Articles: postoperative-pain.
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Anesthesia and analgesia · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of epidural bupivacaine, levobupivacaine, and ropivacaine on postoperative analgesia and motor blockade.
In this prospective, randomized, observer-blinded clinical trial, we compared the incidence of unwanted lower extremity motor blockade and the analgesic efficacy between small-dose (0.125%; 0.2 mg x kg(-1) x h(-1)) postoperative epidural infusions of bupivacaine (Group B; n = 28), levobupivacaine (Group L; n = 27), and ropivacaine (Group R; n = 26) in children after hypospadias repair. Motor blockade and pain were assessed at predetermined time points during 48 h by using a modified Bromage scale and the Children's and Infant's Postoperative Pain Scale (CHIPPS). ⋯ In conclusion, significantly less unwanted motor blockade was associated with postoperative epidural infusions of 0.125% levobupivacaine or ropivacaine in children after hypospadias repair as compared with a similar infusion of bupivacaine. However, no difference with regard to postoperative analgesia could be detected among the three different local anesthetics studied.
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J. Oral Maxillofac. Surg. · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesic safety and efficacy of diclofenac sodium softgels on postoperative third molar extraction pain.
The purpose of this single-blind, placebo-controlled, 3-arm parallel, randomized study was to compare the analgesic efficacy and tolerability of a single dose of 100 mg diclofenac potassium (Cataflam; Novartis, Stein, Switzerland), 100 mg diclofenac sodium softgel, and placebo in patients experiencing moderate to severe postoperative pain after third molar extraction. ⋯ More diclofenac anion was absorbed at a quicker rate using the formulation diclofenac sodium softgel 100 mg than Cataflam. The softgel provided a very rapid onset of analgesic activity, a prolonged analgesic duration, and an acceptable side-effect profile in the postoperative third molar surgery pain model. In an acute pain situation, the rapid absorption of nonsteroidal anti-inflammatory drugs from a formulation like the Softgel may positively affect the time of onset and duration of inflammatory pain compared with other commercially available nonsteroidal anti-inflammatory drug formulations.
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Anesthesia and analgesia · Jul 2004
Randomized Controlled Trial Clinical TrialPostoperative analgesia after total knee replacement: the effect of an obturator nerve block added to the femoral 3-in-1 nerve block.
Femoral nerve block (FNB) does not consistently produce anesthesia of the obturator nerve. In this single-blind, randomized, controlled study we added a selective obturator nerve block (ONB) to FNB to analyze its influence on postoperative analgesia after total knee replacement (TKR). Before general anesthesia, 90 patients undergoing TKR received FNB (Group 1), FNB and selective ONB (Group 2), or placebo FNB (Group 3). ⋯ We conclude that FNB does not produce complete anesthesia of the obturator nerve. Single-shot FNB does not provide additional benefits on pain at rest over opioids alone in the early postoperative period. The addition of an ONB to FNB improves postoperative analgesia after TKR.
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Regional anesthesia techniques are used in pain treatment for more than a century. Although its use for acute pain conditions, such as intraoperative, postoperative and traumatic pain, is very well accepted, its use for the chronic pain syndromes is still lacking a consensus among the practitioners. The interventional techniques, which are mostly originated from the regional anesthetic techniques, have gained an increasing interest for the treatment of chronic pain syndromes during the last few decades. In this review, the development and clinical aspects of epidural injections, epiduroscopy, facet denervaion, intradiscal applications, vertebroplasty, sympathetic neurolysis, and central and peripheral continuous infusion techniques are discussed.
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Veterinary surgery : VS · Jul 2004
Randomized Controlled Trial Comparative Study Clinical TrialPre-emptive epidural ketamine or S(+)-ketamine in post-incisional pain in dogs: a comparative study.
To compare the pre-emptive analgesic effects of epidural ketamine or S(+)-ketamine on post-incisional hyperalgesia. ⋯ Although anesthetic and analgesic potency of S(+) ketamine is twice that of ketamine, the racemic form is seemingly better for post-incisional hyperalgesia.