Articles: postoperative-pain.
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Twenty patients who underwent thoracotomy were given 2mg of epidural morphine postoperatively. Serum morphine concentrations were determined, analyzed pharmacokinetically, and compared with the degree of analgesia obtained. Excellent analgesia was attained in 11 patients and fair analgesia in the remaining 9 patients. ⋯ Maximal concentration (Cmax) was calculated to be 38.5 +/- 4.2 ng.ml-1 in the excellent analgesia group and 25.7 +/- 4.3 ng.ml-1 in the fair group. The area under the concentration-time curve (AUC) in the fair group was approximately 20% of that in the excellent group. It is concluded that serum morphine levels correlated with analgesic effect in patients receiving epidural morphine after thoracotomy.
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Randomized Controlled Trial Clinical Trial
The effects of peritonsillar infiltration on the reduction of intraoperative blood loss and post-tonsillectomy pain in children.
Improved hemostasis and reduction of postoperative pain are desired goals when performing tonsillectomy. This is especially true in children, who may be reluctant to receive intramuscular injections for pain relief and who may lose a higher percentage of total blood volume during surgery than adults. This study evaluated the effects of peritonsillar infiltration upon operative blood loss and postoperative pain in 42 children. ⋯ Because of the small sample size we were unable to evaluate the beneficial effects of peritonsillar infiltration performed with bupivacaine upon the reduction of the severity of pain and the requirement for narcotic analgesics following tonsillectomy. Therefore, until further studies demonstrate such efficacy, all peritonsillar infiltrations should be performed solely for the purpose of reducing operative blood loss. As such, infiltrations should be performed with either normal saline containing epinephrine (1:200,000) or lidocaine containing epinephrine (1:200,000).
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Randomized Controlled Trial Comparative Study Clinical Trial
Ibuprofen and acetaminophen in the relief of postpartum episiotomy pain.
A single-dose, double-blind, randomized clinical trial was conducted to examine the relative analgesic efficacy of ibuprofen 400 mg (n = 36), acetaminophen 1000 mg (n = 37), and placebo (n = 38) in postpartum patients who had moderate to severe pain after episiotomy. At regular intervals over 4 hours, patients evaluated pain severity and relief on categorical scales and completed a categorical overall evaluation at the end of the trial. ⋯ No adverse effects were reported. Based on the results of this conventional postpartum episiotomy pain model, both agents are considered efficacious and ibuprofen 400 mg is a more effective analgesic for the relief of acute pain than acetaminophen 1000 mg.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind clinical trial of nefopam in comparison with pentazocine in surgical patients.
A double-blind clinical study comparing a new non-narcotic analgesic, nefopam, with pentazocine was carried out on 50 Indian patients. Forty patients had undergone surgical procedures, and the remaining 10 had musculoskeletal or traumatic disorders. There were 25 patients in each group. ⋯ It was also noted that the incidence of side effects was greater in the pentazocine group (61) than the nefopam group (22), the difference being statistically highly significant (p less than 0.001, chi 2-test). A few patients (score 4) in both groups required additional morphine as relief analgesic on the first day of therapy. Thus the non-narcotic nefopam is equally effective as the narcotic pentazocine and has less side effects.