Articles: postoperative-pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Buprenorphine and morphine efficacy in postoperative pain: a double-blind multiple-dose study.
The analgesic activity of buprenorphine was monitored versus that of morphine in a double-blind, randomized, multiple-dose, parallel-design study involving 97 postsurgical patients. Patients could receive intramuscular injections of either buprenorphine (0.3, o.45, or 0.6 mg) or morphine (10, 15, or 20 mg) every 3 or more hours. ⋯ It has been suggested that the addictive potential of buprenorphine may be less than that of morphine. Since both drugs seem to be effective analgesics, buprenorphine appears to offer an effective and safe alternative to morphine for patients with acute pain.
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Thirty-five patients were delivered by electric Caesarean section under general or epidural anaesthesia. For postoperative analgesia they received narcotic analgesics as required and either transcutaneous nerve stimulation or an inactive stimulator. ⋯ The epidural patients did not receive any additional benefit from active stimulation, but had the same amount of pain and the same analgesic requirement as patients receiving active stimulation following general anaesthesia. The possible causes for the failure of transcutaneous nerve stimulation after epidural anaesthesia and their implications are discussed.
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NIDA research monograph · Apr 1982
Clinical analgesic assay of sublingual buprenorphine and intramuscular morphine.
A six-point, incomplete block assay of sublingual buprenorphine and intramuscular morphine has been carried out, providing valid relative potency estimates of the two drugs in terms of total relief on both categorical and visual analog scales. Sublingual buprenorphine was about 15.5 times as potent as intramuscular morphine in terms of these total relief estimates. Similar relative potency estimates were obtained using first-dose-only data. ⋯ At equivalent peak effects, it produced longer-lasting analgesia. Side effect occurrence was roughly comparable for the two drugs, and no evidence of narcotic antagonist activity was seen after buprenorphine. The six-point assay proved to be effective in defining the dose-effect curves and relative potencies of the two drugs.
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Surg Gynecol Obstet · Mar 1982
Clinical Trial Controlled Clinical TrialEpidurally administered morphine for postcesarean analgesia.
A double blind study was performed to evaluate analgesia from epidurally injected morphine sulfate in 30 mothers after cesarean section following similar regional anesthetics. When compared with a saline placebo and 2 milligrams of epidurally injected morphine, a 4.5 milligram epidurally administered morphine dose resulted in a highly significant reduction in the initial 24 hour parenterally administered narcotic requirement, p less than 0.001, and a significantly greater duration of analgesia after epidural injection, p less than 0.0003. ⋯ No significant side-effects were noted. Epidurally administered morphine appears promising as a potent analgesic approach of extended duration with potential advantages for early maternal mobilization, improved fetal maternal interaction and reduced fetal narcotic exposure in the breast fed infant.
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Clinical Trial Controlled Clinical Trial
[Peridural anesthesia and analgesia results in general surgery].
Anesthesia for major general surgery should involve the use of anesthetic techniques that might reduce the risk of intraoperative and postoperative complications. The combination of intraoperative epidural anesthesia with local anesthetics (EPA) and the use of epidural opiates for postoperative pain relief shows advantages over the application of pure general anesthesia and over postoperative systemic analgesia. Epidural opiates lead to better quality analgesia with a quicker onset and longer duration than systemical analgesics. ⋯ After epidural opiates no significant decrease could be seen. Intraoperative use of EPA has the advantages of better hemodynamic conditions and a blockade of the endocrine-metabolic response to surgery. Postoperative peridural opiates block the endocrine response as well: the serum levels of ADH and cortisol are lower than under systemic analgesia.