Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
Perianal blockage with 0.5% bupivacaine for postoperative pain relief in hemorrhoidectomy.
Hemorrhoidectomy can be done in many positions under many anesthetic techniques as an ambulatory surgery. Post-procedural pain is frequently severe enough to delay home discharge. A combination between preincisional local anesthetics and general anesthesia looks attractive in terms of preemptive analgesia and starting time of surgery. The study aimed to compare anesthetic time, pain-free period and pain relief in patients with and without 0.5% plain bupivacaine infiltration after mask inhalation, total intravenous anesthesia or endotracheal tube general anesthesia. ⋯ Better postoperative pain relief could be accomplished by preincisional 0.5% plain bupivacaine infiltration after general anesthesia. The technique helped relax anal muscles for surgical ease and avoided patient discomfort in case of a prolonged procedure. Preemptive analgesia and key pain management were discussed.
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Paediatric anaesthesia · Jun 2004
Clinical TrialUse of intravenous ketorolac in the neonate and premature babies.
Ketorolac is a powerful nonsteroidal anti-inflammatory drug widely used for pain control in children and adults. The aim of this study was to evaluate its safety and analgesic efficacy in the neonate. ⋯ Ketorolac could represent an efficacious analgesic alternative to opioids, particularly in neonates. It would avoid the side-effects associated with opioid analgesics, especially respiratory depression.
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Randomized Controlled Trial Clinical Trial
Intraoperative and postoperative analgesia with subcutaneous ring block of the penis with levobupivacaine for circumcision in children.
The purpose of the study is to evaluate both the efficacy of ring block of the penis with levobupivacaine in preventing intraoperative and postoperative pain associated with circumcision in children and the quality of the recovery. Thirty boys aged 3 - 12 years who underwent circumcision under general anaesthesia as day case patients were allocated randomly to receive either a subcutaneous ring block with levobupivacaine or intravenous fentanyl (2 microg/kg) and paracetamol (30 mg/kg) rectally, after induction of anesthesia but before surgery. The efficacy of intraoperative analgesia was estimated using the heart rate and alterations in blood pressure. ⋯ Paracetamol was given depending on the pain score and the time of first dose given was recorded. The quality of postoperative analgesia was based on the children's activity and mobilisation. The ring block group showed intraoperative cardiovascular stability and a faster and better recovery (p < 0.0005) while the postoperative analgesia tended to be longer and more adequate, although that no statistically significant difference was noted (p < 0.1).
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Pol. Merkur. Lekarski · Jun 2004
Clinical Trial Controlled Clinical Trial[Effectiveness of extrameningeally administered opioids in patients with aortic prosthesis].
The examination was carried out in 60 men at the age of 56 to 78 (mean age 65.3 years) treated by suturing of vascular prosthesis due to aneurysm of abdominal part of aorta, in which postoperative analgesia was done with the use of bupivacaine with opioids administered extradurally. Patients were divided into two groups consisting of 30 individuals each. In group I, patients were given 0.25% bupivacaine with phentanyl, while in group II--bupivacaine appropriate for the need of the patient. ⋯ Twenty-four hour long dose of bupivacaine to 210+/-20.5 mg in group I and 145+/-11.5 mg, while morphine 5.1+/-1.2 mg. Fluctuation of the chosen haemodynamic and gasometric parameters were of no clinical importance. 7 patients suffered from nausea and vomiting, these patients included 2 patients from group I and in 5 patients from group II. On this basis of results, one may confirm that both methods of analgesia are equally effective, although it was possible to reduce the twenty-four hour long dose of bupivacaine, thus limiting the risk of depressive effect on heart muscle.
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The aim of this study was to explore gender differences in anticipatory emotional distress, coping strategies, post-operative pain perception, and patient-controlled analgesia (PCA) use among adolescent surgical patients. One hundred and two 12-18-year-old adolescents undergoing surgeries with overnight hospital stay were recruited. Participants completed pre-operative measures of anxiety and anticipated pain. ⋯ Patterns of PCA use did not vary by gender on post-operative days 0 or 1. Findings suggest that adolescent boys' and girls' pain experiences are different in several important respects, although somewhat less divergent than has been reported in samples of adult males and females. Results have implications for the development of targeted intervention strategies to help adolescents cope effectively with acute post-operative pain.