Articles: postoperative.
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Surveys show consistently that pain is not treated well. Improvement depends on knowing which treatments are the most effective. We used systematic review to compare the relative efficacy of two common analgesics, ibuprofen and diclofenac, in post-operative pain. ⋯ Both drugs worked well. Choosing between them is an issue of dose, safety and cost. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.
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The extent of surgical trauma was related to postoperative pain intensity in a previous study. However, more extensive surgical procedures with higher baseline pain intensity did not appear to influence the ability to document the additive analgesic effect of codeine when given with paracetamol, partly due to large interindividual variation in baseline pain intensity. The aim of the present study was to attempt to improve upside assay sensitivity in this dental pain model by: (1) selecting patients with high baseline pain intensity; and (2) closer supervision of outpatients>> drug intake and compliance with protocol. ⋯ More pain relief was revealed when codeine 60 mg was added to paracetamol 1000 mg on the following measures of effect: change of pain intensity with time (p<0.05, Mann-Whitney), sum of pain intensities (p=0.019), pain intensity difference (p
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The authors report a 50-year-old man with a ruptured large carotid-ophthalmic aneurysm on the right side and an unruptured anterior communicating artery (A Com) aneurysm. The A Comm aneurysm was clipped and the carotid-ophthalmic aneurysm was managed by combining internal carotid artery (ICA) trapping with an interposed radial artery graft from the external carotid artery (ECA) to the middle cerebral artery (MCA). ⋯ Postoperative vertebral angiography showed the right ophthalmic artery to be fed by the posterior communicating artery. It is speculated that collateral circulation from the angular artery of the ECA to the ophthalmic artery did not develop because of high flow graft from the ECA to MCA and ICA trapping.
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To approach the diagnosis and management of two different features of hepatic mesenchymal hamartoma (HMH) in the neonate. ⋯ The management of HMH is surgical treatment, because it does not disappear spontaneously. Some cases evolve to giant forms even in the neonatal period leading to fatal complications. Preoperative differential diagnosis from hemangioma is quite difficult for cystic types, and immunohistochemical analysis is important for pathological confirmation.
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Postoperative nausea and vomiting remains an important problem. Many risk factors have been identified; however, the importance of postoperative analgesic technique and patient expectation remain poorly defined. ⋯ Study results show that patient expectation is a potent predictor of postoperative nausea, a risk factor hitherto ignored in the anaesthetic literature, and that, in the provision of analgesia following major surgery, epidural analgesia is associated with less PONV than intravenous morphine.