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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiac rhythm was monitored in 219 patients who had ocular operations under general anaesthesia and in 15 patients who had cataract surgery under local analgesia. Of these, 140 were children having squint surgery. The high incidence of the oculo-cardiac reflex and the adequate protective effect of atropine 0-01 mg/kg given intravenously was confirmed. Isolated extrasystoles were common, particularly in older patients, and sustained ectopic cardiac arrhythmias were observed in 4-6 per cent of patients of all ages. The significance of these arrhythmias in relation to surgical stimulation and the anaesthetic drugs used is discussed.
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PMID:Reflex disturbances of cardiac rhythm during ophthalmic surgery. 5 91

A female child with brachycephaly, hypertelorism, convergent strabismus, interstitial keratitis, analgesia on both sides of the face, absent corneal reflexes, and focal congenital alopecia of a zone of the occipital and posterior parietal scalp is presented. The patient also had generalized hypotonia in early life, and at age 4 years 9 months, she was found to be moderately mentally subnormal and to have severe cerebellar deficit consisting of gait and truncal ataxia. There was no clinical evidence of other cranial nerves being affected. It is postulated that the patient has a cerebellotrigeminal and focal dermal dysplasia due to a development arrest of the ectoderm, which gives rise to the alar plate of the rhombencephalon, the overlying epidermis, the motor nucleus of V, and the trigeminal placodes.
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PMID:Cerebellotrigeminal and focal dermal dysplasia: a newly recognized neurocutaneous syndrome. 9 27

An account of an operation for squint using acupuncture analgesia is given. This is the first ophthalmic operation carried out in Australia using this form of analgesia; and is probably the first surgical operation of any type carried out in Australia using acupuncture technique. The indications and possibilities of this method are discussed.
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PMID:Acupuncture anaesthesia for squint surgery. 73 37

A randomized study was performed to assess the effect of topical 1% amethocaine hydrochloride on postoperative analgesia requirements after strabismus surgery. Forty children scheduled for elective operation were allocated randomly to receive either topical amethocaine or normal saline. Postoperative analgesia was evaluated with the use of a four-point assessment score and analgesic requirements. The topical amethocaine provided significantly better postoperative analgesia (p less than 0.001) as measured by both the assessment score and the postoperative analgesia requirement.
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PMID:Topical amethocaine in strabismus surgery. 203 82

The usefulness of intra-operative antiemetics and postoperative oral fluid restriction in the prevention of vomiting following anaesthesia for ophthalmic surgery, was studied in 200 patients. They were allocated into four groups of 50 and given either saline (as control), droperidol, metoclopramide or prochlorperazine. Oral intake was restricted postoperatively in half of the patients of each group. Anaesthesia comprised morphine and atropine premedication and a halothane, nitrous oxide and oxygen spontaneous breathing technique. No significant beneficial effects resulted from intra-operative antiemetics; vomiting incidences of 26% after saline and droperidol, 28% after metoclopramide and 14% after prochlorperazine were observed. Younger patients and females vomited most frequently. Restriction of oral fluids did not decrease the incidence of vomiting but demonstrated that approximately half of those patients who vomit do so with their first postoperative oral intake. Vomiting was observed more frequently after non intra-ocular surgery than after intra-ocular surgery (37% cf. 16%, p less than 0.01) and postoperative analgesics were required by more non intra-ocular patients than by intra-ocular patients (25% cf. 5%, p less than 0.001). Squint patients vomited most frequently (48%) and most frequently required postoperative analgesia (35%).
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PMID:Vomiting after ophthalmic surgery. Effects of intra-operative antiemetics and postoperative oral fluid restriction. 357 26

Postoperative vomiting is induced by different mechanisms such as age, anaesthetic technique and medications, postoperative analgesia, and surgical traction on the extra-ocular muscles. The influence of anticholinergic premedication and the use of benzodiazepines as factors affecting the incidence of vomiting is controversial. In a prospective, randomised, single-blind study we examined two different treatments with regard to postoperative pain, vigilance, and vomiting in young children undergoing strabismus repair. METHODS. After institutional ethical committee approval, informed written consent was obtained from all parents. The children were randomly assigned to three groups: (1) paracetamol (P)--17 patients who received 250-500 mg paracetamol rectally (dependent on body weight) immediately after intubation of the trachea; (2) bupivacaine (B)--17 patients who received two drops 0.5% bupivacaine hydrochloride on the conjunctiva of the eye(s) being corrected following intubation of the trachea and again 10 min after intubation. After the surgeon had exposed the extra-ocular muscle and before readaptation of the conjunctiva, two drops of the same solution were applied again each time directly on the muscle; and (3) controls (C)--16 patients who received rectal paracetamol after completion of the operation but before extubation. The children were premedicated with 0.05 mg/kg flunitrazepam sublingually. After 0.25 mg atropine i.v., anaesthesia was induced with 0.1 mg/kg vecuronium, 5 mg/kg thiopentone, 1.5 vol% enflurane, and N2O/O2 50:50. When the trachea was intubated anaesthesia was maintained with enflurane as required and 70% N2O in oxygen. Extubation was performed only if the patient could touch or did not tolerate the tube. Oral diet was allowed 6 h after extubation at the earliest. EXAMINATION OF VIGILANCE AND ANALGESIA. The degrees of vigilance and pain were evaluated preoperatively and after extubation over 24 h using two different scales. Evaluation of the scales was performed during the first 3 postoperative h at 12 different time points (Figs. 1, 2) and 6, 12, and 24 h after extubation. The evaluation was conducted by nursing staff who were blinded to the treatment (single-blind study). Postoperative analgesia consisted of 250-500 mg rectal paracetamol (all patients). Parametric data were expressed as mean +/- SD, and comparisons were made with the one-way analysis of variance. Fisher's exact test was applied to ordinal data. P < 0.05 indicates a statistically significant difference. RESULTS. Two patients (P) were excluded from the study postoperatively because of refusing rectal paracetamol in spite of pain and postoperative infection of the upper airways, which had manifested on the afternoon of the operative day. No significant differences were found between the three groups in patient characteristics (Table 1). The quantity of enflurane administered, rate, postoperative consumption of rectal paracetamol, and postoperative emesis were highest in the control group (Tables 2, 3), but the incidence of postoperative vomiting ranged only between 13% and 24% (Table 3). Children with preoperative paracetamol needed more time to fulfill the criteria to "stick out the tongue" and "recognising the mother". VIGILANCE. The time to postoperative crying or screaming and restlessness was shorter in the control group. The values reached significant difference at 10 min (P) and 25 min (P and B) after extubation compared with the other groups (Fig. 1). ANALGESIE. At 5, 10, and 150 min after extubation pain was significantly higher in patients in the control group (Fig. 2). CONCLUSIONS. Intraoperative administration of rectal paracetamol or topical 0.5% bupivacaine was most effective in the treatment of postoperative pain for strabismus surgery in younger children. Sublingual flunitrazepam and i.v. atropine given as premedication probably decrease postoperative vomiting.
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PMID:[Strabismus surgery in children. The effect of paracetamol and bupivacaine]. 761 77

Fifty-four ASA I and II children 1 to 10 yr of age undergoing strabismus surgery were randomized to receive in a double-blind fashion intravenous ketorolac (0.9 mg/kg), fentanyl (1 microgram/kg), or saline placebo (2 mL) during a standardized general anesthetic. Patients received no analgesic or antiemetics intraoperatively except for the study drug. Patients receiving ketorolac or placebo compared to fentanyl had a significantly lower incidence of postoperative vomiting in the day surgery unit (DSU) (P = 0.03) and overall (DSU plus home) (P = 0.005). The severity (number of episodes) of post-operative vomiting was significantly lower in the DSU, at home (first 24 h after hospital discharge), and overall for patients receiving ketorolac or placebo compared to fentanyl (P < 0.01). Postoperative pain scores and frequency of acetaminophen administration did not differ among the study groups, suggesting that the intraoperative use of ketorolac or fentanyl during pediatric strabismus surgery is unnecessary. No patients required fentanyl postoperatively, indicating that rectal acetaminophen administered in the postanesthesia recovery room provides sufficient analgesia for pediatric strabismus surgery. In conclusion, neither ketorolac nor fentanyl was associated with less postoperative vomiting or analgesic requirements compared to saline placebo administered during pediatric strabismus surgery. Fentanyl should be avoided, as it was associated with a significantly greater incidence of postoperative vomiting compared to ketorolac or placebo.
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PMID:The effects of ketorolac and fentanyl on postoperative vomiting and analgesic requirements in children undergoing strabismus surgery. 861 27

Propofol anaesthesia may reduce postoperative emesis. The purpose of this study was to compare the incidence of emesis after propofol anaesthesia with and without nitrous oxide, compared with thiopentone and halothane anaesthesia, in hospital and up to 24 hr postoperatively, in outpatient paediatric patients after strabismus surgery. Seventy-five ASA class I or II, unpremedicated patients, aged 2-12 yr were randomly assigned to one of three groups: Thiopentone, 6.0 mg.kg-1 i.v. induction followed by halothane and N2O/O2 for maintenance (T/H); propofol for induction, followed by propofol and oxygen for maintenance (P/O2); and propofol for i.v. induction, followed by propofol infusion and N2O/O2 for maintenance (P/N2O). All received vecuronium, controlled ventilation, and acetaminophen pr. Morphine was given as needed for postoperative analgesia. There were no differences in age, weight, number of eye muscles operated upon, duration of anaesthesia or surgery. The P/N2O group (255 +/- 80 micrograms.kg-1 x min-1) received less propofol than the P/O2 group (344 +/- 60 micrograms.kg-1 x min-1) (P < or = 0.0001) and had shorter extubation (P < 0.001) and recovery (P < 0.01) times. Emesis in the hospital, in both the P/N2O (4.0%) and P/O2 group (4.0%) was less than in the T/H group (32%) (P < 0.01). Antiemetics were required in four patients in the T/H group (16.0%). Overall emesis after surgery was not different among the groups: T/H (48%), P/O2 (28%) and P/N2O (42%). The use of propofol anaesthesia with and without N2O decreased only early emesis. This supports the concept of a short-acting, specific antiemetic effect of propofol.
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PMID:Propofol anaesthesia reduces early postoperative emesis after paediatric strabismus surgery. 822 31

Forty children undergoing strabismus surgery as day patients were randomly allocated to receive oxybuprocaine 0.4% eyedrops or 0.1% diclofenac eyedrops for perioperative analgesia. A non-invasive anaesthetic technique using the reinforced laryngeal mask airway was used. The study demonstrated that both topical analgesics provided good to excellent analgesia and the anaesthetic technique was associated with a relatively low incidence of nausea and vomiting. Complications were limited to two children who were admitted with persistent postoperative nausea and vomiting.
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PMID:Diclofenac vs oxybuprocaine eyedrops for analgesia in paediatric strabismus surgery. 918 68

Administration of analgesics before surgery can decrease the intra-operative anesthetic requirement and pain during the early post-operative period (pre-emptive analgesia). The objective of this study was to evaluate an intra-muscular preparation of ketoprofen as analgesic in mild to moderate pain in children. In a double-blind placebo-controlled study, 91 healthy ASA I or II children undergoing squint opthalmic surgery was undertaken in the Ophthalmic Services at King Abdel-Aziz University Hospital Riyadh. The postoperative analgesic effects of intra-muscular pethidine and ketoprofen, just after the induction of anesthesia were compared. Patients were randomized to receive ketoprofen (1 mg W kg-1), pethidine (1 mg W kg-1) or saline (0.1 ml W kg-1). Anesthesia was induced and maintained with halothane and nitrous oxide via a facemask. Post-operative pain was assessed by a blinded observer using an objective pain scale. Results revealed that the ketoprofen group had lower post-operative pain scores and required less frequent analgesic therapy in the early postoperative period compared to the pethidine and placebo groups. In contrast, there were no differences in pain scores or analgesic requirements between the pethidine and the placebo groups. It is concluded that the preoperative administration of intramuscular ketoprofen, but not pethidine, provided better postoperative pain control than placebo in children undergoing ophthalmic surgery.
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PMID:Analgesic effects of intra-muscular ketoprofen (Profenid) and pethidine for squint surgery in children. 1006 69


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