and comprehensive pain assessment decisions.