Articles: postoperative-pain.
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In this randomized study, the efficacy of i.v. patient-controlled analgesia (PCA) was determined for the opioid piritramide (a pure mu-receptor agonist) and the antipyretic analgesic metamizole (Dipyrone) in three groups of patients following abdominal surgery. The doses of piritramide were 1.5 mg (40 patients) and 3 mg (40 patients) on demand. In addition, we studied the effect of 71 mg metamizole in combination with on-demand boluses of 1.5 mg piritramide in 40 patients. ⋯ The intensity of typical side effects of opioids and antipyretic analgesics (nausea, vomiting, lowering of respiratory frequency, sweating) was low and always easily controlled. The acceptance by patients, nurses, and physicians of PCA was high. PCA with on-demand intravenous injection of the combination of piritramide and metamizole improved the degree of analgesia and concomitantly reduced the opioid dose.
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Twelve patients undergoing elective cholecystectomy received as analgesic medication a single dose of methylprednisolone (30 mg/kg) preoperatively and thoracic epidural analgesia with plain bupivacaine for 48 hours + epidural morphine 4 mg and systemic indomethacin 100 mg, both every 8 hours for 96 hours. Assessments of pain, various parameters of response to injury, peak flow and subjective fatigue were made preoperatively, before and 3 and 6 hours after skin incision and 1, 2, 4 and 8 days postoperatively. ⋯ There were no side effects. These results may be explained by inhibition of various trauma-induced inflammatory mediators.
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Comparative Study Clinical Trial Controlled Clinical Trial
Relaxation technique and postoperative pain in patients undergoing cardiac surgery.
A two-group pretest and posttest quasi-experimental design was used to determine the effectiveness of a slow, deep-breathing relaxation technique in relieving postoperative pain after coronary artery bypass graft surgery. A convenience sample of 29 subjects was divided into an experimental group (n = 15), who received relaxation training on the evening before surgery and performed the technique after surgery, and a control group (n = 14), who did not receive relaxation training. Analysis of variance was used to analyze the data. ⋯ No significant differences were seen in analgesic use or visual analogue scale scores. Eleven subjects (73.3%) said the technique was helpful in their pain management. All experimental subjects stated that the relaxation technique was simple to perform, and they would recommend it to others who have postoperative pain.
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Patient-controlled analgesia (PCA) is a method of administering narcotics in which the patient activates a machine to administer a small bolus of narcotic. In the first year of PCA use in our hospital, 26 patients used PCA. ⋯ No clinical respiratory depression was noted, and patients did not titrate themselves to complete analgesia. PCA is an effective means of pain control in adolescent patients.
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We reported the requirement of supplemental analgesics following epidural opioids including Opial 5mg and 10mg, and morphine HCl 2.5mg, for 24 hours in postoperative period after surgery of body surface, and lower and upper abdominal surgeries. Incidence of their side effects was also observed. Opial contains 50% morphine HCl and other opioids such as codeine, thebaine, papaverine, and noscapine etc. ⋯ Kinds and doses of opioids used, suggest that epidural administration of other opioids contained in Opial has some analgesic effect. After the surgery of body surface the opioid requirement may be influenced by the intraoperative anesthetic technics and the state of mind of the patient. Urinary retention was the most interesting side effect observed and our data suggest that papaverine contained in Opial may have favorable effect and morphine HCl may have adverse effects regarding its incidence.