Articles: pain.
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Randomized Controlled Trial Clinical Trial
Epidural morphine for analgesia after caesarean section.
A randomized double blind placebo controlled study of the efficacy, duration and safety of epidural morphine for the management of pain after Cesarean section is reported. Three similar groups of patients received either 0, 4 mg or 8 mg of morphine sulphate in 10 ml of normal saline through an epidural catheter at the completion of the operation. ⋯ Two patients who received epidural morphine 8 mg plus additional narcotic or antihistamine had reduced respiratory rates but were easily rousable. Our experience suggests that the epidural administration of morphine 4 mg may be a safe and reliable method of obtaining prolonged analgesia following Caesarean section.
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The medial tibial stress syndrome is a symptom complex seen in athletes who complain of exercise-induced pain along the distal posterior-medial aspect of the tibia. Intramuscular pressures within the posterior compartments of the leg were measured in 12 patients with this disorder. These pressures were not elevated and therefore this syndrome is a not a compartment syndrome. Available information suggests that the medial tibial stress syndrome most likely represents a periostitis at this location of the leg.
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Randomized Controlled Trial Clinical Trial
[Investigations on epidural morphine. Efficacy, solvent, analgesic supplementation].
The effects of epidural morphine for pain relief after orthopaedic surgery of the lower extremity were examined in 60 patients. Intraoperative analgesia was achieved with epidural administration of 2% mepivacaine. The patients were divided in a double-blind, random fashion into 3 groups. ⋯ The solution (glucose or normal saline) had no influence on morphine effectiveness. The side effects were urinary retention in 8 patients (20%) and pruritus in one (3%). It is concluded that 2 mg of morphine base administered epidurally is an effective method of postoperative pain relief in orthopaedic patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic efficacy of parenteral metkephamid acetate in treatment of postoperative pain.
The analgesic efficacy and side-effects of a single parenteral dose of metkephamid acetate 70 mg were compared with those of pethidine (meperidine) hydrochloride 100 mg and placebo in a double-blind, randomised, controlled clinical trial. 30 out of 32 postoperative patients completed the study--10 in the metkephamid group, 11 in the pethidine group, and 9 in the placebo group. The time-effect curves of summated pain measures and analyses of derived measures all indicated that the analgesic activity of metkephamid 70 mg was significantly greater than that of placebo and not less than that of pethidine 100 mg. The metkephamid group had a greater incidence of side-effects than the other two treatment groups. Some side-effects, such as sensations of heaviness of the extremities and nasal congestion, were peculiar to metkephamid but not distressing.