Articles: postoperative-pain.
-
J. Oral Maxillofac. Surg. · Feb 1987
Randomized Controlled Trial Clinical TrialEffect of pretreatment with acetaminophen-propoxyphene for oral surgery pain.
To determine the effect of pretreatment and multiple doses on postsurgical pain, a study of the relative analgesic efficacy of placebo, acetaminophen 650 mg, and propoxyphene napsylate 100 mg alone and in combination was conducted. Forty-five patients undergoing surgical removal of impacted third molar teeth under local anesthesia were randomly allocated to the four treatment regimens under double-blind conditions. The first oral dose was administered one hour preoperatively and the second dose when the pain became moderate or severe, following the dissipation of the local anesthesia. ⋯ Duration of analgesia was also significantly longer with both propoxyphene-containing treatments. No side effects were reported. The results suggest that pretreatment with a narcotic agonist markedly improves postoperative analgesia.
-
Int J Oral Maxillofac Surg · Feb 1987
Randomized Controlled Trial Comparative Study Clinical TrialSuprofen versus paracetamol after oral surgery.
A randomized double-blind trial was performed to evaluate efficacy and tolerability of suprofen 200 mg (Suprocil) in comparison to paracetamol 500 mg after surgical extraction of a wisdom tooth. The study lasted 4 days per patient at the longest. Pain intensity and pain relief were evaluated by the patients using a visual analog scale. ⋯ No significant differences between the 2 treatments was seen. Tolerability was rated good by all but 1 patient in each treatment group; with suprofen, 1 result was moderate, while with paracetamol, 1 result was poor. Adverse reactions occurred in 3 patients on suprofen and in 2 patients on paracetamol, though these reactions could not be related to the use of the drug itself.
-
Small doses of epidural and intrathecal opioids produce effective and prolonged analgesia postoperatively, although the quality of analgesia does not differ from when conventional routes are used. The different opioids differ only in the speed of onset and duration of action, and in the incidence of side-effects. 'Minor' complications such as nausea, vomiting, pruritus and retention of urine are relatively common. ⋯ It is commoner after morphine and after intrathecal administration, and is also associated with advanced age, concomitant use of other central depressant drugs, respiratory disease and large doses. Because of the potentially lethal nature of this complication, it is recommended that the epidural and intrathecal routes of administration are used only when patients can be closely and constantly observed postoperatively.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Continuous intercostal blockade after cardiac surgery.
The provision of analgesia using continuous bilateral intercostal blockade was compared with that provided by conventional i.v. narcotics for the first 48 h after cardiac surgery. The subjective quality of analgesia was significantly superior with the regional technique. However, pulmonary function tests, gas exchange, lung volume, and radiological and clinical evidence of pulmonary complications were not improved. The failure to reduce morbidity and the potential for complications such as pneumothorax, makes it difficult to recommend the regional analgesia technique in this situation.
-
Five patients who underwent thoracic operations had an extradural catheter placed in the paravertebral space. X-ray contrast was injected through the catheters. ⋯ In one patient, contrast appears to have entered the extradural space and, in another who had no detectable analgesia, the contrast was probably dispersed intrapleurally. The significance of these findings is discussed.