Articles: postoperative-pain.
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Acta Anaesthesiol Scand · Dec 1980
Comparative Study Clinical TrialDouble-blind, multiple-dose comparison of buprenorphine and morphine in postoperative pain.
The analgesic profile and side-effects of buprenorphine 0.3 mg and morphine 10 mg intramuscularly were compared postoperatively in a double-blind, non-crossover, multiple-dose study. When the patient complained of moderate to severe postoperative pain after halothane-relaxant anesthesia for upper abdominal surgery, the first test dose of either drug was given. Subsequent similar doses of buprenorphine 0.3 mg or morphine 10 mg were given when required (maximum ten doses). ⋯ Other effects of the two drugs on vital signs were similar. The incidence of other side-effects was fairly similar after both analgesics. The patients' subjective appraisal favoured buprenorphine.
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Morphine 2 mg was injected directly into the intrathecal space in 33 patients. In the nonoperative group (group I) morphine was given with 2 ml saline solution; in the operative group (group II, 21 patients) morphine was given with 2 ml 10% glucose solution immediately before induction of anaesthesia. The onset of pain relief occurred after 12 to 35 min and the duration of analgesia was 14 and 18 35 min and the duration of analgesia was 14 and 48 hours. ⋯ In group I bladder insufficiency occurred in 2 cases. The disturbed bladder function recovered spontaneously in a few hours after morphine application. Respiratory depression was treated successfully with naloxone.
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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.