Articles: pain.
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While pain can be a most useful symptom, it becomes a problem requiring attention when it causes or increases the patient's anxiety, prevents sleep, or starts the patient on a vicious cycle of increasing doses of narcotics with concomitant depression, anorexia, and lethargy. Various surgical modalities and their indications are discussed.
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Comparative Study
Intercostal nerve block for postoperative somatic pain following surgery of thorax and upper abdomen.
From 1948 to 1973, intercostal nerve block was used 10,941 times or a total of approximately 100,000 individual nerves were blocked. Junior staff (residents) performed 95% of the blocks. The local anaesthetic solution of choice used 0.25 or 0.5% bupivacaine (Marcaine) with adrenaline. ⋯ The duration of the blocks was 9-18 hr. No severe systemic toxic reactions occurred, e.g. disorientation, convulsions, etc. The incidence of pneumothorax was 0.073%.
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Acta Anaesthesiol Scand Suppl · Jan 1975
Comparative Study Clinical TrialEtidocaine in intercostal nerve block for pain relief after thoracotomy; a comparison with bupivacaine.
For pain relief after thoracotomy, intercostal nerve block with etidocaine 1% and bupivacaine 0.5%, both containing adrenaline 5 mug/ml, was used. Duration of skin analgesia for sharp pain was around 11 hours for both solutions. Post-operative pain was noted 6 and 5 hours after injection for etidocaine and bupivacaine respectively. ⋯ Arterial and venous blood levels of the local anaesthetics were low and no signs of toxicity were noted. All patients experienced a certain pain relief from the blocks. Because of shoulder pain in some patients intercostal nerve block alone does not seem to be a perfect post-operative method for pain relief after thoracotomies.