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Analgesia
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1. Comparative study on treatment of acute gouty arthritis by electroacupuncture with different frequency.
Match Strength: 6.281

OBJECTIVE: To study the therapeutic effect of treatment of acute gouty arthritis (AGA) respectively by electroacupuncture (EA) with different frequency and oral intake of Western medicine. METHODS: Seventy-two patients of AGA were randomly assigned into three groups, 24 in each group. Group A was treated with EA 100 Hz; Group B with EA 2 Hz; and Group C with Western medicine. The analgesic effect, initiating time and sustaining time of analgesia were observed and the level of serum uric acid was measured before and after treatment. RESULTS: The initiating time of analgesia was shorter while ... Read More »
» Published in Chin J Integr Med. 2006 Sep;12(3):212-4.

2. Fentanyl and clonidine as adjunctive analgesics with levobupivacaine in paravertebral analgesia for breast surgery.
Match Strength: 6.108

The addition of fentanyl or clonidine to levobupivacaine was evaluated in patients undergoing breast surgery under general anaesthesia with intra- and postoperative paravertebral analgesia. Patients were randomly allocated to four groups: Group L received 19 ml bolus levobupivacaine 0.25% plus 1 ml saline followed by an infusion of levobupivacaine 0.1%; Group LF received 19 ml bolus levobupivacaine 0.25% plus fentanyl 50 microg followed by an infusion of levobupivacaine 0.05% with fentanyl 4 microg x ml(-1); Group LC received 19 ml bolus levobupivacaine 0.25% plus clonidine 150 microg followed ... Read More »
» Published in Anaesthesia. 2006 Oct;61(10):932-7.

3. Case report: cerebral vein thrombosis after subarachnoid analgesia for labour.
Match Strength: 5.779

PURPOSE: We report a case of sagittal sinus thrombosis occurring after spinal analgesia for labour to highlight the difficulty of such diagnosis in the presence of postpartum atypical headache following regional anesthesia/analgesia. CLINICAL FEATURES: A previously healthy 21-yr-old, primiparous, preeclamptic parturient was admitted to the hospital at 37 weeks gestation for uterine contractions. Before pregnancy she was taking no medication other than oral contraceptives and was a non-smoker. Spinal analgesia was established on the first attempt at 8 cm of cervical dilation, in the setting of ... Read More »
» Published in Can J Anaesth. 2006 Oct;53(10):1015-9.

4. Cardiac arrest due to a vagal reflex potentiated by thoracic epidural analgesia.
Match Strength: 5.685

Reflex bradycardia and cardiac arrest may be the result of a vagal reflex, which can occur during a variety of surgical procedures. We report a patient who developed cardiac arrest as a result of a vagal reflex that was potentiated by thoracic epidural analgesia during general anaesthesia. A 53-year-old man was scheduled for subtotal gastrectomy because of an early gastric adenocarcinoma. After an epidural catheter had been inserted, general anaesthesia was induced. During surgery, an abdominal self-retaining retractor was set up but bradycardia and cardiac arrest developed. The patient ... Read More »
» Published in J Int Med Res. 2006 Jul-Aug;34(4):433-6.

5. Fentanyl or tramadol, with midazolam, for outpatient colonoscopy: analgesia, sedation, and safety.
Match Strength: 5.534

The present study determined the acceptability of colonoscopy in outpatients treated with tramadol or fentanyl for analgesia and sedation. One hundred fifty patients were randomly assigned to receive midazolam, 0.05 mg/kg, and fentanyl, 2 microg/kg, intravenously (group 1), midazolam, 0.05 mg/kg, and tramadol, 1 mg/kg, per os (group 2), or midazolam, 0.05 mg/kg, and tramadol, 2 mg/kg, per os (group 3). Pain severity, level of sedation, cardiorespiratory parameters, and procedure-related side effects and complications were registered and analyzed. No significant cardiorespiratory disturbances ... Read More »
» Published in Dig Dis Sci. 2006 Nov;51(11):1946-51. Epub 2006 Sep 29.

6. Efficacy of suppository analgesia in postabortion pain reduction.
Match Strength: 5.355

PURPOSE: Termination of pregnancy is a painful procedure. Currently, there are no sufficient data regarding the best mode to reduce this pain. The aim of the study was to evaluate postabortion pain levels and to examine the analgesic effect of three different generic types of suppositories provided at the end of the surgical procedure prior to awakening from general anesthesia. METHOD: Two hundred seventeen women were randomly assigned to four groups: indomethacin (100 mg), paracetamol (1000 mg), tramadol (100 mg), and control group with no suppository treatment. Pain levels were evaluated by ... Read More »
» Published in Contraception. 2006 Oct;74(4):345-8. Epub 2006 May 15.

7. Audit of the influence of body mass index on the performance of epidural analgesia in labour and the subsequent mode of delivery.
Match Strength: 5.075

OBJECTIVE: To assess the influence of body mass index (BMI) on the performance of epidural analgesia in labour and the subsequent mode of delivery. DESIGN: A retrospective audit of prospectively collected quality assurance data. SETTING: The delivery suite of Leeds General Infirmary, Leeds, UK. This is a 4500-delivery teaching hospital unit. POPULATION: All women receiving epidural analgesia during labour in our unit between April 1997 and December 2005. METHODS: Epidural recipients were divided into BMI groups according to World Health Organization (WHO) categories and compared for indices of ... Read More »
» Published in BJOG. 2006 Oct;113(10):1178-81.

8. Acetaminophen self-administered in the drinking water increases the pain threshold of rats (Rattus norvegicus).
Match Strength: 4.750

Previous studies have suggested that the addition of flavored acetaminophen suspension (for example, Children's Tylenol) in the drinking water of rats may not be effective in producing postoperative analgesia because of low levels of consumption. However, these investigations neither measured analgesia nor compared the consumption by rats that had undergone surgery with that by unmanipulated rats. The present study reports that although unmanipulated rats naive to the taste of flavored acetaminophen do indeed drink significantly less of this liquid than tap water, they drank sufficient amounts ... Read More »
» Published in J Am Assoc Lab Anim Sci. 2006 Sep;45(5):48-54.

9. Breaking down the barriers: fMRI applications in pain, analgesia and analgesics.
Match Strength: 4.566

This review summarizes functional magnetic resonance imaging (fMRI) findings that have informed our current understanding of pain, analgesia and related phenomena, and discusses the potential role of fMRI in improved therapeutic approaches to pain. It is divided into 3 main sections: (1) fMRI studies of acute and chronic pain. Physiological studies of pain have found numerous regions of the brain to be involved in the interpretation of the 'pain experience'; studies in chronic pain conditions have identified a significant CNS component; and fMRI studies of surrogate models of chronic pain are ... Read More »
» Published in Mol Pain. 2006 Sep 18;2:30.

10. Postcesarean analgesia: the efficacy of bupivacaine wound instillation with and without supplemental diclofenac.
Match Strength: 4.437

STUDY OBJECTIVE: To assess the analgesic efficacy of diclofenac when administered as an adjuvant to bupivacaine wound instillation. DESIGN: Prospective, randomized, double blind, placebo-controlled study. SETTING: Large referral hospital. PATIENTS: 90 women recovering from cesarean delivery performed via a Pfannenstiel incision. INTERVENTIONS: A standard intrathecal anesthetic was administered. On completion of surgery, a multiorifice 20-gauge epidural catheter was placed within the surgical wound. Postoperatively, the catheter was attached to a patient-controlled analgesia (PCA) device ... Read More »
» Published in J Clin Anesth. 2006 Sep;18(6):415-21.

11. Etomidate versus midazolam for procedural sedation in pediatric outpatients: a randomized controlled trial.
Match Strength: 4.427

STUDY OBJECTIVE: Midazolam is widely used for procedural sedation and analgesia. Etomidate has been studied mostly in adults. Our objective is to compare the efficacy of etomidate and midazolam for achieving procedural sedation and analgesia in children. METHODS: A randomized, double-blind, emergency department and orthopedic clinic-based trial was carried out among patients aged 2 to 18 years with displaced extremity fractures. Patients were administered 1 microg/kg of fentanyl and either 0.2 mg/kg of etomidate or 0.1 mg/kg of midazolam. Adequate sedation was defined, for the purpose of this ... Read More »
» Published in Ann Emerg Med. 2006 Oct;48(4):433-40, 440.e1. Epub 2006 Apr 27.

12. Randomized Double-Blind Placebo-Controlled Trial of Two Intravenous Morphine Dosages (0.10 mg/kg and 0.15 mg/kg) in ED Patients With Moderate to Severe Acute Pain.
Match Strength: 3.926

STUDY OBJECTIVE: We compare pain relief and safety of morphine 0.10 mg/kg with 0.15 mg/kg in adult emergency department (ED) patients with acute pain. METHODS: This was a randomized double-blind placebo-controlled trial of intravenous morphine 0.10 mg/kg versus 0.15 mg/kg, (delivered in 2 divided doses) in adult ED patients with acute pain requiring opioid analgesia. Assessment was made at baseline, 30 minutes, and 60 minutes with a validated verbal numeric rating scale. Pain reduction and satisfaction scores were measured at 30 and 60 minutes. The primary outcome measure was the between-group ... Read More »
» Published in Ann Emerg Med. 2006 Sep 13;

13. The utility of supplemental oxygen during emergency department procedural sedation and analgesia with midazolam and fentanyl: a randomized, controlled trial.
Match Strength: 3.720

STUDY OBJECTIVE: To determine whether supplemental oxygen reduces the incidence of hypoxia by 20% in study patients receiving midazolam and fentanyl for emergency department procedural sedation and analgesia. METHODS: Patients were randomized to receive either supplemental oxygen or compressed air by nasal cannula at 2 L per minute. Physicians were blinded to the gas used and end-tidal carbon dioxide (ETCO2) data. Respiratory depression was defined a priori as oxygen saturation less than 90%, ETCO2 level greater than 50 mm Hg, an absolute change from baseline of 10 mm Hg, or loss of the ETCO2 ... Read More »
» Published in Ann Emerg Med. 2007 Jan;49(1):1-8. Epub 2006 Sep 15. Comment in: Ann Emerg Med. 2007 Jan;49(1):31-6.

14. Case report: epidural abscess in a parturient with pruritic urticarial papules and plaques of pregnancy (PUPPP).
Match Strength: 3.532

PURPOSE: To describe the risk factors for epidural abscess (EA) formation following epidural analgesia in a parturient with pruritic urticarial papules and plaques of pregnancy (PUPPP). CLINICAL FEATURES: A 33 yr-old gravida 2 nulliparous patient at 36 weeks gestation presented with severe pre-eclampsia, and PUPPP (treated with prednisone). Magnesium prophylaxis was started and labour was induced. An epidural catheter was placed at the L(3-4) level using standard aseptic technique. Bupivacaine was incrementally injected to achieve a T10 sensory level, and analgesia was maintained using a ... Read More »
» Published in Can J Anaesth. 2006 Oct;53(10):1010-4.

15. Use of neostigmine in the management of acute postoperative pain and labour pain: a review.
Match Strength: 3.333

Neostigmine is a parasympathomimetic agent that has been recently investigated for use as an adjunct analgesic agent in the perioperative and peripartum period. A number of studies have investigated the intrathecal, epidural, caudal and intra-articular routes of administration of this agent, as well as the addition of neostigmine to local anaesthetics used for brachial plexus block and intravenous regional anaesthesia. While the intrathecal administration of neostigmine produced useful analgesic effects in the postoperative period in some studies, the high incidence of adverse events, mainly ... Read More »
» Published in CNS Drugs. 2006;20(10):821-39.

16. Dexmedetomidine infusion is associated with enhanced renal function after thoracic surgery.
Match Strength: 3.306

STUDY OBJECTIVE: To test the hypothesis that dexmedetomidine, a selective alpha-2 agonist, enhances urine flow rate and perioperative renal function, a post hoc analysis was conducted on a recently completed study of dexmedetomidine used as an adjunct to epidural analgesia after thoracotomy. DESIGN: Post hoc analysis of a randomized, placebo-controlled, double-blind clinical trial. SETTING: Tertiary-care university medical center. PATIENTS: 28 patients undergoing elective thoracotomy. INTERVENTIONS: Patients were prospectively randomized to receive a supplemental 24-hour intravenous infusion ... Read More »
» Published in J Clin Anesth. 2006 Sep;18(6):422-6.

17. Simultaneous laparoscopic resection of rectal cancer and liver metastasis.
Match Strength: 3.250

Simultaneous resection of colorectal tumor and liver metastasis has been advocated because of the benefits of avoiding a second operation, reduced morbidity, shorter treatment time, and similar outcomes. We report a case of simultaneous laparoscopic resection. The operative time was 350 minutes and the estimated blood loss was 500 mL. The patient required parenteral analgesia for less than 48 hours. Flatus was passed on postoperative day 3, and a solid diet was resumed on postoperative day 5. He was fully mobile on postoperative day 4 and was discharged 3 days later. With the advance of ... Read More »
» Published in J Laparoendosc Adv Surg Tech A. 2006 Oct;16(5):486-8.

18. Leiomyoma of the oesophagus managed by thoracoscopic enucleation.
Match Strength: 3.127

The authors document two patients with oesophageal leiomyoma. In the first patient, a 41-year-old man, enucleation of the oesophageal leiomyoma was initially attempted by a thoracoscopic approach, but because of adherence of the tumour to the oesophageal mucosa, enucleation was completed by thoracotomy. Thoracoscopic enucleation was successfully performed in the second patient, a 62-year-old man. This paper includes a literature review on the pathology, diagnosis and surgical approach in the management of oesophageal leiomyoma. In conclusion, prudent use of thoracoscopic approach in the ... Read More »
» Published in Singapore Med J. 2006 Oct;47(10):901-3.

19. Delivery of local anaesthetic via a sternal catheter to reduce the pain caused by sternal fractures: first case series using the new technique.
Match Strength: 2.950

Sternal fractures cause considerable pain, and a proportion of patients require admission for analgesia. Local anaesthetic techniques have been used to reduce the pain from chest wall injuries and may reduce complications from these injuries. The use of a local anaesthetic delivered via a sternal catheter over a fractured sternum has been described in a patient whose pain was inadequately controlled with opiates. This technique was recently offered to patients in the emergency department at the Royal Devon and Exeter Hospital, Exeter, UK, and the experiences of patients and doctors are ... Read More »
» Published in Emerg Med J. 2006 Oct;23(10):791-3.

20. Single-dose extended-release epidural morphine for pain following hip arthroplasty.
Match Strength: 2.741

This open-label, serial-cohort pilot study evaluated DepoDur, a new, single-dose, extended-release epidural morphine (EREM) for pain control after hip arthroplasty. Single-dose EREM (10-30 mg) or a single dose of standard morphine sulfate (MS) (5 mg) was administered before surgery and spinal anesthesia. Among the 39 patients enrolled, total 48-hour supplemental fentanyl use was lower (P = 0.011 overall treatment) and median time to first postoperative fentanyl use was three- to six-fold longer (P < 0.001 overall treatment), among 10-, 20-, and 30-mg single-dose EREM patients versus MS ... Read More »
» Published in Am J Ther. 2006 Sep-Oct;13(5):423-31.

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