Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
Effects of intrathecal morphine, injected with bupivacaine, on pain after orthopaedic surgery.
Morphine hydrochloride 0.4 mg was administered with isobaric 0.5% bupivacaine intrathecally for orthopaedic surgery and produced good analgesia for about 24 h after operation in both elderly (60-80 yr) and middle-aged patients (30-50 yr). Morphine 0.2 mg (older patients only) was not as effective in preventing pain after operation, but even this dose postponed the requirement for analgesia. Morphine did not change the quality of spinal anaesthesia. ⋯ Severe delayed respiratory depression was not noted. Urinary retention and minor voiding difficulties were the most disturbing side-effects. This complication did not appear to be dose-dependent, and also occurred in patients not receiving morphine.
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Morphine sulphate 5 mg and placebo administered epidurally after caesarean section under epidural analgesia were compared in a double-blind fashion. Morphine was significantly superior to placebo for pain relief, duration of pain relief, and reduction of parenteral narcotic requirements. ⋯ There was no statistical difference between morphine and placebo in the incidence of urinary catheterisation, vomiting, nausea, dizziness or drowsiness. No serious respiratory depression requiring treatment was observed.
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J. Clin. Periodontol. · May 1983
Comparative StudyEfficacy of paracetamol in reducing post-operative pain after periodontal surgery.
In a double-blind, placebo-controlled study, the efficacy of 2 doses of paracetamol (500 and 1000 mg) was assessed in post-operative pain after periodontal flap surgery. Both doses of paracetamol provided greater analgesia than placebo, however, significant analgesia (P less than 0.05) was only noted in the early post-operative period. The analgesia from both doses of paracetamol did not differ significantly throughout the 3-day observation period, however, greater analgesia was attributable to 1000 mg paracetamol in the immediate post-operative period. The results from this study suggest that paracetamol is an effective analgesic for controlling post-operative pain after periodontal flap surgery, with 1000 mg dose being more effective than 500 mg immediately after surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of effects of intraoperative and postoperative methadone: acute tolerance to the postoperative dose?
The effects of methadone 10 mg administered in two different clinical contexts, at induction of anaesthesia and following operation, were studied in two groups of patients undergoing elective total hip replacement. The intraoperative group received methadone 10 mg i.v. at induction of anaesthesia as part of a balanced anaesthetic technique. The postoperative group received methadone 10 mg i.v. following operation, extradural bupivacaine being used for the operative period. ⋯ Subsequently, the postoperative group had a significantly greater analgesic requirement which resulted in significantly greater plasma methadone concentrations the following morning. Thus, the administration of methadone following operation appeared to exert less analgesic effect than the same dose given during operation. The reasons for this are discussed.