Articles: postoperative-pain.
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This article reviews methods to relieve postoperative pain in most children. It also discusses the major barriers to treatment and considers the provision of opioids via a painless route as an alternative to the more usual intramuscular (and painful) route.
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Clinical Trial Controlled Clinical Trial
Low-dose intrathecal morphine for postoperative pain control in patients undergoing transurethral resection of the prostate.
Thirty patients undergoing lidocaine spinal anesthesia for transurethral resection of the prostate (TURP) were studied to evaluate the effectiveness of low-dose intrathecal morphine (ITM) for postoperative analgesia. In a double-blinded fashion, groups of ten patients received either 0.1 mg morphine, 0.2 mg morphine, or placebo (control group) intrathecally with lidocaine 75 mg. Standard postoperative analgesics were available to all patients. ⋯ Six patients (60%) in the 0.2 mg ITM group, two patients (20%) in the 0.1 mg ITM group, and one patient (10%) in the control group experienced nausea and vomiting. No clinically evident respiratory depression occurred in any of the subjects. The authors conclude that administration of 0.1 mg or 0.2 mg of morphine intrathecally is effective in reducing postoperative pain following TURP and that 0.1 mg ITM is not associated with nausea and vomiting.
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Anaesth Intensive Care · Aug 1989
Comparative Study Clinical Trial Controlled Clinical TrialInterpleural administration of bupivacaine after cholecystectomy: a comparison with intercostal nerve block.
Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. ⋯ Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P less than 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter 'top-ups' between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P less than 0.05).
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Randomized Controlled Trial Comparative Study Clinical Trial
Less pain with epidural morphine after knee arthroplasty.
Twenty-two patients were randomly allocated to systemic opioids or epidural morphine the first 10 days after total knee arthroplasty. Pain was recorded daily in a visual analogue scale, and knee motion was measured on Day 10. Pain was lower in the epidural group, with no difference in knee flexion or range of motion.