Objective To observe the analgesia and side effects of butorphanol or morphine combined with ropivacaine in postoperative patients with controlled epidural analgesia(PCEA).Methods 100patients,undergoing abdominal hyst...Objective To observe the analgesia and side effects of butorphanol or morphine combined with ropivacaine in postoperative patients with controlled epidural analgesia(PCEA).Methods 100patients,undergoing abdominal hysterectomy with contious epidural anesthesia,were randomly divided two groups.Butorphanol 15 mg/L(experiment groups) or morphine 20 mg/L(control groups) with 1.5 g/L ropivacaine were given epidurally after surgery respectively.Postoperative pain was assessed using VAS.The patients’ satisfaction level and adverse events were also recorded.Results the VAS scores of study group were significantly lower than control group at 2 h and 8 h after operations.The incidences and degree of nausea and vomiting of study group were lower than control group when patients were in state of rest or coughing respectively(P<0.05).The number of effective consumption in study group was significantly less than that in control group. Conclusion 15 mg/L butorphanol with 1.5 g/L ropivacaine could be safe in PCEA after abdominal hysterectomy.Butorphanol had better analgesic effect than morphine,with less side effects.展开更多
BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question...BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question is“How does the use of opioid medications in pain management,compared with non-opioid medications,affect pain intensity over the short,intermediate,and long-term in adults with acute traumatic pain?”.METHODS The protocol was prospectively registered on the International Prospective Re-gister of Systematic Reviews:CRD42021279639.Medline and Google Scholar were electronically searched for controlled peer-reviewed studies published in full,with the PICO framework:P:Adult patients with traumatic injuries,I:Opioid medications,C:Non-opioid medi-cations,O:A minimum clinically important difference(MCID)in pain.RESULTS After full-text screening,we included 14 studies in the qualitative synthesis.Of these 14 studies,12 were rando-mized clinical trials(RCTs)and 2 were pseudo-RCTs with a total of 2347 patients enrolled.There was heteroge-neity in both medication utilized and outcome in these studies;only two studies were homogeneous regarding the type of study conducted,the opioid used,its comparator,and the outcome explored.The MCID was evaluated in 8 studies,while in 6 studies,any measured pain reduction was considered as an outcome.In 11 cases,the setting of care was the Emergency Department;in 2 cases,care occurred out-of-hospital;and in one case,the setting was not well-specified.The included studies were found to have a low-moderate risk of bias.CONCLUSION Non-opioids can be considered an alternative to opioids for short-term pain management of acute musculoskeletal injury.Intravenous ketamine may cause more adverse events than other routes of administration.展开更多
文摘Objective To observe the analgesia and side effects of butorphanol or morphine combined with ropivacaine in postoperative patients with controlled epidural analgesia(PCEA).Methods 100patients,undergoing abdominal hysterectomy with contious epidural anesthesia,were randomly divided two groups.Butorphanol 15 mg/L(experiment groups) or morphine 20 mg/L(control groups) with 1.5 g/L ropivacaine were given epidurally after surgery respectively.Postoperative pain was assessed using VAS.The patients’ satisfaction level and adverse events were also recorded.Results the VAS scores of study group were significantly lower than control group at 2 h and 8 h after operations.The incidences and degree of nausea and vomiting of study group were lower than control group when patients were in state of rest or coughing respectively(P<0.05).The number of effective consumption in study group was significantly less than that in control group. Conclusion 15 mg/L butorphanol with 1.5 g/L ropivacaine could be safe in PCEA after abdominal hysterectomy.Butorphanol had better analgesic effect than morphine,with less side effects.
文摘BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question is“How does the use of opioid medications in pain management,compared with non-opioid medications,affect pain intensity over the short,intermediate,and long-term in adults with acute traumatic pain?”.METHODS The protocol was prospectively registered on the International Prospective Re-gister of Systematic Reviews:CRD42021279639.Medline and Google Scholar were electronically searched for controlled peer-reviewed studies published in full,with the PICO framework:P:Adult patients with traumatic injuries,I:Opioid medications,C:Non-opioid medi-cations,O:A minimum clinically important difference(MCID)in pain.RESULTS After full-text screening,we included 14 studies in the qualitative synthesis.Of these 14 studies,12 were rando-mized clinical trials(RCTs)and 2 were pseudo-RCTs with a total of 2347 patients enrolled.There was heteroge-neity in both medication utilized and outcome in these studies;only two studies were homogeneous regarding the type of study conducted,the opioid used,its comparator,and the outcome explored.The MCID was evaluated in 8 studies,while in 6 studies,any measured pain reduction was considered as an outcome.In 11 cases,the setting of care was the Emergency Department;in 2 cases,care occurred out-of-hospital;and in one case,the setting was not well-specified.The included studies were found to have a low-moderate risk of bias.CONCLUSION Non-opioids can be considered an alternative to opioids for short-term pain management of acute musculoskeletal injury.Intravenous ketamine may cause more adverse events than other routes of administration.
