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Items 1 - 4 of 4 |
One page. |
Double-blind comparison of intrapleural saline and 0.25% bupivacaine for ipsilateral shoulder pain after thoracotomy in patients receiving thoracic epidural analgesia.
Pennefather SH, Akrofi ME, Kendall JB, Russell GN, Scawn ND.
Department of Anaesthesia, Cardiothoracic Centre, Thomas Drive, Liverpool L14 3PE, UK.
BACKGROUND: The aim of this prospective double-blind randomized placebo-controlled study was to investigate the effect of intrapleural bupivacaine on ipsilateral post-thoracotomy shoulder pain in patients receiving thoracic epidural analgesia. METHODS: Of the 68 patients recruited to the study, 41(60%) developed ipsilateral shoulder pain within 2 h of surgery. These patients were randomly assigned to receive either 40 ml of intrapleural bupivacaine 0.25% with epinephrine 1:200 000 or 40 ml of intrapleural saline. The study solution was injected into the tube of a basal drain that had been clamped distal to the site of administration. Shoulder pain at rest and on coughing was assessed using a visual analogue scale (VAS) and an observer verbal rating score (OVRS) immediately before and 30 min, 1 h, 2 h, 3 h and 4 h after intrapleural bupivacaine/saline. The total volume of epidural solution administered was recorded. RESULTS: Thirty-nine patients completed the study and were included in the analysis. There were no significant differences in baseline characteristics between the two groups. There were no significant differences between groups for VAS or OVRS pain scores at rest or with cough at any of the six assessment times. The total volumes of epidural solution administered to the bupivacaine and saline groups were 56 ml and 48 ml, respectively. This difference was not significant. CONCLUSION: Intrapleural administration of 40 ml of bupivacaine 0.25% does not provide effective pain relief for ipsilateral post-thoracotomy shoulder pain.
PMID: 15567813 [PubMed - in process]
Quantification of acute neck pain following whiplash injury by computer-aided pressure algesimetry.
Stude P, Nebel K, Ludecke C, Wiese H, Diener HC, Keidel M.
Department of Neurology, University of Essen, Essen, Germany. philipp.stude@uni-essen.de
Until now the clinical investigation of cervical pain due to whiplash injury is mainly based on finger palpation. The present study introduces a PC-interactive pressure algesimetry to standardize cervical pain measurement. Pressure pain scores of the splenius and trapezius muscles of 23 patients with an acute cervical syndrome after whiplash injury were compared to those of 24 healthy subjects. The pressure painfulness of neck and shoulder muscles was significantly increased in whiplash patients. The splenii muscles showed an equally increased muscle pain whereas the trapezii muscles showed a left-sided preponderance of painfulness, possibly due to the seat belt position in this group of motor vehicle drivers. The computer-interactive pressure algesimetry enables a standardized and rater-independent quantification of the cervical syndrome with neck and shoulder pain caused by whiplash injury.
PMID: 15566421 [PubMed - in process]
Back pain and renal failure.
Delanaye P, Bovy C, de Leval L, Fassotte MF, Witvrouw N, Dechenne C, Tassin F, Krzesinski JM.
Department of Nephrology, University Hospital of Liege B35, B-4000 Liege, Belgium. pierre_delanaye@yahoo.fr
Publication Types:
PMID: 15567017 [PubMed - indexed for MEDLINE]
Topical 4% amethocaine gel reduces the pain of subcutaneous measles-mumps-rubella vaccination.
O'Brien L, Taddio A, Ipp M, Goldbach M, Koren G.
Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Toronto, Ontario, Canada.
OBJECTIVES: Ametop gel (4% amethocaine) is a relatively new topical anesthetic that produces anesthesia within 30 to 45 minutes and therefore may be appropriate for use in busy outpatient settings. The objective of this study was to assess the efficacy and safety of 4% amethocaine in reducing the pain of subcutaneous measles-mumps-rubella vaccination in 1-year-old infants. METHODS:A double-blind, randomized, placebo-controlled trial was conducted in pediatric outpatient clinics. RESULTS:A total of 120 infants participated in the study; 60 were followed up for assessment of antibody titers after 1 month. Either 1 g of amethocaine or placebo was applied for 30 minutes before vaccination. The Modified Behavioral Pain Scale was used to assess pain; the mean (standard deviation) pain scores for the amethocaine group (n = 61) was 1.5 (1.6) versus 2.3 (2.2) for the placebo group (n = 59). The rate of vaccination success (88% and 87%) was not different between treatment groups. CONCLUSIONS:4% Amethocaine significantly reduces the pain of measles-mumps-rubella vaccination in infants when compared with placebo and does not seem to interfere with subsequent development of protective antibody levels. Because of its relatively short application time (30 minutes), 4% amethocaine may be suitable for busy clinics and emergency departments.
PMID: 15574604 [PubMed - in process]
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