Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
[The effects of application of rectal naproxen on postoperative analgesia, sedation and morphine use in heart surgery operations].
In this study, effects and side effects of application of rectal naproxen, combined with patient controlled intravenous morphine analgesia, were investigated in the elective coronary bypass operations for postoperative pain control, sedation and opioid use. Following the ethical committee approval and individual patient self consent, 40 patients, who underwent coronary artery bypass surgery were included in the study. A double blind study was performed by administering rectal naproxen to group N (n = 20) and placebo to group P (n = 20), at the end of the operation. ⋯ There was no difference between two groups with respect to their demographic features duration of surgery, extubation time and side effects (p > 0.05). With respect to group P, decrease in opioid use, better sedation and decrease in pain scores during both resting and coughing was seen in group N (p < 0.05). In conclusion, analgesia applied by addition of rectal naproxen to opioids achieved better pain management in selected patients after cardiac surgery.
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J Pain Symptom Manage · Apr 2004
Controlled-release oxycodone for the management of pediatric postoperative pain.
Studies addressing pain management after pediatric spinal fusion surgery have focused on the use of patient-controlled or epidural analgesia during the immediate postoperative period. Controlled-release (CR) analgesics have been found to be safe and effective in adults. The purpose of this study was to describe the use of oxycodone-CR in pediatric patients after the immediate postoperative period. ⋯ Common side effects included dizziness, constipation, and nausea. Oxycodone-CR was used for an average of 13.3 days, which included an average wean time of 6 days. Results of this study demonstrate safe and effective use of oxycodone-CR in the pediatric spinal fusion population.
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Neurosurgery has for a long time been considered as a minimal painful surgery. This explains why there are few references in the literature concerning postoperative neurosurgical pain. Recent papers have demonstrated that even if postoperative pain is less important than in other specialities, such pain exists and should be taken care of. ⋯ In this respect, the use of remifentanil or other techniques like target-controlled injection of opioids should absolutely be considered. In most cases, class I and II analgesics seem to provide optimal pain relief. However, for some patients, the use of an opioid may be required.
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Obstructive sleep apnea (OSA) in children is often associated with recurrent hypoxemia during sleep. In developing animals, central opioid neuropeptide content is high, and opioid receptors are up-regulated after recurrent hypoxia. The authors hypothesized that children with recurrent hypoxemia due to OSA might have altered central opioid functionality that could affect their responsiveness to opioid drugs. Using a retrospective database, we assessed the relation of age and preoperative oxygen saturation to the cumulative postoperative morphine dose administered for analgesia in children with OSA undergoing adenotonsillectomy. ⋯ The authors speculate that the reduced morphine requirement for analgesia in children displaying oxygen desaturation associated with severe OSA may be related to their young age and to an up-regulation of central opioid receptors consequent to recurrent hypoxemia. In evaluating OSA in children, preoperative determination of the SaO2 nadir is important for predicting the postoperative opioid dosage required for analgesia.
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The evaluation of patients' satisfaction and outcome after surgery is of increasing importance. An optimized postoperative pain management may contribute substantially to this important goal. ⋯ Evaluation of patients' satisfaction with postoperative epidural pain therapy resulted in a high degree of satisfaction without correlation between patients' satisfaction and recalled maximum pain levels. These results, including side effects and special problems during pain therapy, provide motivation to further improve postoperative pain management.