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Verfasst von:Kunst, Gudrun [VerfasserIn]   i
 Chrubasik, Sigrun [VerfasserIn]   i
 Black, A. M. S. [VerfasserIn]   i
 Chrubasik, Joachim [VerfasserIn]   i
 Schulte-Mönting, J. [VerfasserIn]   i
 Alexander, J. I. [VerfasserIn]   i
Titel:Patient-controlled epidural diamorphine for post-operative pain
Titelzusatz:verbal rating and visual analogue assessments of pain
Verf.angabe:G. Kunst, S. Chrubasik, A.M.S. Black, J. Chrubasik, J. Schulte-Mönting, J.I. Alexander
Jahr:1996
Umfang:13 S.
Fussnoten:Elektronische Reproduktion der Druck-Ausgabe 4. August 2006 ; Gesehen am 17.07.2024
Titel Quelle:Enthalten in: European journal of anaesthesiology
Ort Quelle:Philadelphia, Pa. : Lippincott Williams & Wilkins, 1996
Jahr Quelle:1996
Band/Heft Quelle:13(1996), 2, Seite 117-129
ISSN Quelle:1365-2346
Abstract:Twenty-two patients were studied while receiving epidural analgesia with diamorphine after major lower abdominal surgery under combined regional and general anaesthesia. Epidural PCA began when the intra-operative epidural block with bupivacaine wore off enough for the patient to request treatment. It was started with 2 mg of diamorphine and continued with a reducible background infusion that was initially set at 0.2 mg h−1 and supplemented by on-demand doses of 0.2 mg, with a lockout time of 15 min. The patients received routine post-operative monitoring and care, with pain at rest being assessed on a four-point verbal rating scale (VRS, none, mild, moderate, severe) at 5, 10, 15, 30, 45, 60, 90 and 120 min from the start of ePCA, then hourly until 24 h and then 2-hourly until 48 h. VRS on coughing and a 10 cm visual analogue score (VAS) at rest and on coughing were recorded at the same times at 4 h, then 4 hourly until 24 h and then at 48 h, at which times, blood samples were also taken to measure morphine concentrations by radioimmunoassay. Analgesia started promptly and reached a maximum at between 30 and 45 min, accompanied by maximum sedation. Thereafter clinically acceptable analgesia was maintained without undue sedation for 48 h, though pain on coughing was less well controlled than pain at rest. After the initial loading dose of diamorphine, the 95%confidence intervals (CI) for further consumption were 3.7 to 17 mg (average 9.7) in the first 24 h and 2.1 to 12.9 mg (average 6.7 mg) in the second 24 h. The plasma morphine concentrations rose to a plateau by about 15 min, with concentrations within 95% CI from 0 to 11 ng mL−1 (average 5 ng mL−1). The VRS and VAS pain scores were analysed by a conservative approach that treated them as ordinal data, and by a parametric approach that treated them as interval data. Both approaches conveyed broadly similar information about the post-operative analgesia.
DOI:doi:10.1046/j.1365-2346.1996.00940.x
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1046/j.1365-2346.1996.00940.x
 Volltext: https://www.cambridge.org/core/journals/european-journal-of-anaesthesiology/article/abs/patientcontrolled-epidural-diamo ...
 DOI: https://doi.org/10.1046/j.1365-2346.1996.00940.x
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Diamorphine epidural
 Patient controlled
 Post-operative
K10plus-PPN:189565419X
Verknüpfungen:→ Zeitschrift

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