Articles: postoperative-pain.
-
Southern medical journal · Nov 1988
Review Clinical Trial Controlled Clinical TrialTranscutaneous electrical nerve stimulation for pain control after cholecystectomy: lack of expected benefits.
We did a prospective study of two groups of patients having elective cholecystectomy through a right subcostal incision to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS). Of 64 patients, 30 received TENS postoperatively and 34 did not. Narcotic use in total dose or on a weight basis was not statistically different between the two groups, nor was there any difference in the occurrence of pulmonary or gastrointestinal complications. The use of TENS after this particular operation did not appear to lessen narcotic use or pain-related complications.
-
Others have demonstrated the effectiveness of intercostal analgesia with bupivacaine hydrochloride (Marcain Plain; Astra). We present a greatly simplified method of effecting this. Our method is dependent on an intact pleura. ⋯ Only 2 patients had postoperative pulmonary complications. No complication related either to the procedure or to the infusion of bupivacaine occurred. The technique as described here is a safe and reliable method of providing analgesia without any side effects after thoracotomy.
-
Minerva anestesiologica · Oct 1988
Randomized Controlled Trial Comparative Study Clinical Trial[Stress and postoperative analgesia].
-
Acta Anaesthesiol Scand · Oct 1988
Pharmacokinetics and protein binding of bupivacaine in postoperative epidural analgesia.
We describe a method, which is both specific and rapid, for the measurement of bupivacaine concentrations in plasma using high-performance liquid chromatography. Bupivacaine plasma concentrations, pharmacokinetics and protein binding in the postoperative period were investigated in seven patients (58-77 years old) following hip surgery. Postoperative analgesia was achieved by epidural bolus injections of 25 mg bupivacaine 0.25% every 6 h. ⋯ The free fraction decreased from 5.4% preoperatively to 2.7% in the postoperative period (P less than 0.05). Changes in plasma protein binding of bupivacaine and changes in plasma levels of the acute phase reactant alpha-1-acid glycoprotein were correlated (r = 0.8, P less than 0.05). Difficulties in interpreting the elimination parameters following epidural administration are discussed, leading to the conclusion that the derivation of dosage regimens from kinetic parameters following epidural administration is not warranted.