Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 35-year-old twin primigravida with aortic stenosis underwent cesarean section under epidural anesthesia. She had her ventricular septal defect repaired at 3 years of age. Preoperative ultrasonic study revealed severe aortic stenosis in which valve area was 0.77 cm2 and pressure gradient between the left ventricle and the aorta was 80 mmHg. We persuaded her and her husband to discontinue pregnancy and recommended aortic valve replacement surgery. They rejected our suggestions, and cesarean section was scheduled at 29 weeks' gestation. We chose epidural anesthesia. A 20-gauge catheter and a pulmonary artery catheter were inserted to monitor the hemodynamics. Two lumbar epidural catheters were placed at the L 1-2 and L 4-5 intervertebral spaces. Sixteen milliliters of 1.5% mepivacaine were injected, producing anesthesia up to T 6 level. The babies were delivered, and postnatal conditions of both infants were satisfactory. Methoxamine 1 mg was administered four times when systolic blood pressure decreased to 80 mmHg following deliveries. Otherwise, peripartal hemodynamics was stable, and she was transferred to the intensive care unit (ICU). Postoperative pain was controlled with epidural infusion of fentanyl. She did not complain of chest pain perioperatively and was discharged from the ICU next day.
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PMID:[Epidural anesthesia for cesarean section in a twin pregnant patient with severe aortic stenosis]. 983 93

To determine the optimal duration of epidural analgesia (EA) after lung cancer surgery, a retrospective analysis was conducted to compare chest pain, pulmonary function, and respiratory muscle strength between patients given EA until postoperative day (POD) 3 and those given EA until POD 8. Each group comprised 25 lung cancer patients who underwent a lobectomy under anterior limited thoracotomy and given continuous thoracic EA using morphine until POD 3 (POD3-EA group) or POD 8 (POD8-EA group). The two groups were matched by sex and age. Postoperative pain from PODs 1 to 12 was evaluated by the pain score and analgesic requirements. The pulmonary function and respiratory muscle strength were measured on POD 7. The POD3-EA group did not experience any increase in pain after withdrawal, but the POD8-EA group did show a significant increase in pain the day after withdrawal (P < 0.05). The pain scores on PODs 8 and 9 in the POD8-EA group were significantly higher than those in the POD3-EA group (P < 0.05). There was no significant difference in pulmonary function and respiratory muscle strength on POD 7 between the two groups. Although the postoperative thoracic EA did not affect pulmonary function and respiratory muscle strength, prolonged thoracic EA after a limited thoracotomy significantly increased the pain after withdrawal, thus negatively affecting postoperative pain control.
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PMID:Comparison of short-term versus long-term epidural analgesia after limited thoracotomy with special reference to pain score, pulmonary function, and respiratory muscle strength. 1131 19