Articles: nerve-block.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison between celiac plexus block and morphine treatment on quality of life in patients with pancreatic cancer pain.
Twenty-one patients with pancreatic cancer pain were studied to evaluate the effectiveness of celiac plexus block (CPB) on pain relief and quality of life (QOL), compared to the traditional NSAID-morphine treatment. The criteria were morphine consumption, visual analogue pain scale (VAS), performance status (PS) determined by medical and nursing staffs, and answers to QOL questionnaires. Morphine consumption, VAS, PS, and self-assessed QOL scores were taken when the administration of morphine was necessary for pain relief and those scores were used as control. ⋯ Self-assessed QOL scores did not ameliorate statistically after CPB; however, they did deteriorate remarkably in the patients treated only with morphine-NSAID during their survival periods, while they deteriorated only slightly in the CPB group. There were fewer side effects after CPB. These results indicate CPB does not directly improve QOL in patients with pancreatic cancer pain, but it may prevent deterioration in QOL by the long-lasting analgesic effect, limitation of side effects and the reduction of morphine consumption, compared to treatment only with NSAID-morphine.
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Rev Esp Anestesiol Reanim · Mar 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Brachial plexus anesthesia: results of a modified perivascular supraclavicular technique].
To compare a modified supraclavicular perivascular approach with the axillary perivascular technique for providing brachial plexus blockade. ⋯ The modified perivascular lateral supraclavicular technique is a safe, effective method for providing brachial plexus block.
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Two hundred patients with upper-abdominal malignancy were treated with oral morphine sulfate (OMS) during a 2-year period. Twenty-five of these patients experienced left-sided dragging pain and epigastric discomfort following a few months of adequate pain relief. An increase in the OMS did not relieve the pain. ⋯ All of these patients continued to receive OMS without reduction in dose. Three patients required repeat block after 90 days. This experience documents the value of unilateral celiac plexus block as an adjuvant technique for the management of pain due to upper abdominal cancer.
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Acta Anaesthesiol Scand · Mar 1996
Randomized Controlled Trial Clinical TrialIs preoperative ketorolac a useful adjunct to regional anesthesia for inguinal herniorrhaphy?
Nonsteroidal antiinflammatory drugs (NSAIDs) have become a popular component of analgesia regimens, particularly in combination with narcotics. We questioned whether there might also be a place for their use in conjunction with regional anesthesia and whether there was a preferable route for NSAID administration. ⋯ Beyond the analgesia provided by the regional anesthesia of the ilioinguinal and field blocks, the preoperative use of ketorolac further reduced postoperative pain scores and the need for additional postoperative analgesic medication. Comparable outcomes for the i.v., i.m. and i.w. groups indicate the lack of any benefit to concentrating the non-steroidal anti-inflammatory drug at the wound (i.w.) or to achieving high blood levels rapidly (i.v.). In conclusion, ketorolac is a useful supplement to ilioinguinal plus field block regional anesthesia for hernia surgery and is most effective administered parenterally.