Articles: postoperative-pain.
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Little research has examined the care older people receive in the acute surgical setting. Although pain assessment and management are judged to be a priority in nursing, often pain, in older people, is undermanaged for a variety of reasons. Factors such as stoicism, communication and ageism can shape both the patients' and nurses' attitude towards the perception of pain which subsequently affects pain management. ⋯ It is suggested that to improve pain management there is a need to individualize pain assessment for older people and to assist clinicians with enhancing their education and decision-making abilities in this field. This may best be achieved by supporting a programme of change to develop the skills of staff and encouraging learning through reflective practice. There is however a need for further research in this area.
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Paediatric anaesthesia · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialEffectiveness of morphine via thoracic epidural vs intravenous infusion on postthoracotomy pain and stress response in children.
Thoracotomy causes severe pain in the postoperative period. The aim was to evaluate effectiveness of two pain treatment methods with morphine on postthoracotomy pain and stress response. ⋯ Single dose TEP morphine offers no advantage over INF for pain treatment for thoracotomy in children and neither technique provided suppression of stress hormones in the first 24 h postoperatively.
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Reg Anesth Pain Med · Sep 2004
Randomized Controlled Trial Clinical TrialPeripheral opioid analgesia in laparoscopic cholecystectomy.
Recent research has revealed that opioids can act directly on the peripheral terminals of afferent nerves to mediate antinociception. The aim of this study was to assess the influence of peripheral morphine administration on the nociception process in the postoperative period. ⋯ Results of the study confirm the possibility of modifying the nociception process in the postoperative period through peripheral opioid administration.
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Randomized Controlled Trial Clinical Trial
Epidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia for knee arthroplasty.
Peripheral neural blockade appears to provide effective analgesia with potentially less morbidity than central neuraxial techniques. We compared the relative benefits of combined femoral (3-in-1) and sciatic nerve block with epidural blockade for postoperative knee arthroplasty analgesia. ⋯ Combined femoral (3-in-1) and sciatic blocks offer a practical alternative to epidural analgesia for unilateral knee replacements.
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Randomized Controlled Trial Comparative Study Clinical Trial
The postoperative analgesic efficacy of wound instillation with ropivacaine 0.1% versus ropivacaine 0.2%.
To assess the influence of ropivacaine concentration on wound instillation-induced postoperative analgesia following total abdominal hysterectomy with bilateral salpingo-oophorectomy. ⋯ With a pre-set volume, varying the concentration of ropivacaine (0.1% versus 0.2%) does not affect the analgesic efficacy of wound instillation following total abdominal hysterectomy with bilateral salpingo-oophorectomy.