Articles: postoperative-pain.
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Randomized Controlled Trial Clinical Trial
Epidural morphine for analgesia after caesarean section.
A randomized double blind placebo controlled study of the efficacy, duration and safety of epidural morphine for the management of pain after Cesarean section is reported. Three similar groups of patients received either 0, 4 mg or 8 mg of morphine sulphate in 10 ml of normal saline through an epidural catheter at the completion of the operation. ⋯ Two patients who received epidural morphine 8 mg plus additional narcotic or antihistamine had reduced respiratory rates but were easily rousable. Our experience suggests that the epidural administration of morphine 4 mg may be a safe and reliable method of obtaining prolonged analgesia following Caesarean section.
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Randomized Controlled Trial Clinical Trial
[Investigations on epidural morphine. Efficacy, solvent, analgesic supplementation].
The effects of epidural morphine for pain relief after orthopaedic surgery of the lower extremity were examined in 60 patients. Intraoperative analgesia was achieved with epidural administration of 2% mepivacaine. The patients were divided in a double-blind, random fashion into 3 groups. ⋯ The solution (glucose or normal saline) had no influence on morphine effectiveness. The side effects were urinary retention in 8 patients (20%) and pruritus in one (3%). It is concluded that 2 mg of morphine base administered epidurally is an effective method of postoperative pain relief in orthopaedic patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic efficacy of parenteral metkephamid acetate in treatment of postoperative pain.
The analgesic efficacy and side-effects of a single parenteral dose of metkephamid acetate 70 mg were compared with those of pethidine (meperidine) hydrochloride 100 mg and placebo in a double-blind, randomised, controlled clinical trial. 30 out of 32 postoperative patients completed the study--10 in the metkephamid group, 11 in the pethidine group, and 9 in the placebo group. The time-effect curves of summated pain measures and analyses of derived measures all indicated that the analgesic activity of metkephamid 70 mg was significantly greater than that of placebo and not less than that of pethidine 100 mg. The metkephamid group had a greater incidence of side-effects than the other two treatment groups. Some side-effects, such as sensations of heaviness of the extremities and nasal congestion, were peculiar to metkephamid but not distressing.
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Different doses of epidural morphine were studied in order to determine their effectiveness in providing postoperative pain relief after surgery of the lower extremities and their relationship to the incidence of untoward reactions. The study was carried out in a double-blind fashion using five dosages of epidural morphine (0.5, 1.0, 2.0, 4.0, and 8.0 mg) and included 60 patients. The higher doses of morphine (2.0, 4.0, and 8.0 mg) were equally effective and more effective than the lower doses (0.5 and 1.0 mg) in providing postoperative analgesia. ⋯ No statistically significant difference was found between the doses studied with regard to itching, urinary retention, and respiratory depression; the latter was evaluated in a subgroup of 20 patients. These data suggest that effective postoperative pain relief after surgery of the lower extremities can be achieved with relatively low doses of morphine sulfate and with minimal side effects. For the type of surgery studied, 2 mg morphine sulfate appeared to be the optimum dose.
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Anasth Intensivther Notfallmed · Jun 1982
Clinical Trial Controlled Clinical Trial[Pain treatment by sub or epidural opiate administration].
Morphine and opiate analogues for pain relief were applied epidurally or intrathecally. Synthetic opioids, eg. pethidine, pentazocine or piritramide proved unsuitable with both modes of administration. Only morphine in doses as low as 2 mg reliably produced analgesia lasting from 16-24 hours. ⋯ Conversely this very side effect may advantageously be employed in patients on ventilator treatment as a method for analgesia and sedation. Lumbar epidural administration of single doses of morphine 2 mg at present is the most effective treatment both for pain following thoracotomy, laparotomy, surgery on the vertebral column, gynecological and urological procedures and pain due to trauma to the chest wall or pelvis, provided supervision in an intensive care ward guards against possible side effects. Epidural or intrathecal opiate is not suitable for the treatment of chronic or functional pain.