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  • 1
    Electronic Resource
    Electronic Resource
    Differences in the assessment of postoperative pain when evaluated by patients and doctors (1993)
    Springer
    Journal of anesthesia 7 (1993), S. 287-292 
    Details
    ISSN: 1438-8359
    Keywords: PAIN—postoperative ; PAIN MEASUREMENT—visual analogue scale ; ANESTHETIC TECHNIQUES—epidural
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was undertaken to compare the assessment of pain intensity by 59 patients and by their doctors according to a visual analogue scale (VAS) at rest and when coughing at 5 and 20 hr after major abdominal surgery. The rating given by the patients, who received epidural analgesia to relieve postoperative pain, was significantly above, and moreover, significantly correlated with that given by the doctors at any time or under any condition of the assessment. However, the correlation between the ratings given by patients and doctors at rest at 5 hr after surgery was low (r = 0.39, rs = 0.38) and significantly different from that when coughing at 20 hr after the operation (r = 0.79, rs = 0.80). Our findings indicate that the assessment of postoperative pain may be associated with some unreliability, especially during early periods, when using the subjective or objective-rated VAS at rest separately, and thus requires the combined use or the concomitant use of the VAS when coughing. Substitutional use of the objective-rated VAS for the subjective-rated VAS is not advised. (Sakura S, Nonoue T, Nomura T, et al.: Differences in the assessment of postoperative pain when evaluated by patients and doctors. J Anesth 7: 287–292, 1993)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s0054030070287
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  • 2
    Electronic Resource
    Electronic Resource
    A simple method to advance a winged epidural needle (1995)
    Springer
    Journal of anesthesia 9 (1995), S. 385-386 
    Details
    ISSN: 1438-8359
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02479962
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Continuous epidural infusion for postoperative mechanical ventilation (1990)
    Springer
    Journal of anesthesia 4 (1990), S. 219-225 
    Details
    ISSN: 1438-8359
    Keywords: Mechanical ventilation ; Postoperative ; Epidural ; Morphine ; Bupivacaine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated in analgesic and sedative effects of continuous epidural infusion of two analgesic regimens in ventilated patients following esophagectomy. Forty-six patients, divided into two treatment groups, received postoperative continuous epidural infusion of morphine, or that of a combination of bupivacaine and morphine. Assessments were made with the following indices: pain relief score, somnolence score, patient ventilator coordination score, and the number of supplemental administrations of analgesics and sedatives. No significant differences occurred in somnolence scores or patient ventilator coordination scores between the two groups, which revealed satisfactory sedation for mechanical ventilation. Patients receiving the combination of bupivacaine and morphine had significantly less pain postoperatively, requiring a smaller number of supplemental administrations of analgesics and sedatives (P ≪ 0.05). It is concluded that: 1) continuous epidural infusion of analgesics gives potent analgesia and sedation of ventilated patients following esophagectomy; 2) the combination of bupivacaine and morphine gives pain relief superior to morphine alone. (Sakura S, Sumi M, Saito Y et al.: Continuous epidural infusion for postoperative mechanical ventilation. J Anesth 4: 219–225, 1990)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s0054000040219
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Continuous epidural infusion for postoperative pain relief: a comparison of three regimens (1990)
    Springer
    Journal of anesthesia 4 (1990), S. 138-144 
    Details
    ISSN: 1438-8359
    Keywords: Postoperative pain ; Epidural ; Morphine ; Bupivacaine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the postoperative pain relief and side-effects of continuous epidural infusion of three analgesic regimens following major thoracic and/or abdominal surgery. One hundred and twenty patients were randomly divided into three treatment groups: (1) 0.25% or 0.5% bupivacaine at a rate of 3–7 ml·hr−1, (2) 0.01% morphine at a rate of 1–2 ml·hr−1, (3) a combination of 0.125% or 0.25% bupivacaine and 0.0025% or 0.005% morphine at a rate of 2–4 ml·hr−1. The study continued for the first 48 postoperative hours. The effect of pain relief was evaluated by assessment of the further requirement for parenteral analgesics. Sixty-four percent of the patients given bupivacaine, 56% of the patients given morphine and 80% of the patients given the combination required no supplemental analgesics. Continuous epidural infusion of bupivacaine was associated with hypotension (21%) and with numbness and weakness of hands or legs (18%). Continuous epidural infusion of morphine was associated with pruritus (18%) and with peristaltic depression (12%). The combination regimen was associated with pruritus (17%) and with drowsiness (14%). We conclude that the combination of bupivacaine and morphine significantly provides superior analgesia with less deleterious complications compared with either bupivacaine or morphine alone. (Sakura S, Uchida H, Saito Y et al.: Continuous epidural Infusion for postoperative pain relief: A comparison of three regimens. J Anesth 4: 138–144, 1990)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s0054000040138
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Changes in pulmonary function during continuous epidural bupivacaine with or without morphine following upper abdominal surgery (1990)
    Springer
    Journal of anesthesia 4 (1990), S. 319-326 
    Details
    ISSN: 1438-8359
    Keywords: Pulmonary function ; Postoperative ; Epidural ; Bupivacaine ; Morphine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess the effect of postoperative continuous thoracic epidural infusion of bupivacaine on pulmonary function, a prospective randomized study was conducted in patients undergoing upper abdominal surgery (UAS). Sixteen patients, divided into two treatment groups, received continuous epidural infusion of 0.25% bupivacaine at a rate of 2–5 ml·hr−1, or that of a combination of 0.125% or 0.25% bupivacaine and 0.0025% or 0.005% morphine at a rate of 2–4 ml·hr−1. One, 4, 10, 16, 24 and 40 hr postoperatively, the following indices were measured: visual analogue scale score, modified Prince Henry pain scale score, arterial PaO 2 and PaCO 2, functional residual capacity (FRC), and tidal volume (TV). There was no difference in pain scores between the two groups except for significantly less pain at 40 hr in the combination group. Postoperative measurements of pulmonary function revealed a significant fall in PaO 2, FRC and TV, indicating a reduction of 15–25% as compared with the preoperative values, and no significant differences between the two groups. The authors conclude that postoperative continuous epidural infusion of bupivacaine combined with morphine is highly effective in alleviating pain and impoving pulmonary function in patients following USA. (Sakura S, Yanagidani T, Saito Y et al.: Changes in pulmonary function during continuous epidural bupivacaine with or without morphine following upper abdominal sugery. J Anesth 4: 319–326, 1990)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s0054000040319
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    Paper (German National Licenses)
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