Articles: postoperative-pain.
-
Journal of neurosurgery · Sep 1985
Randomized Controlled Trial Clinical TrialUse of intrathecal morphine for postoperative pain relief following lumbar spine surgery.
A randomized prospective double-blind trial of intrathecal morphine for postoperative pain relief following lumbar spine surgery is described. Intrathecal morphine significantly reduced the mean pain score in the postoperative period (p less than 0.01) and there was a corresponding significant reduction in the need for additional postoperative analgesia (p less than 0.05). The possible mechanism of action of intrathecal morphine and the potential advantages of this technique are discussed. Possible side effects are also considered, and caution is urged until wider experience has been obtained.
-
The incidence of post-operative pain was determined among 200 adult Nigerian patients who presented for a variety of surgical procedures. The overall incidence of moderate to severe post-operative pain was 68% while the remaining 32% complained of only mild pain. ⋯ The use of opiates pre-operatively for premedication and anaesthetic techniques using intra-operative opiates or ketamine delay the onset and reduce the severity of post-operative pain. No sex difference was observed but elderly patients (especially above 50 years of age) tended to have lower pain ratings.
-
Anesthesia and analgesia · Aug 1985
Randomized Controlled Trial Clinical TrialEpidural morphine: a clinical double-blind study of dosage.
The purpose of this randomized double-blind study was to determine the optimal dose of epidural morphine by establishing a dose-effect relationship. The 139 patients, who had orthopedic operations on the lower extremities, received continuous lumbar epidural anesthesia with bupivacaine, 0.75%, with or without the addition of 1, 2, 3, 4, or 5 mg of morphine hydrochloride. Analgesia and side effects were determined during the first 24 hr postoperatively. ⋯ Frequency of catheterization and pruritus increased dose-dependently. The mean PaCO2 after 5 mg of epidural morphine averaged 5 mm Hg higher than in the control group, indicating minor respiratory depression, better analgesia, or both. The dose of 3 mg of epidural morphine added to the local anesthetic is recommended for postoperative analgesia after surgery of the lower extremity; it is a compromise that provides adequate analgesia with an acceptably low frequency and intensity of side effects.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Efficacy and quality of ibuprofen and acetaminophen plus codeine analgesia.
Ibuprofen, 400 mg, was compared with 300 mg acetaminophen plus 30 mg of codeine and placebo in 120 post-orthopedic surgery patients with moderate to severe pain. The study was designed as a double-blind, single-dose, parallel-group analgesic efficacy assay. Estimates of analgesia were obtained up to 6 h using categorical and visual analog measures of pain intensity and pain relief. ⋯ Ibuprofen provided greater improvement in selected elements of mood than acetaminophen plus codeine at comparable levels of pain relief. While decreases in the sensory component of pain were most highly associated with pain relief provided by ibuprofen, decreases in the affective component were most highly associated with pain relief following acetaminophen plus codeine. These latter results indicate that mood assessment and the discrimination between sensory and affective components of pain could be particularly useful within analgesic drug assays, especially when comparing analgesics of differing pharmacologic class and when comparing the results of such assays in pain syndromes characterized by differing pain quality.