Articles: postoperative-pain.
-
Acta Chir Scand Suppl · Jan 1989
ReviewThe influence of anesthesia and postoperative analgesic management of lung function.
General anesthesia itself may influence postoperative lung function. It leads to a depression of the functional residual capacity, which, in combination with surgical trauma and postoperative pain, can provoke insufficient breathing, retention of bronchial secretions, and atelectasis. ⋯ After upper abdominal or thoracic surgery, postoperative epidural analgesia causes a significant increase of lung function as compared with systemic analgesia. The combination of regional anesthesia and general anesthesia intraoperatively appears to reduce lung function much less than general anesthesia alone.
-
Review Clinical Trial
Assessment and management of postoperative pain in children.
This paper focuses on the knowledge base about the assessment and management of postoperative pain in children. The first section deals with the nature and characteristics of postoperative pain. A description of current pain management practices with children, focusing on analgesic administration, is derived from available research literature. ⋯ Recent advances in pain assessment and measurement in all age groups, particularly with verbal children and the new self-report measures, are discussed. The latest developments in pharmacological and nonpharmacological techniques for the relief of children's postoperative pain are also described. Finally, the paper concludes with a few suggestions for pediatricians relative to their role in assisting in the search for better assessment and management techniques in the care of postoperative children.
-
In recent years hospitals have begun to institute special postoperative pain services staffed by anesthesia department personnel. The charter for such services is to provide the best and most appropriate postoperative analgesia for surgical patients, in particular for the increasing numbers of patients who, released from hospital soon after surgery, still require pain relief on an outpatient basis. This review focuses on the relative benefits and risks of the currently available options for postoperative pain relief: intramuscular (i.m.) and intravenous (i.v.) administration of narcotics; epidural or subarachnoid administration of narcotics and/or local anesthetics; and peripheral nerve blocks with local anesthetics. In terms of efficacy, cost, risk, and personnel requirements, the particular advantages of continuous analgesia techniques--including patient-controlled analgesia--are discussed.
-
Anesthesia and analgesia · Jan 1989
Randomized Controlled Trial Clinical TrialFailure of proglumide, a cholecystokinin antagonist, to potentiate clinical morphine analgesia. A randomized double-blind postoperative study using patient-controlled analgesia (PCA).
The potential clinical utility of drug interactions between morphine and the cholecystokinin antagonist proglumide was examined in 80 postoperative patients suffering from moderate to severe pain. Four groups of ASA I-III patients (mean age 51 years, mean weight 72 kg) recovering from major abdominal or gynecological surgery (mean duration of surgery 141 minutes) performed under balanced anesthesia (midazolam, droperidol, fentanyl, N2O, enflurane) were randomly assigned to self-administer morphine-proglumide mixtures on the first postoperative day (ODAC; morphine demand dose 3 mg; infusion rate 0.36 mg/hr; lockout time 2 minutes; hourly maximum dose 15 mg/hr; proglumide doses per demand 0, 50 micrograms, 100 micrograms, or 50 mg). ⋯ There were no statistically significant differences between the groups either for drug consumption, pain scores, or side effects. It is therefore concluded that proglumide does not potentiate morphine analgesia in a clinical (postoperative) setting.
-
Minerva anestesiologica · Jan 1989
Randomized Controlled Trial Comparative Study Clinical Trial[Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine].
A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA system was set to deliver bolus of either morphine 1 mg or buprenorphine 0.03 mg, with a lockout interval of 10 and 15 min respectively. ⋯ No difference in side effects between the groups was observed. The mean potency ratio between buprenorphine and morphine was 32:1. Patients receiving buprenorphine showed a more prolonged analgesia and a significant improvement of sedation score.