Articles: postoperative-pain.
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Our experience in treating 10 patients with intractable pain with paraplegia employing percutaneous epidural or dorsal column stimulation is presented. Initial and long-term results in this group are contrasted with those of 9 patients with intractable post-amputation or post-traumatic neuroma pain. The successful results of neurostimulation treatment of peripheral nerve pain contasts with the disappointing results in the treatment of paraplegic pain.
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The effect of local nerve blockade on the relief of postoperative pain is reported in a series of 167 patients who underwent surgery of the arm, knee or foot. In 80% of cases analgesics were not required within 4 hours postoperatively, and in 39% analgesics were not required within 8 hours. Conventional methods of postoperative pain relief are not always effective. Local nerve blockade can be used to provide complete analgesia after limb surgery and is therefore of great value to postoperative care.
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Transcutaneous electrical nerve stimulation (TENS) was evaluated as a postoperative analgesic. Patients undergoing lumbar spine operations, hip surgery, and gynecological laparotomies were studied. ⋯ Results from 46 experimental patients demonstrated that TENS could reduce the demand for postoperative narcotics in a group of patients who had not used narcotic analgesics before operation. No significant benefit was observed for patients who had used narcotics prior to operation.
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Comparative Study Clinical Trial
A double-blind comparison of parenteral dipyrone and pethidine in the treatment of post-operative pain.
A double-blind trial was carried out in 100 patients with moderate to severe post-operative pain to compare the analgesic effectiveness over a 6-hour period of single intramuscular injections of 2.5 g dipyrone and 100 mg pethidine. Maximum pain relief was seen 2 hours after drug administration in both groups and there was no statistically significant difference in responses. No side-effects were reported.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of lysine acetylsalicylate and oxycodone in postoperative pain following upper abdominal surgery.
Intravenous lysine acetylsalicylate (LAS) and oxycodone were compared under double-blind conditions for analgesia after upper abdominal surgery in sixty patients anaesthetized by N2O--O2--halothane--relaxant technique. Either 125 mg/10 kg or 250 mg/10 kg LAS or 0.4 mg/10 kg or 0.8 mg/10 kg oxycodone was randomly administered when the patients complained of moderate or severe postoperative pain. When 30 min had elapsed following the injection of the test drug, oxycodone was given in 4 mg increments on demand until adequate pain relief was achieved. ⋯ However, LAS had a slower onset of action. Sweating seemed to occur more frequently after LAS than oxycodone, but significant changes in respiratory rate or sedation following LAS-oxycodone combinations when compared to oxycodone alone were not noted. The results show that for analgesia after upper abdominal surgery, 1.8 g of LAS may be substituted for about 6 mg of oxycodone.