Articles: postoperative-pain.
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Comparative Study
Postoperative analgesia in major orthopaedic surgery. Epidural and intrathecal opiates.
Sixty-two patients were given morphine 2 mg and 69 patients were given diamorphine 0.5 mg by either the epidural or intrathecal route. All had undergone either total hip replacement or spinal disc surgery. ⋯ Headache, pruritus, urinary retention and nausea and vomiting were recorded, the incidence of the latter being unacceptably high, particularly when the drugs were administered by the intrathecal route: one patient required resuscitation. It is suggested that previously reported respiratory depression using these techniques is associated with the administration of other analgesics contemporaneously; that dosage should be limited to one-fifth of the estimation intramuscular dose; and that patients should be observed in a recovery ward for 24 hours.
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Comparative Study Clinical Trial
Postsurgical pain: zomepirac sodium, propoxyphene/-acetaminophen combination, and placebo.
Zomepirac sodium, a new, nonnarcotic analgesic agent, was compared with the combination of propoxyphene/acetaminophen in a placebo-controlled, double-blind, single-dose study in 196 hospitalized postsurgical patients with pain severe enough to require a prescription analgesic. Patients received 100 mg zomepirac sodium, 50 mg zomepirac sodium, 100 mg propoxyphene napsylate with 650 mg acetaminophen, or placebo. Total pain relief during the 6-hour observation period showed that 100 mg zomepirac sodium was significantly more effective than the propoxyphene combination. ⋯ Percentages of patients requiring remedication before the end of the study were: 77 per cent for placebo, 48 per cent for propoxyphene/acetaminophen, 43 per cent for 50 mg zomepirac sodium, and 29 per cent for 100 mg zomepirac sodium. The numbers of patients reporting side effects were not significantly different among the treatment groups. These results confirm those of other single-dose pain studies which showed 100 mg zomepirac sodium significantly more efficacious than the propoxyphene/acetaminophen combination.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of meptazinol and pethidine given i.v. on demand in the management of postoperative pain.
Meptazinol and pethidine were compared under double-blind conditions in 20 patients, using an on-demand analgesic system to provide pain relief after upper abdominal surgery. The degree of analgesia, subjectively assessed, was good with both meptazinol and pethidine; although meptazinol produced significantly more nausea than did pethidine (P less than 0.01), there was no statistically significant difference in the frequency of other side-effects. Over 24 h average consumption of meptazinol was 2.4 times that of pethidine, suggesting that, when given by i.v. injection, meptazinol is less potent that pethidine.
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Comparative Study Clinical Trial Controlled Clinical Trial
Postoperative spinal analgesia with morphine.
Patients with pain after operation received morphine hydrochloride intrathecally in doses of 0.02 mg kg-1 (n = 30) and 0.2 mg kg-1 (n = 30). The high-dose group showed slightly longer-lasting and more potent analgesia than the low-dose group. ⋯ Two patients of the high-dose group showed evidence of respiratory depression which appeared after a late change in posture (7 and 11 h). We conclude that postoperative analgesia with intrathecal morphine 0.02 mg kg-1 must be followed by a prolonged head-up posture and be performed in hospital units where the treatment of respiratory depression is competent.
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Comparative Study Clinical Trial
Zomepirac sodium vs APC with codeine for oral surgery pain.
In this double-blind, repeat-dose study, 323 outpatients with moderate to severe pain after oral surgery assessed zomepirac sodium, a new oral, single-entity, nonnarcotic analgesic, and APC with codeine, 30 mg, a reference standard. Pain relief obtained with 100 mg of zomepirac sodium was significantly superior to that of APC with codeine, 30 mg; 50 mg of zomepirac sodium was as effective as the reference drug. The analgesic acceptability was highest for 100 mg of zomepirac sodium. Both doses of this new drug produced significantly fewer adverse reactions than APC with codeine, 30 mg.