Articles: postoperative-pain.
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Anaesth Intensive Care · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialEpidural pethidine or fentanyl during caesarean section: a double-blind comparison.
The onset, quality and duration of analgesia and side-effects of a single bolus dose of either epidural pethidine 50 mg or fentanyl 100 mcg, administered immediately post-delivery, were compared in a randomised, double-blind study of fifty-five women undergoing epidural caesarean section. The onset of effect was more rapid with fentanyl, a significantly larger number of women achieving complete pain relief fifteen minutes post-administration (P less than 0.05). ⋯ One patient in the pethidine group experienced early onset respiratory depression; however, she did not require active treatment. Epidural fentanyl 100 mcg appears to offer a small clinical advantage over pethidine 50 mg for intraoperative use during caesarean section.
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Randomized Controlled Trial Clinical Trial
Use of transcutaneous electrical nerve stimulation for postoperative pain.
This study examined the effects of transcutaneous electrical nerve stimulation (TENS) on incisional pain caused by the procedure of cleaning and packing an abdominal surgical wound. Seventy-five subjects (mean age 56.9 years) were randomly assigned to one of three intervention groups: TENS, placebo-TENS, or no-treatment control. ⋯ Subjects who received TENS reported a significantly lower level of pain after dressing change than did those subjects who received either placebo-TENS or no-treatment. Drug administration variables did not contribute significantly to level of reported pain.
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A transdermal formulation of fentanyl (TTS-fentanyl, Alza Corp., Palo Alto, CA) was evaluated in 13 surgical patients after an abdominal operation. An intraoperative dose of fentanyl (100-200 micrograms i.v.) was administered at the same time as the TTS-fentanyl systems (50-125 micrograms/h) were applied to the antero-lateral chest wall. The TTS-fentanyl systems remained in situ for 24 h and were then removed and a second lot of systems were applied to the contra-lateral chest wall. ⋯ These effects were due to the combined effects of a sustained blood fentanyl concentration and the intermittent supplementary pethidine doses. Side effects due to the topical formulation were transient and included erythema (8 patients) and a minor rash (2 patients) in the area occluded by the systems. The TTS-fentanyl systems provided a significant contribution to postoperative pain control but, at the TTS dose rates used, supplementary doses of pethidine were required by all patients probably to control 'incident' pain.
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Anaesth Intensive Care · May 1989
Randomized Controlled Trial Clinical TrialEpidural morphine by the thoracic or lumbar routes in cholecystectomy. Effect on postoperative pain and respiratory variables.
Thirty-seven women undergoing elective cholecystectomy were randomised into two groups, receiving either lumbar epidural morphine (group L) or epidural morphine via the thoracic route (group T). The effect on pain relief was assessed by a visual analogue scale and included both resting pain and 'provoked' pain. ⋯ No significant difference was observed between the groups concerning pain relief or respiratory performance. We conclude that after cholecystectomy lumbar epidural morphine is as effective as thoracic epidural morphine in relieving postoperative pain.