Extradural and parenteral morphine: kinetics and effects in postoperative pain. a controlled clinical study
TLDR
In a controlled clinical study of 20 patients undergoing arthrotomy a single dose of morphine 0.05 mg kg-1 administered extradurally resulted in more pronounced and prolonged pain relief than morphine 0% i.m. in the period immediately after operation.Abstract:
SUMMARY In a controlled clinical study of 20 patients undergoing arthrotomy a single dose of morphine 0.05 mg kg-1 administered extradurally resulted in more pronounced and prolonged pain relief than morphine 0.1 mg kg-1 i.m. in the period immediately after operation. This difference was significant between 2 and 11 h after morphine administration. The maximum analgesic effect for nine patients in the extradural group was obtained about 2 h after injection. Two of 10 in the extradural group experienced urinary retention. Other side-effects were mild for both groups. Plasma concentrations of morphine were measured in five patients in each group. Four hours after administration, morphine was not detectable in plasma in any of the extradural group and in two of the i.m. group. Our study gives further support for the theory that extradural morphine acts on the spinal cord.read more
Citations
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Effects of Intravenous Patient-Controlled Analgesia with Morphine, Continuous Epidural Analgesia, and Continuous Three-in-One Block on Postoperative Pain and Knee Rehabilitation After Unilateral Total Knee Arthroplasty
TL;DR: After total knee arthroplasty, loco-regional analgesic techniques (epidural analgesia or continuous 3-in-1 block) provide better pain relief and faster postoperative knee rehabilitation than IV patient-controlled analgesia with morphine.
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Postoperative urinary retention: anesthetic and perioperative considerations.
TL;DR: An evidence-based approach to prevention and management of POUR during the perioperative period is proposed, which may be responsible for bladder overdistension, urinary tract infection, and catheter-related complications.
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Ockelbo disease: epidemic arthritis-exanthema syndrome in sweden caused by sindbis-virus like agent
Marcus Skogh,Åke Espmark +1 more
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Use of patient-controlled analgesia to compare the efficacy of epidural to intravenous fentanyl administration.
TL;DR: The analgesic effects of epidural fentanyl appear largely mediated by systemic absorption, and intravenous fentanyl achieves a similar degree of analgesia and a more rapid onset of effect without the need for epidural catheterization.
References
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Analgesia mediated by a direct spinal action of narcotics.
Tony L. Yaksh,T. A. Rudy +1 more
TL;DR: Narcotic analgetics administered directly into the spinal subarachnoid space of the rat via a chronically inserted catheter produce a potent analgesia that can be antagonized by naloxone.
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Immunohistochemical analysis of peptide pathways possibly related to pain and analgesia: enkephalin and substance P
TL;DR: The present immunohistochemical-anatomical findings support the hypothesis that stimulation-produced analgesia is related to activation of spinal and spinal trigeminal enkephalin interneurons forming axo-axonic synapses with (substance P?) pain afferents in the superficial laminae of the dorsal horn and the spinal trigEMinal nucleus.
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Pain relief by intrathecally applied morphine in man.
TL;DR: Pain Relief by Intrathecally Applied Morphine in Man Josef Wang;Lee Nauss;Juergen Thomas; Anesthesiology.
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Comparison of fixed interval and visual analogue scales for rating chronic pain
TL;DR: The VAS appeared to be more satisfactory than the FPS for patient self-rating of pain intensity in patients suffering from prolonged constant pain due to chronic inflammatory or degenerative arthropathy.
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Sensitivity and accuracy of the visual analogue scale: a psycho- physical classroom experiment.
TL;DR: It was concluded that this was due to a shift in either perception, cognition or scoring between the two sessions, and it was recommended that authors using the visual analogue scale have valid reason in their own setting for using a transformation and present the distribution, or at least the medians and ranges of their raw scores.