Articles: postoperative-pain.
-
J. Neurol. Neurosurg. Psychiatr. · Dec 1981
Comparative StudyExtradural diamorphine in the control of pain following lumbar laminectomy.
Catheters were inserted into the extradural space under direct vision at the time of surgery for prolapsed intervertebral disc or lumbar canal stenosis. In the post-operative period, diamorphine (3 mg in 5 ml water) was injected through the catheter when patients requested analgesia. In only four of 49 patients was significant pain relief not achieved after extradural diamorphine injection. ⋯ As judged by the improved mobility and by grading on a linear analogue pain scale, the quality of analgesia achieved was better than after intramuscular papaveretum (10-20 mg) and extradural diamorphine was requested less frequently. There were no serious side-effects in the patients studied, although the technique was not used in patients over 55 years of age. Extradural diamorphine appeared to be less effective in two patients who had undergone re-explorations.
-
The effectiveness of methadone given postoperatively by the lumbar epidural route to patients following upper abdominal or thoracic surgery was assessed. Intermittent injections of methadone diluted in large volumes of normal saline were given during the first 48 hours after surgery. Pain relief was assessed by both the patient and an observer using a visual linear analogue scoring system. Methadone 4-5 mg in 18-20 ml normal provided good postoperative pain relief for 6-8 hours.
-
Br Med J (Clin Res Ed) · Oct 1981
Randomized Controlled Trial Comparative Study Clinical TrialImproved pain relief after thoracotomy: use of cryoprobe and morphine infusion.
In a randomised controlled trial carried out during the first to days after thoracotomy patients who had had intercostal nerves frozen with a cryoprobe or were given morphine by continuous intravenous infusion had significant less pain at rest than patients given intramuscular morphine. Differences between the groups with respect to pain on movement and during physiotherapy were not significant. ⋯ The trial did not distinguish between the cryoprobe and infusion treatment. The simplicity of the cryoprobe had much to commend it, but in units without access to this equipment a small infusion pump offers a satisfactory alternative.
-
Acta Anaesthesiol Scand · Oct 1981
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of epidural morphine and epidural bupivacaine for postoperative pain relief.
In 32 patients subjected to total hip replacement, postoperative pain relief was achieved by random treatment with either 5 mg of morphine in 10 ml of saline (n = 15) or 6-8 ml of 0.5% bupivacaine with epinephrine (n = 17), both drugs administered by the lumbar epidural route. In an additional group of 10 patients, post-traumatic thoracic or post-operative abdominal pain was relieved first by 4-6 ml of 0.5% bupivacaine with epinephrine and subsequently by 5 mg of morphine in 10 ml of saline, both drugs being administered by the thoracic epidural route. The duration of analgesia was significantly longer, on average, with morphine (28 h) than with bupivacaine (4.3 h) when the drugs were given by the lumbar route. ⋯ Plasma concentrations of morphine were not detectable 8 h after injection, though the patients still had pain relief. One case of delayed severe respiratory depression occurred 6 h after morphine injection via the thoracic route. Epidural morphine analgesia should therefore be reserved for patients in whom continual surveillance is possible, at least until more is known about the pharmacokinetics of narcotics in the epidural and subarachnoid space.
-
Acta Anaesthesiol Scand · Oct 1981
Comparative StudyCaudal block for post-operative pain relief in children after genital operations. A comparison between bupivacaine and morphine.
Twenty-two children formed the basis for a controlled study of the effect and duration of the postoperatively applied caudal block on postoperative pain after genital operations. The purpose of the study was to compare the effect and duration of bupivacaine and morphine. Ten children (Group I, outpatients) underwent circumcision and 12 children (Group II, inpatients) underwent correction of hypospadias. ⋯ Outpatients were discharged after 4-5 h, and the caudal blocks with both bupivacaine and morphine were then still effective. In inpatients, the duration of pain relief was significantly longer using morphine (range 610-2195 min) than using bupivacaine (range 245-515 min). There were no complications of the caudal blocks.