Search results for "patient-controlled analgesia"

Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study

2012

Remifentanil has a suitable pharmacological profile for labour analgesia. In this prospective, observational study, intravenous patient-controlled analgesia with remifentanil, using stepwise bolus doses without background infusion, was examined during the first and second stages of labour. Outcomes were pain reduction, maternal satisfaction, maternal and neonatal side effects and remifentanil metabolism in the neonate.Parturients with normal term singleton pregnancies were recruited. The initial remifentanil bolus dose was 0.15 μg/kg, increasing in steps of 0.15 μg/kg, with a 2-min lock-out. Pain scores using a 100 mm visual analogue scale, systolic and diastolic blood pressures, respirator…

Anesthetic management of a patient diagnosed with CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopat…

2011

CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leu-koencephalopathy) is an infrequent inherited disease that could have anesthetic implica-tions. However these have rarely been reported. We present a male patient previously diagnosed with CADASIL, who had suffered an ischemic vascular cerebral accident with a MRI compatible with leukoencephalopathy, and who was dependent for daily activities, and sustained dementia, mood alterations, apathy, and urine incontinence. He had famil-ial antecedents of psychiatric symptoms and ischemic stroke events in several relatives including his father, two brothers and one sister. He was scheduled for arthrodesis of the le…

Background Infusion during Intravenous Patient-Controlled Analgesia: The New Routine Analgesia?

2002

Intraoperative clonidine modulates sympathetic tone in the early postoperative period after remifentanil. A double blind, placebo-controlled study

1999

Abstract Aim of the study : Severe pain following major surgery can impair the control of the cardiovascular system (CVS) by causing sympathetic stimulation, possibly leading to myocardial ischaemia. In this study we examine the influence of intraoperative intravenous (i.v.) clonidine infusion on postoperative analgesia and blood concentrations of noradrenaline and adrenaline after major gynaecological surgery. Methods : All patients underwent an abdominal hysterectomy under balanced general anaesthesia using the new opioid remifentanil. The patients were randomised to receive either 5 μg kg −1 of i.v. clonidine intraoperatively ( n =20), or placebo ( n =20). Over a period of 240 minutes po…

The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial

2022

Abstract Background The erector spinae plane (ESP) block has recently been shown to effectively alleviate postoperative pain and reduce opioid consumption in breast surgery patients. However, data are still limited concerning the quality of recovery in patients following this procedure. Methods This study was a randomized controlled trial (RCT) performed in a university hospital. We randomly allocated patients to one of three groups: ESP, SHAM, and control (CON). Procedures in the ESP and SHAM blocks were performed ipsilaterally with 0.375% ropivacaine or 0.9% saline (0.4 mL/kg). Our primary outcome was the assessment of the patient’s improvement with quality-of-recovery 40 (QoR-40) a day a…

Quadratus Lumborum Block Reduces Postoperative Opioid Consumption and Decreases Persistent Postoperative Pain Severity in Patients Undergoing Both Op…

2021

Background: New regional techniques can improve pain management after nephrectomy. Methods: This study was a randomized controlled trial conducted at two teaching hospitals. Patients undergoing elective open and laparoscopic nephrectomy were eligible to participate in the trial. A total of 100 patients were divided into a quadratus lumborum block (QLB) group (50 patients) and a control (CON) group (50 patients). At the end of surgery, but while still under general anesthesia, unilateral QLB with ropivacaine was performed on the side of nephrectomy for patients in the QLB group. The main measured outcome of this study was oxycodone consumption via a patient-controlled anesthesia (PCA) pump d…

The use of a questionnaire for improvement of postoperative analgesia after transurethral resection of the prostate

2003

Abstract Background : Postoperative analgesic studies with methods like i.v. patient controlled analgesia (i.v. PCA) or epidural analgesia have reported effective pain relief after major surgery, also after urologic cancer surgery. In contrast, systematic results after minor urologic surgery are widely unknown, although the pain intensities may be high for a short time. The aim of the study was to evaluate the usefulness of a pain questionnaire as a measurement tool of postoperative analgesic quality after transurethral resection of the prostate (TUR-P). Methods : A questionnaire of the American Pain Society (APS) for quality assurance of postoperative pain therapy was adapted to estimate t…

A double blind placebo-controlled study on the rectal administration of morphine as a premedication in abdominal hysterectomy

2000

Abstract Benzodiazepines are now commonly used as anxiolytic premedication prior to surgery. However, the role of opioids, as a premedication, has diminished over the last decades and they are no longer routinely used for premedication. Rather, opioids are generally used to treat severe pain in the postoperative period. Studies have shown that both NSAIDs and opioids improve analgesia in the early postoperative period. Until now, there have been no studies investigating the effect of morphine as a rectal premedication in adults in combination with blood levels of morphine. The effect of a rectal premedication with 30 mg of morphine sulphate, on postoperative pain levels and opioid consumpti…

The long and winding road of non steroidal antinflammatory drugs and paracetamol in cancer pain management: A critical review

2013

The aim of this review was to assess the value of NSAIDs and paracetamol in patients with cancer pain to update a previous review performed ten years ago on this topic. The approach was analytic and based on clinical considerations, rather than on raw evidence, which often does not provide useful information in clinical practice. Both published reports from an extensive search of electronic data bases were collected from January 2001 to December 2011. A free-text search method was used including the following words and their combination: “Anti-inflammatory drugs OR paracetamol OR acetaminophen” AND/OR “cancer pain”. Any randomized-controlled trial was considered. Thirteen reports fulfitted …