Articles: postoperative-pain.
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In the mid-1990s, the authors introduced a minimally invasive system of cesarean delivery. This article illustrates the improvements made since the technique's initial publication. ⋯ The procedure described herein features a short operating time, minimal instrumentation, reduced surgical dissection, decreased postoperative pain, and reduced risk of blood loss, infection, and wound complications. It is easily learned and cost-effective, with a brief postoperative recovery period.
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The Journal of urology · Jan 2004
Randomized Controlled Trial Comparative Study Clinical TrialRandomized trial of lidocaine vs lidocaine/bupivacaine periprostatic injection on longitudinal pain scores after prostate biopsy.
Periprostatic lidocaine reduces immediate post-prostate biopsy pain but still many men will not consent to re-biopsy. We performed a randomized study to assess whether adding long acting local anesthesia to a short acting agent would further reduce pain. ⋯ Long and short acting local anesthetics together significantly attenuate the 1-hour rebound increase in pain scores seen after short acting anesthesia alone. Improved pain scores were sustained during the subsequent week and we advocate routine combination use for transrectal ultrasound guided prostate biopsy.
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Anesthesia and analgesia · Jan 2004
Randomized Controlled Trial Clinical TrialThe pharmacokinetics and efficacy of ropivacaine continuous wound instillation after spine fusion surgery.
Because local anesthetic continuous wound instillation has not been evaluated after spine fusion surgery, we designed this study to determine whether this technique could enhance analgesia and improve patient outcome after posterior lumbar arthrodesis. Thirty-eight patients undergoing spine stabilization were randomly divided into two groups. The M group received a postoperative baseline IV infusion of morphine plus ketorolac for 24 h, and the R group received IV saline. In both groups, a multihole 16-gauge catheter was placed subcutaneously; in the R group, the wound was infiltrated with a solution of ropivacaine 0.5% 200 mg/40 mL, and infusion of ropivacaine 0.2% 5 mL/h was maintained for 55 h. In the M group, saline infusion was given at the same rate. Pain scores were taken at rest and on passive mobilization by nurses blinded to patient analgesic treatment. The total plasma ropivacaine concentration was evaluated. Pain scores and rescue medication requirements (diclofenac and tramadol) were significantly less in the R group than in the M group. Postoperative blood loss was less and the length of hospital stay was shorter in the R group. The ropivacaine peak total plasma concentration occurred at 24 h during infusion and was within safe limits; no toxic local anesthetic side effects were observed. These results suggest that wound infiltration and continuous instillation of ropivacaine 0.2% is effective for pain management after spine stabilization surgery. ⋯ Postoperative pain after lumbar arthrodesis is related to soft tissue and muscle dissection and to manipulations and removal at the operation site. By blocking noxious stimuli from the surgical area, infiltration and wound perfusion with ropivacaine were more effective in controlling pain than systemic analgesia.
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Randomized Controlled Trial Clinical Trial
Evaluation of intraperitoneal and incisional lidocaine or bupivacaine for analgesia following ovariohysterectomy in the dog.
To determine if intraperitoneal (i.p.) and incisional (s.c.) lidocaine or bupivacaine provide analgesia following ovariohysterectomy (OHE). ⋯ Our findings support the use of i.p. and s.c. bupivacaine for post-operative analgesia following OHE in the dog.
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Eur J Gynaecol Oncol · Jan 2004
Randomized Controlled Trial Clinical TrialPostoperative patient-controlled analgesia with intravenous tramadol, intravenous fentanyl, epidural tramadol and epidural ropivacaine+fentanyl combination.
The aim of this study was to compare the effects of IV tramadol, IV fentanyl, epidural tramadol, and an epidural ropivacaine+fentanyl combination in patient-controlled analgesia (PCA) after lower abdominal surgery. ⋯ Although adequate pain relief was achieved with all regimens that were used in the study, intravenous tramadol and intravenous fentanyl are associated with a high incidence of nausea and vomiting.