Articles: postoperative-pain.
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Postoperative analgesia remains frequently insufficient in children. This is in part due to the difficult assessment of pain in the different age groups. ⋯ The different analgesic drugs and techniques available allow to establish guidelines for postoperative analgesia in different age groups of children, under different surgical and postoperative conditions. On the basis of such guidelines, ordered analgesics have a greater chance to be really administered at the proper time to each child.
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Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1990
Review[Perioperative respiratory therapy and postoperative pain therapy].
Especially patients with preexisting bronchopulmonary diseases or those undergoing operations in the upper abdomen or thoracotomies are susceptible to post-operative pulmonary complications. All patients at risk should learn the prophylactic respiratory maneuvers preoperatively. ⋯ If given in an equipotent dose, nearly every opioid provides sufficient postoperative analgesia. Wide interindividual variation in the needed dose requires that opioids be titrated intravenously.
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Circumcision in children is followed by severe pain. This study analysed retrospectively anesthetic techniques of 110 children from 17 months to 14 years old who had undergone ambulatory of 24 h stay circumcision. There were two groups of patients: one being operated on under locoregional techniques combined with general anesthesia (53.6%), the other one under general anesthesia alone (46.4%). ⋯ In the first group, dorsal nerves block of the penis (DNBP) was performed on 47 children (79.8% of the locoregional techniques), caudal block on 10 patients and ring block on 2 patients. Regional techniques offered a satisfactory, safe and reliably effective post circumcision analgesia. DNBP should be used systematically in order to shorten duration of day circumcision stay.
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Comparative Study Clinical Trial Controlled Clinical Trial
Caudal analgesia for pediatric day case surgery: assessment of motor function prior to discharge.
The benefits of caudal analgesia are well recognized in the prevention of postoperative pain following pediatric surgery. The possibility of motor weakness may deter anesthetists from using this technique. This study investigates motor function prior to discharge in boys who, as day case patients, received caudal analgesia for pain relief following circumcision. ⋯ Three different dosage regimens of bupivacaine were compared. No important motor weakness was demonstrated, and there was no difference with respect to motor block in the three groups. Caudal analgesia may be recommended as a suitable technique for day case patients.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Intramuscular ketorolac and morphine in the treatment of moderate to severe pain after major surgery.
A multicenter, randomized, open, parallel study in 227 patients with moderate or severe postoperative pain compared the analgesic efficacy and safety of multiple intramuscular injections of ketorolac 30 mg (184 patients) and morphine 10 mg (43 patients) administered as needed as often as every 2 hours for a maximum of 40 doses or 10 days. Supplemental standard analgesics, usually opiates, were permitted if additional pain medication was required. ⋯ Given alone or with supplemental analgesics, ketorolac was better tolerated than morphine, as reflected by rate of terminations due to adverse events and frequency of common complaints. Intramuscular ketorolac thus provides an important additional approach to management of pain.