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

The cardiopulmonary effects of two different types of postoperative analgesic regimes were compared in 31 cardiorespiratorily healthy patients subjected to total hip replacement surgery. The investigation was performed preoperatively on the morning of the day of surgery and during the first 3 days postoperatively. All patients received continuous lumbar epidural analgesia preoperatively, during surgery and up to the end of the first measurement period, which started 2.5 h after surgery. Ten patients were subseuqently given pentazocine (Fortalgesic) intramuscularly on demand for pain relief throughout the investigation, while 14 patients received 0.4% plain lidocaine (Xylocain), and seven patients 0.4% lidocaine with adrenaline (1/400,000) as a continuous lumbar epidural drip for analgesia thorughout the investigation. It was confirmed that the operative procedure itself did not significantly influence the postoperative arterial oxygenation, while the type of postoperative analgesic regimen was of considerable importance in this respect. Thus, patients given pentazocine showed a significant increase in pulmonary venous admixture, due both to an increase in true shunt and to an increase in ventilation/perfusion disturbances. This pattern of poor pulmonary function still persisted on the third postoperatively. In patients given an epidural block no significant changes in pulmonary venous admixture were noted postoperatively, and thus there was no reduction in PaO2. All patients, irrespective of the type of analgesic regimen used, had a significantly increased cardiac index and oxygen uptake postoperatively, although patients given an epidural block showed a greater increase in cardiac index, and thus a tendency towards a more hyperkinetic circulation than those given pentazocine.
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PMID:Respiration and circulation after total hip replacement surgery. A comparison between parenteral analgesics and continuous lumbar epidural block. 96 31

40 Patients undergoing elective orthopaedic surgery of the lower limb randomly received either Buprenorphin sublingual (0,4 mg.) (Bsl) or Pentazocin i.m. (30 mg.) (Pim) for postoperative pain therapy. They were neither premedicated nor sedated. Analgesia was measured with a Visual Analogue Scale (VAS) and assessments by the anaesthetist and patient. Physiological measures were: Blood pressure, heart rate, arterial blood gases and serum cortisol. Side effects were registered. After Pim well known data were obtained: onset (10-30 min.) and duration (2 hours) of action and a significant pain reduction 20, 30 and 60 minutes after injection, whereas with Bsl onset was 60-120 min. and duration 6-7 hours of action and significant pain reduction was seen 120 and 180 min. after administration. 8 dropouts after Bsl up to 120 min. post applications are interpreted as a result of late onset or lack of analgesic action whereas the 13 drop outs 3 hours after Pim can be explained with the short lasting analgesic action of Pentazocin. Serum cortisol levels were better after Bsl, but did not correlate with the VAS. In Blood gas analyses, there were no group differences, especially no hypoxic or hypercapnic periods. There were no severe cardiocirculatory side effects, but significantly more hypertonic reactions and tachycardia after Pim. Other side effects were rare in both groups. The methods are discussed. Bsl has late onset but long duration of action with a higher efficacy than Pim. Bsl is strong and long acting. After an initial intravenous injection Bsl (0,4 mg.) should be administered at 6-hourly intervals.
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PMID:[Sublingual buprenorphine in the therapy of postoperative pain]. 647 99