Articles: postoperative-pain.
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Anesthesia and analgesia · Sep 1987
Randomized Controlled Trial Comparative Study Clinical TrialEpidural butorphanol or morphine for the relief of post-cesarean section pain: ventilatory responses to carbon dioxide.
To determine the safety, efficacy, and the ventilatory responses to carbon dioxide (CO2) of epidurally administered butorphanol or morphine, 122 healthy women who underwent cesarean section with epidural anesthesia were studied. Patients were randomly assigned to receive one of four epidural regimens for the relief of postoperative pain: 5 mg morphine (n = 32), 4 mg butorphanol (n = 30), 2 mg butorphanol (n = 29), or 1 mg butorphanol (n = 31). Epidural morphine provided satisfactory analgesia with slow onset and long duration of approximately 21 hr. ⋯ The ventilatory response to CO2 was depressed after morphine and after 2 and 4 mg butorphanol, but the duration of depression was more prolonged after morphine. It is concluded that epidural butorphanol is effective in providing pain relief after cesarean section with minor side effects. However, patients must be observed closely because of possible respiratory depression.
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To determine how pain is assessed and managed in the early postoperative period, what the prescribing habits and general opinions on postoperative pain are, and what suggestions for future improvement could be made, questionnaires were sent to 430 anesthesia departments in the FRG. Of these, 188 were returned (38% response). ⋯ The study highlighted deficiencies in communication between the anesthetic staff and the patients that resulted in poor assessment of acute pain problems. The findings indicate a need to document pain and pain relief more often and more precisely in order to improve postoperative pain control.
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Anesthesia and analgesia · Aug 1987
Randomized Controlled Trial Comparative Study Clinical TrialEpidural ketamine for postoperative pain relief after gynecologic operations: a double-blind study and comparison with epidural morphine.
This double-blind study evaluates whether ketamine given epidurally is effective for postoperative pain relief, and compares the effects of epidural ketamine with those of epidural morphine. Sixty-eight patients undergoing abdominal gynecologic surgery were randomly assigned into six groups (control; ketamine 4, 6, and 8 mg in saline; 6 mg in 10% glucose; morphine 3 mg). ⋯ Significantly, none of the patients in the morphine group needed additional analgesics within 24 hr, whereas 85% in the other five groups did. We conclude that ketamine administered epidurally is inadequate for postoperative pain relief after gynecologic operations.