Articles: postoperative-pain.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Multicenter clinical trial of ibuprofen and acetaminophen in the treatment of postoperative dental pain.
Pharmacological management of pain for acute and chronic conditions has been guided by a scientific understanding of peripheral and central acting mechanisms for the control of inflammation as well as pain. Oral surgery pain is a reliable model to reference the effectiveness of commonly used analgesics such as ibuprofen and acetaminophen. ⋯ After 6 hours, the degree of pain relief and tolerance was assessed. Ibuprofen has important implications for postoperative pain in clinical practice.
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Acta Anaesthesiol Scand · Aug 1990
Randomized Controlled Trial Comparative Study Clinical TrialContinuous blockade of the lumbar plexus after knee surgery: a comparison of the plasma concentrations and analgesic effect of bupivacaine 0.250% and 0.125%.
In 20 patients a continuous block of the lumbar plexus was administered after knee-joint surgery, and the analgesic effect of two different concentrations of bupivacaine was compared. The same volume of bupivacaine was given to both groups of patients: a bolus dose of 0.4 ml/kg, 0.5% or 0.25%, followed by infusion of 0.14 ml/kg/h, 0.25% or 0.125%, respectively, via a catheter placed in the neurovascular fascial sheath of the femoral nerve according to the "3-in-1 block" technique. The median morphine consumption during the first 16 h postoperatively was 6.0 mg when bupivacaine 0.5/0.25% was used and 9.5 mg when 0.25/0.125% was used. ⋯ The visual analogue pain scores were also similar in the two groups (P greater than 0.05). All plasma concentrations were below 4 micrograms/ml, the highest concentration measured being 3.6 micrograms/ml. It is concluded that when used for a continuous block of the lumbar plexus after knee-joint surgery, bupivacaine in a concentration of 0.125% offers the same pain relief as a concentration of 0.25%, and the risk of toxic reactions is reduced.
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J Pain Symptom Manage · Aug 1990
Clinical TrialPostoperative patient-controlled analgesia with alfentanil: analgesic efficacy and minimum effective concentrations.
Forty ASA I-III patients recovering from major abdominal or orthopedic operations were investigated in an open clinical study to evaluate analgesic efficacy and threshold plasma concentrations of alfentanil during the early postoperative period using patient-controlled analgesia (PCA) by means of the On-Demand Analgesia Computer. Alfentanil demand dose was 212 micrograms, continuous infusion rate 25 micrograms/hr, hourly maximum dose 1.5 mg/hr; the lockout time was set to 1 min. The duration of PCA was 18.1 +/- 5.2 hr (mean, SD) during which time 23.8 +/- 14.2 demands per patient were recorded, resulting in an average alfentanil consumption of 4.99 +/- 3.03 micrograms/kg/hr. ⋯ Based on our own earlier PCA experience with other opiate analgesics, alfentanil proved to be about 1/15th as potent an analgesic as fentanyl and about 6-7 times more potent than morphine if both intensity and duration of effect were considered. Minimum effective alfentanil plasma concentration (MEC) varied greatly and could be best described by a lognormal distribution (range 0.6-99.2 ng/mL, median 14.9 ng/mL). Intraindividual MEC variability was consistently lower than intersubject variability (37.0% vs 65.2%).
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Anesthesia and analgesia · Aug 1990
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative pain control with a continuous infusion of epidural sufentanil in the intensive care unit: a comparison with epidural morphine.
A prospective, randomized, double-blind trial was conducted to compare the analgesic actions and side effects of sufentanil continuously infused (5 micrograms/h) into the lumbar epidural space (L2-3) with those of an infusion of lumbar epidural morphine (0.5 mg/h). Forty patients admitted to an intensive care unit after elective major abdominal surgery participated over a varying period of 24-40 h. Post-operative pain was treated with an epidural bolus of either sufentanil (50 micrograms) or morphine (5 mg), followed by a continuous infusion of the same opiate. ⋯ The incidence of nausea and vomiting, pruritus, and drowsiness was similar in the two groups. In spontaneously breathing patients there were no respiratory complications requiring treatment. Forced vital capacities were statistically significantly better during the first 1-4 h with sufentanil.
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J. Oral Maxillofac. Surg. · Aug 1990
Randomized Controlled Trial Clinical TrialDouble-blind comparison of meclofenamate sodium plus codeine, meclofenamate sodium, codeine, and placebo for relief of pain following surgical removal of third molars.
A single-dose, randomized, double-blind, parallel-treatment study was performed in 200 outpatients with acute pain caused by the surgical removal of impacted third molars. Meclofenamate 100 mg plus codeine 60 mg, meclofenamate 50 mg plus codeine 30 mg, meclofenamate 100 mg, codeine 60 mg, and placebo treatment groups were compared for sum of pain intensity differences, peak pain intensity difference, sum of pain relief scores, peak pain relief, number of observations at which pain was half relieved, overall evaluation of effectiveness, and time to remedication with a backup analgesic. ⋯ Both meclofenamate-codeine combinations and meclofenamate 100 mg alone were significantly more effective (P less than .005) than placebo for all variables. Eleven adverse experiences were reported in 7 patients (3.5%); the most common was somnolence in 1 patient receiving meclofenamate 100 mg plus codeine 60 mg, in 2 treated with meclofenamate 50 mg plus codeine 30 mg, and in 1 treated with codeine 60 mg.