Articles: postoperative-pain.
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Ann R Coll Surg Engl · Jan 1990
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of postoperative pain relief techniques in orchidopexy.
Fifty consecutive patients admitted to the Western General Hospital for orchidopexy, were randomly allocated to receive either a caudal bupivacaine block or peroperative wound instillation with bupivacaine, to provide postoperative analgesia. Bupivacaine wound instillation reduced the total operating time, gave more efficient postoperative pain relief in hospital and proved both inexpensive and simple in its application.
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Anesthesia and analgesia · Jan 1990
Randomized Controlled Trial Clinical TrialEpidural and intravenous fentanyl infusions are clinically equivalent after knee surgery.
The management of postoperative pain with continuous epidural fentanyl infusion was compared with continuous intravenous fentanyl infusion. In a randomized, doubleblind protocol we prospectively studied 20 patients undergoing repair of the anterior cruciate ligament of the knee. The quality of analgesia and the incidence of side effects were documented. ⋯ There were no significant differences in the incidence of nausea, pruritus, or urinary retention. There was no respiratory depression in either group. We conclude that when compared with continuous intravenous fentanyl infusion, continuous epidural fentanyl infusion offers no clinical advantages for the management of postoperative pain after knee surgery.
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Recent evidence suggests that postoperative pain is poorly controlled and it is reported that nearly 75% of hospitalized patients failed to receive adequate pain relief. It was hypothesized that there was no difference between expected and experienced pain and that pain scores on the first postoperative day would be 'low'. Factors affecting the management of pain were identified using a patient questionnaire. ⋯ The nurse did not play a key role in the preoperative information given to the patient. Patients experienced 'worsened' pain in the morning and evening. Nurses questioning patients about their pain often failed to identify those in pain.
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Recent advances in neurophysiology and neurochemical management of pain has lead to a new concept in pain relief in the post-operative period. After a review of the pain perception mechanism and of the effects of antinociceptive drugs, the authors present simplified protocols for the management of post operative pain in pediatric surgery.
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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.