Articles: postoperative-pain.
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Comparative Study Clinical Trial Controlled Clinical Trial
Analgesic comparison of propiram fumarate with pentazocine, codeine, and placebo in postsurgical pain.
The safety and effectiveness of a single oral dose of 50 mg propiram fumarate as an analgesic was compared in a double-blind clinical trial trial against single doses of standard reference analgesics (50 mg pentazocine hydrochloride or 60 mg codeine sulfate) or placebo. Subjects were adult patients experiencing severe postsurgical pain. ⋯ These were not severe enough to require treatment. Propiram fumarate (50 mg) was shown to be an effective and safe analgesic in the treatment of severe postsurgical pain.
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1 The intensity of postoperative pain is influenced by many factors, for example, individual variation, site of incision and type of operation, anaesthetic technique, and the interval from the end of operation to the appearance of pain. 2 These factors affect the efficacy of analgesics. 3 Mild analgesics provide adequate pain relief in half of our patients in the immediate postoperative phase when the pain is slight to moderate. 4 The maximum effect of mild analgesics corresponds to that produced by morphine 6-10 mg. Adequate analgesia may not therefore be provided for the treatment of severe postoperative pain unless narcotic analgesics have been used peroperatively. 5 When mild analgesics are combined with narcotics synergism is achieved. 6 As postoperative pain decreases with time, mild analgesics usually provide adequate pain relief on the first and following postoperative days.
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It is possible that admission to hospital of methadone maintenance clients requiring treatment for pain with narcotics may result in an increase in methadone maintenance dose and affect subsequent rehabilitation of the client. The hospital admission itself may modify the subsequent outcome of the client. ⋯ Twenty-five had been admitted to the Surgical Service of Bellevue Hospital, New York City, for a variety of conditions and for periods ranging from 2 to 43 days; twenty-five were not admitted to the Hospital. Irrespective of whether or not large amounts of narcotic analgesics had been added to the maintenance methadone, patients were discharged on the same amounts of maintenance methadone as on admission and had eventual courses and outcomes similar to the control group when followed for a mean period of 20 months.
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British medical journal · Aug 1980
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory effects of analgesia after cholecystectomy: comparison of continuous and intermittent papaveretum.
Two methods of administering papaveretum for relieving postoperative pain were compared in two groups of patients who had undergone cholecystectomy. In one group a loading dose of papaveretum was administered by continuous intravenous infusion (1 mg/min) until the patient could breathe deeply without undue pain. ⋯ The intravenous regimen relieved pain better than the intramuscular regimen, which may have reflected the larger dose of papaveretum given to the intravenous group, but it was accompanied by a greater degree of respiratory depression and potentially life-threatening changes in respiratory pattern. These findings suggest that the fear which often accounts for inadequate postoperative pain relief-that larger dose of analgesics will cause respiratory complications-is well founded.