Articles: postoperative-pain.
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Potent systemic (narcotic) analgesics, when given in doses sufficient to produce ample pain relief, usually also produce mental and respiratory depression and, at times, circulatory impairment, that prolong postoperative morbidity. Complications due to morphine sulfate or meperidine hydrochloride can be minimized by titrating the patient's pain with small intravenous doses of narcotics (morphine sulfate, 2 to 3 mg, or meperidine hydrochloride, 15 to 25 mg) administered slowly at 15- to 20-minute intervals until the pain is relieved. On the third or fourth postoperative day, acetaminophen tablets usually suffice to provide relief of pain with little or no risk to patients. ⋯ These are especially useful after operations on the chest or abdomen or the lower extremity. Regional analgesia is especially indicated in patients not adequately relieved from severe postoperative pain with narcotics, or when these drugs are contraindicated by advanced pulmonary, renal, or hepatic disease. Continuous caudal analgesia is also effective to completely releive severe postoperative pain in the lower limbs and perineum.
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind evaluation of buprenorphine hydrochloride for post-operative pain.
In a double-blind, random assignment study of four groups of 40 patients, relief of severe pain with buprenorphine hydrochloride 0.2 mg or 0.4 mg was evaluated and compared with morphine sulphate 5 or 10 mg. Evaluations included pain intensity, pain relief, sedation and other effects for up to 12 hours after drug administration, following recovery of wakefulness from anaesthesia for major abdominal surgery. Analyses of five parameters showed that the four groups were statistically comparable and that buprenorphine hydrochloride is at least 50 times more potent than morphine sulphate and has a substantially longer duration of analgesic action. Further clinical evaluation is, therefore, recommended.
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Comparative Study Clinical Trial Controlled Clinical Trial
Postoperative analgesia with ketamine and pethidine.
A double-blind trial compared ketamine with pethidine, pethidine alone at two dose levels and a placebo, in patients with postoperative pain. By assessment of pain intensity, observed relief and side-effects, the active drugs were clearly distinguishable from the placebo. With the doses used, however, the combination of ketamine with pethidine showed no advantage over pethidine alone.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anidoxime: a clinical trial of an oral analgesic agent.
The new oral analgesic drug anidoxime was compared with dihydrocodeine. There were no side-effects, and no significant differences between the effects of dihydrocodeine 50 mg, anidoxime 75 mg or anidoxime 100 mg.