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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Postoperative pain relief and sedation with epidural midazolam-saline or midazolam-bupivacaine were studied in 46 patients after elective upper abdominal surgery. They were divided into 6 groups. In each group, 10 ml saline, 10 ml saline+midazolam 0.05 mg.kg-1, 10 ml saline+midazolam 0.1 mg.kg-1 (saline group), 0.25% bupivacaine 6 ml, 0.25% bupivacaine 6 ml + midazolam 0.05 mg.kg-1 or 0.25% bupivacaine 6 ml + midazolam 0.1 mg.kg-1 (bupivacaine group) was administered via epidural catheter for complaint of pain. For 120 minutes after epidural injection, blood pressure (BP), heart rate (HR), respiratory rate (RR), sedation score, and serum concentration of midazolam (conc midazolam) were evaluated. The time interval until next complaint of pain (pain relief time) was measured. In midazolam injected group, BP, HR, RR were not changed from preinjection value, but sufficient sedation was obtained and pain relief time was significantly prolonged compared with saline or bupivacaine injected group. Midazolam level was lower than that of sedation level. There were no significant differences between saline group and bupivacaine group, but the pain relief effect was slightly stronger in bupivacaine group. It is concluded that epidural saline - midazolam or 0.25% bupivacaine - midazolam is useful for postoperative pain relief after upper abdominal surgery.
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PMID:[Epidural administration of midazolam with saline or bupivacaine for postoperative pain]. 176 1

Postoperative pain relief and sedation with epidural midazolam were studied. Twenty-one patients for elective upper abdominal surgery were divided into 3 groups. Epidural catheter was inserted into thoracic epidural space before induction of general anesthesia. In each group, either 10 ml saline only, midazolam 0.05 mg.kg-1 + 10 ml saline, or midazolam 0.1 mg.kg-1 + 10 ml saline was injected into epidural catheter for complaint of pain in recovery room. For 120 minutes after epidural injection, blood pressure, heart rate, respiratory rate, serum concentration of midazolam, and sedation score were monitored. In midazolam injected groups, only slight changes were seen in blood pressure, heart rate, and respiratory rate. Sedation score was graded from 1 to 6:1 means complete sleep, and not responded to verbal command, 6 means agitated and many complaints. Midazolam 0.1 mg.kg-1 + 10 ml saline group had the lowest score, and saline 10 ml group had the highest score. Prolonged sedation and pain relief were obtained in midazolam injected group, especially 0.1 mg.kg-1 + 10 ml saline group. Serum midazolam concentrations were lower than 200 ng.ml-1. These values were considered as the lower limit for sedation by intravenous administration. In conclusion, epidural midazolam was useful for postoperative pain relief. The mechanism is considered to involve spinally mediated CNS action or direct spinal action.
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PMID:[Epidural midazolam for treatment of postoperative pain]. 194 8

In a prospective trial in 139 infants ASA classification I-II 13 observational items were scaled during the first postoperative hour (13 assessments). The items were drawn from the literature and chosen for economic purpose. Factor analyses (Principal component, Kaiser Criterion, Scree-test) were used for the elimination of useless items and for the identification of suitable ones. The discriminative properties of single items and different subsets of items to detect an analgetic demand were tested in discriminant analyses and variance analyses with repeated measurements. Due to insufficient variance four items had to be eliminated: "nasolabial folding", "colour of the face", "sweating of the head", and "muscle tone". The factor analysis if the remaining 9 items resulted in a one factorial solution. Neither the corrected item-scale-correlations nor the inter-item-correlations showed advantageous properties of single items compared with the others. For economic reasons two 5-item scales were chosen for further evaluation in regard to sensitivity, specify and validity. The items "crying", "facial expression", "positioning of the legs", "positioning of the trunc" and "motoric restlessness" built the Children's and Infants Postoperative Pain Scale (CHIPPS) whereas an Infants Postoperative Pain Scale (IPPS) contained the items "crying", "facial expression", "positioning of the arms", "positioning of the trunc" and "motoric restlessness". The latter five items had shown the highest factor loadings. The two systems had a high intern consistency with alpha > 0.90 (p < 0.01) with at least 73% explained variance. Inter-item-correlations and corrected item-scale-correlations showed no differences between the two scales. The discriminant analyses resulted in almost identic data for specify, sensitivity and predictive values of the IPPS compared with the CHIPPS. There was a significant interaction between repeated measurements and the supply of Piritramide and Ketamine, but not of Midazolam. Concurrent and constructive validation were positive for both systems, using administration of Piritramide as a criterion. For clinical purpose the CHIPPS should be preferred, because it has been proven to be valid in children up to 4 years of age and because controlled data on its sensitivity, specify, reliability and validity could already be presented.
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PMID:[Development of an observational scale for assessment of postoperative pain in infants]. 968 92

We compared recovery characteristics of propofol anesthesia with those of sevoflurane anesthesia in pediatric outpatients. One hundred and four children, 3 months to 6 years of age, ASA physical status 1 or 2, were randomly assigned to following four groups; sevoflurane (group S), propofol (group P), sevoflurane with premedication (group MS), or propofol with premedication (group MP). Midazolam 0.5 mg.kg-1 and famotidine 1 mg.kg-1 were administered orally 30 min before the induction in the MS and MP group. Recovery from anesthesia, agitation, and postoperative pain were evaluated. The time intervals from the end of surgery to extubation and to discharge from the hospital were recorded. The incidence of vomiting and use of analgesic drugs were also checked. The emergence from anesthesia was slower with propofol anesthesia than with sevoflurane anesthesia, but the time to discharge from the hospital was not significantly different among the four groups. Incidence of agitation was higher in S group compared with P group, but there were no differences between MS and MP. Postoperative pain was similar among the four groups. There were no differences in the incidence of vomiting. Propofol anesthesia provided slower emergence and less agitation compared with sevoflurane anesthesia.
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PMID:[Recovery characteristics of propofol anesthesia in pediatric outpatients; comparison with sevoflurane anesthesia]. 1134 48

Evaluation of the modified "postanaesthesiological questionnaire" pointed to a subtle influencing of the condition of patients who had undergone 3rd molar surgery in general anaesthesia by using different premedication variants: "Atropine, Pethidine and Midazolam" (group A) and "Atropine, Midazolam and S-Ketamin" (group B). The combination in group B seems to be more suitable. On the one hand, a lower incidence of unwanted side-effects was found and, on the other hand, remarkable positive effects were observed. Of particular significance with this combination was also the more effective suppression of postoperative pain. The Propofol-supplemented general anaesthesia prepared in this way and administered using a nasal intubation technique found the full approval of the patients. Postoperative pain therapy was effective and also inexpensive, costing just 8.20 DM per patient, according to current prices calculated by Magdeburg University Hospital.
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PMID:[Condition of patients after surgical wisdom tooth extraction under general anesthesia with different premedication variants--a prospective study based on a post-anesthesia questionnaire]. 1179 50