Articles: postoperative-pain.
-
Systemic application of analgesics is still the most frequently used method of postoperative relief of pain. However, neither intermittent intramuscular nor intermittent intravenous application can provide the patient with a continuous level of analgesia. Lipid-soluble analgesics or those with polar binding that are rapidly metabolized demonstrate an rapid effectiveness. ⋯ After an initial bolus injection, the continuous infusion of an analgesic is guaranteed and may be completed by the patient with several bolus injections. PCA requires careful monitoring. We suggest that a special analgesia team to take care of the patient in special analgesia units might be appropriate in the future.
-
Anesthesia and analgesia · Mar 1988
Comparative Study Clinical Trial Controlled Clinical TrialComparison of buprenorphine with morphine in the treatment of postoperative pain in children.
The safety and efficacy of buprenorphine and morphine as postoperative analgesics for children were compared in 60 boys and girls 4 to 14 years old having elective orthopedic operations on upper or lower extremities. The drugs were given in a double-blind manner initially intravenously and thereafter by sublingual buprenorphine or intramuscular morphine administered as required to relieve pain until the third postoperative morning. ⋯ The most common side effects were nausea and vomiting (28 and 16%) and urinary retention (21 and 19%) in the buprenorphine and morphine groups, respectively. Analgesia with sublingual buprenorphine was as effective and reliable as with intramuscular morphine but a longer duration of action could not be demonstrated.
-
Anesthesia and analgesia · Mar 1988
Randomized Controlled Trial Clinical TrialPostoperative effects of intrathecal morphine in coronary artery bypass surgery.
To determine whether intrathecal morphine is effective in decreasing analgesic and antihypertensive drug requirements after coronary artery bypass (CAB) surgery, a prospective, randomized, double-blind study was designed. Approximately 30 minutes before induction of anesthesia with IV sufentanil and diazepam, and 2 hours before heparinization, one group of patients (n = 16) were given morphine 0.5 mg, while the control group (n = 14) were given placebo intrathecal injections through 22- or 25-gauge lumbar puncture needles. Intraoperatively, there were no differences in the numbers of patients requiring vasodilator drugs or volatile agent titration. ⋯ There were no differences in pain scores, and the only complications (itching, nausea and vomiting) were infrequent. It is concluded that an intrathecal dose of 0.5 mg of morphine is efficacious in reducing analgesic and antihypertensive drug requirements after CAB surgery. Whether these results are clinically important enough to warrant the theoretical risks of postheparinization lumbar hematoma is a topic for further investigation.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Pharmacokinetics and clinical efficacy of intrarectal solution of acetaminophen.
Acetaminophen is frequently administered orally to children for its analgesic properties, although its potency has never been clearly evaluated in this population. In certain situations (patients vomiting or unconscious), acetaminophen has to be given rectally. However, the rectal absorption of suppositories is frequently erratic. ⋯ The absorption of acetaminophen was incomplete (peak serum concentration: 70.8 mumol. L-1) and delayed. We conclude that the rectal administration of acetaminophen at the induction of anesthesia results in incomplete and delayed absorption and does not prevent the occurrence of immediate postoperative pain in children undergoing adeno-tonsillectomy.