Articles: pain.
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To assess the diagnostic value of abdominal and pelvic ultrasound to the emergency physician, we followed 43 patients who required ultrasound out of 1,010 patients who presented to the emergency department with abdominal pain and/or vaginal bleeding during the 33-week study period. Ultrasound confirmed the preliminary diagnosis in 12 patients, was supportive in eight patients, and ruled out the preliminary diagnosis in 23 patients. Ultrasound often shortened the evaluation process by narrowing the differential diagnosis or by excluding potentially serious conditions, thus eliminating the need for additional testing and frequently allowing for safe discharge of the patient. We found ultrasound to be helpful, as well as cost-effective, in certain patients with abdominal pain and/or vaginal bleeding in whom an emergency department evaluation without ultrasound could not exclude a condition necessitating admission or urgent surgery.
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Clinical Trial Controlled Clinical Trial
Epidural morphine infusion. Continuous pain relief.
Epidural morphine infusion is an effective and relatively safe route for postoperative analgesia. Lanz , Theiss , Reiss , and Sommer performed research supporting the use of epidural morphine. Following lumbar epidural anesthesia for orthopedic operations, 174 patients underwent the following study. ⋯ Sympathetic block was only partial; patients still noticed pressure due to a dressing or cast. There was no motor blockade and active mobilization occurred earlier. Following epidural morphine, alertness was heightened, patients were more cooperative, and respiratory depression and postoperative pneumonia were less than after systemic administration of narcotics.(ABSTRACT TRUNCATED AT 250 WORDS)