Articles: postoperative-pain.
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Patient-controlled analgesia (PCA, intravenous self-application of narcotics) was studied during the early postoperative period. Subjects were 40 ASA I-III patients recovering from elective major and minor surgery (each 20 having undergone abdominal or orthopaedic operations). Pentazocine bolusses of each 8 mg were available via a hand-button whenever the patients felt pain relief necessary, and delivered by a microprocessor-controlled injection pump (On-Demand Analgesia Computer, ODAC). ⋯ Side effects (nausea, emesis, sweating) occurred in about 10-18% but were usually of minor intensity. Circulatory or respiratory problems were not observed during the PCA period. Patient-controlled analgesia is discussed as a promising concept for the treatment of acute pain and clinical pain research.
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Int J Clin Pharmacol Ther Toxicol · Jan 1985
Epidural morphine as postoperative analgesic following cesarean section under epidural analgesia.
Low dosage epidural morphine (4 mg) provided adequate postoperative pain relief in patients undergoing elective cesarean section under epidural analgesia. In the control group (n = 11), all but one patient needed opiates postoperatively, but 9 patients out of the 11 receiving epidural morphine needed only mild analgesics or no analgesics at all, postoperatively. Slight nausea and facial itching were the most common unwanted effects in the epidural morphine group. Low dosage epidural morphine is a useful tool in postoperative pain treatment following cesarean section.
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Postoperative pain was treated by epidural administration of 30 to 50 mg pethidine (5 mg X ml-1) in a group of 36 patients who had undergone retropubic prostatectomy. Surgery was carried out under epidural anaesthesia with lidocaine. Pain was assessed by means of the visual analogue scale. ⋯ There was a significant decrease in pain at the first hour after injection; differences in pain scores at the third hour were not significant. No noticeable side-effect was observed. It was concluded that low doses of epidural pethidine were efficient on postoperative pelvic abdominal pain, but that doses should be increased if painless coughing was required.
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Randomized Controlled Trial Clinical Trial
Effects of preoperative teaching on postoperative pain: a replication and expansion.
This study was designed to test the effectiveness of brief relaxation training on postoperative pain, replicating and extending a study of Flaherty and Fitzpatrick (1978). A two-group pre- and post-test experimental design was used to determine if vital signs, analgesic consumption, anxiety, self-reported incisional pain sensation and distress differ in postsurgical patients who have or have not received relaxation training. Seventy-two adult, elective abdominal surgery patients were randomly assigned to treatment groups. ⋯ Vital signs, analgesic consumption and self-reported pain sensation were not altered by relaxation training. These findings only partially agree with those of Flaherty and Fitzpatrick. Additional analyses by type of surgery (cholecystectomy and hysterectomy) showed hysterectomy subjects reported less pain sensation and distress and used less analgesics than cholecystectomy subjects.
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Eur. J. Clin. Pharmacol. · Jan 1985
Randomized Controlled Trial Clinical TrialMultiple doses of paracetamol plus codeine taken immediately after oral surgery.
A double-blind randomized analgesic trial was carried out in 180 patients undergoing surgical removal of an impacted lower wisdom tooth. The patients received the first dose of either paracetamol 1000 mg plus codeine 60 mg, paracetamol 500 mg plus codeine 30 mg or placebo immediately after surgery during the effect of the local anaesthetic. The mean pain intensity, the duration of effect and the number of patients needing additional analgesics were all significantly dose related. ⋯ In addition, the analgesic efficacy was calculated over a 12 hour period after first medication and thereby including the efficacy of a second dose, if taken. Paracetamol 1000 mg plus codeine 60 mg followed by paracetamol 500 mg plus codeine 30 mg after around 5 hours was a very effective treatment and over 40% of these patients did not need any further pain relief during the evaluation period. In conclusion, an effective analgesic taken immediately after oral surgery reduces the total pain and diminishes the need of analgesics.