Efficacy and Economic Evaluation of Tramadol and Hydromorphone Combined with Flurbiprofen Axetil in the Treatment of PCIA for Postoperative Cesarean / 中国药学杂志

OBJECTIVE: To evaluate the efficacy, safety and economy of tramadol and hydromorphone combined with flurbiprofen axetil in the treatment of PCIA for postoperative cesarean through the empirical study, optimize the drug treatment program and provide certain evidence-based medicine and pharmacoeconomics basis for clinical use of drugs. METHODS: Included 240 cases of maternal, these maternal need to use PCIA for postoperative analgesia and meet the inclusion and exclusion criteria. The maternal samples included in the study were divided into two groups: tramadol(tramadol 2 mg •kg-1 + flurbiprofen axetil 5 mg•kg-1) and hydromorphone(hydromorphone 0.04 mg •kg-1 + flurbiprofen axetil 5 mg•kg-1). The efficacy index, safety index and cost index of the two groups were observed. The effectiveness, adverse reactions and cost data were collected. Statistical analysis and cost effectiveness analysis were used to evaluate the economic effects of the two groups. RESULTS: The analgesic effect of tramadol group was same as the hydromorphone group, but the total cost of analgesia in tramadol group was lower than that in hydromorphone group, the results of the minimum cost analysis showed that the tramadol regimen was superior and the results were stable. CONCLUSION: The PCIA regimen of tramadol group is superior to that of the hydromorphone group, considering the efficacy, safety and economy.

Descripción de la Cronología del Dolor de las Contracciones Uterinas para Analgesia del Trabajo de Parto, una tarea pendiente / Description of the chronology of the pain of uterine contractions for analgesia of labor, a pending task

Propósito: Describir la periodicidad del momento de máxima intensidad del dolor de las contracciones uterinas (CUs) durante el trabajo de parto (TDP) para eventualmente permitir el desarrollo de nuevos modelos de administración de analgesia endovenosa. Material y método: Embarazadas de término en TDP, reclutadas desde marzo 2014 por 18 meses, de manera no probabilística consecutiva. Se obtuvo el momento de máximo dolor por autoreporte de las pacientes con cronómetros, previa capacitación. Análisis: Regresión para medidas repetidas de efectos mixtos a los 3-5, 6-7 y 8-10cm de dilatación. La variable respuesta es el intervalo de tiempo desde el momento de máximo dolor de la CU basal al de la contracción siguiente. Resultados: En 64 pacientes, se obtuvo 5 intervalos de tiempo. Para la dilatación de 3-5cm una mediana=140.92 segundos y los coeficientes de regresión (CR) en 4 intervalos de tiempo con respecto al basal de 4.2, 15.9, -2.7 y -5.8 segundos. Para 67cm una mediana=131.16 seg y CR 13.4, 11.3, 2 y -10 seg. Para 8-10cm una mediana=129.3 seg y CR -6.7, 0.49, -2.5 y -7.7 seg. No hubo diferencias significativas entre los coeficientes de regresión. Conclusiones: Con los datos obtenidos podemos señalar que no hubo diferencias estadísticas significativas entre los intervalos de tiempo de los momentos de máximo dolor durante el TDP en fase activa. Esta información es relevante para apoyar el desarrollo de un modelo predictivo del dolor.

Aim: To describe the timing of the moment of maximum intensity of uterine contraction (UC) pain in labor to possibly enable the development of new models for administering endovenous analgesia. Materials and Methods: Full-term pregnant women in labor, recruited from March 2014 for 18 months, using consecutive nonprobability sampling. The moment of maximum pain was ascertained as self-reported by patients previously trained with chronometers. Analysis: Regression for repeated measurements from mixed results at 3-5, 6-7 and 8-10cm of dilation. The response variable was the time interval from the moment of maximum pain of the baseline UC to the following contraction. Results: In 64 patients, 5 time intervals were obtained. For the dilation of 3-5cm, a median=140.92 seconds and regression coefficients (RC) in 4 time intervals relative to the baseline of 4.2, 15.9, -2.7 and -5.8 seconds. For 6-7cm, a median =131.16 sec and RC 13.4, 11.3, 2 and -10 sec. For 8-10cm, a median =129.3 sec and RC -6.7, 0.49, -2.5 and -7.7 sec. There were no significant differences among the regression coefficients. Conclusions: With the data collected we can report that there were no statistically significant differences between the time intervals of the moments of maximum pain during active labor. This information is relevant to support the development of a predictive model for this pain.

Clinical observation of wrist-ankle needle therapy combined with patient controlled intravenous analgesia for pain after laparoscopic surgery for eccyesis / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect difference between wrist-ankle needle therapy combined with patient controlled intravenous analgesia (PCIA) and simple PCIA for pain after laparoscopic surgery for eccyesis.</p><p><b>METHODS</b>Ninety-eight patients were assigned into an observation group and a control group by random number table, 49 cases in each one. General static inhalation combined anesthesia was used in the two groups. Simple PCIA for pain was applied in the control group. Wrist-ankle needle therapy at bilateral ankle area 1 and 2 combined with PCIA were implemented in the observation group. The pain state of cut was recorded by visual analogue scale (VAS) 1 h, 2 h, 6 h, 12 h, 24 h, 36 h and 48 h after surgery. The total effective rates and adverse reaction rates within 48 h after surgery were compared between the two groups.</p><p><b>RESULTS</b>The VAS scores 6 h, 12 h and 24 h after surgery in the observation group were lower than those in the control group (all<0.01), and the scores in the other time points were not statistically different (all>0.05). The total effective rate of the observation group was 98.0% (48/49), which was better than 83.7% (41/49) of the control group (<0.05). The adverse reaction rate of the observation group was 12.2% (6/49), and that of the control group was 69.4% (34/49), with statistical difference (<0.01).</p><p><b>CONCLUSION</b>Wrist-ankle needle therapy combined with PCIA can effectively relieve pain after laparoscopic surgery for eccyesis, and reduce adverse reaction rate after surgery.</p>

Dose titration of transdermal fentanyl patches with fentanyl administrated by patient-controlled intravenous analgesia for cancer-related pain of opioid-naive patients / 中国肿瘤临床

Objective:To evaluate the safety and efficacy of dosing transdermal fentanyl patch by patient-controlled intravenous anal-gesia (PCIA) with fentanyl to treat opioid-naive patients suffering from cancer-related pain. Methods:In this open non-controlled trial, 30 patients with moderate to severe cancer pain were enrolled in the study. Titration conditions, pain score (NRS), and pain of life im-pact scores were assessed and recorded during four periods of treatment, as follows:before fentanyl-PCIA;during fentanyl-PCIA treat-ment;during Duragesic with fentanyl-PCIA treatment;and during Duragesic treatment. Adverse reactions were assessed and recorded during the two periods of treatment (the period before fentanyl-PCIA and the period after fentanyl-PCIA). Results:A total of 20 cases of titration were a success, whereas 10 cases failed. The general pain score, the most serious pain score, activity pain score, resting pain score, and the pain of life impact scores were all significantly reduced during fentanyl-PCIA treatment, during Duragesic with fen-tanyl-PCIA treatment, and during Duragesic treatment compared with the period before fentanyl-PCIA treatment (P<0.05). Nausea was the only adverse reaction that occurred during treatment. Obvious muscle rigidity, loss of consciousness, cough, respiratory depres-sion, and bradycardia were not observed. Conclusion:Dose titration of transdermal fentanyl patch with fentanyl administrated by PCIA for opioid-naive patients provides an effective and convenient method for pain relief treatment.

Comparison of the Effect of Patient-Controlled Epidural Analgesia and Patient-Controlled Intravenous Analgesia on Postoperative Nausea and Vomit In Gynecologic and Obstetric Patients / 中国康复理论与实践

@#ObjectiveTo compare the effects of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomit (PONV) in gynecologic and obstetric patients. Methods56 gynecologic or obstetric patients (ASA Ⅰ～Ⅱ) scheduled for lower abdominal surgeries were randomly allocated to receive either 1 mg/ml morphine plus 0.1 mg/ml droperidol intravenously (group PCIA) or 0.1 mg/ml morphine plus 0.125% bupivacaine (group PCEA-Ⅰ) or 0.1 mg/ml morphine plus 0.1 mg/ml droperidol plus 0.125% bupivacaine (group PCEA-Ⅱ) epidurally. 4, 24, and 48 h after operation, pain scores with visual analogus scale (VAS), sedation scores with Ramesay and the incidences of nausea, vomiting, pruritus, respiratory depression were assessed. ResultsVAS scores in the two PCEA groups were much lower than that of PCIA (P<0.01). The incidences of nausea and vomiting in PCEA-Ⅱ group were significantly lower than those in PCIA group (P<0.05), incidences of other side-effects such as pruritus, respiratory depression etc. were similar between the three groups (P>0.05). ConclusionThe regimen morphine/droperidol/bupivacaine by PCEA shows superiorities in relieving pain and reducing postoperative nausea and vomiting in gynecologic and obstetric patients.

Comparison of the Effect of Patient-Controlled Epidural Analgesia and Patient-Controlled Intravenous Analgesia on Postoperative Nausea and Vomit In Gynecologic and Obstetric Patients / 中国康复理论与实践

@#ObjectiveTo compare the effects of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomit (PONV) in gynecologic and obstetric patients. Methods56 gynecologic or obstetric patients (ASA Ⅰ～Ⅱ) scheduled for lower abdominal surgeries were randomly allocated to receive either 1 mg/ml morphine plus 0.1 mg/ml droperidol intravenously (group PCIA) or 0.1 mg/ml morphine plus 0.125% bupivacaine (group PCEA-Ⅰ) or 0.1 mg/ml morphine plus 0.1 mg/ml droperidol plus 0.125% bupivacaine (group PCEA-Ⅱ) epidurally. 4, 24, and 48 h after operation, pain scores with visual analogus scale (VAS), sedation scores with Ramesay and the incidences of nausea, vomiting, pruritus, respiratory depression were assessed. ResultsVAS scores in the two PCEA groups were much lower than that of PCIA (P<0.01). The incidences of nausea and vomiting in PCEA-Ⅱ group were significantly lower than those in PCIA group (P<0.05), incidences of other side-effects such as pruritus, respiratory depression etc. were similar between the three groups (P>0.05). ConclusionThe regimen morphine/droperidol/bupivacaine by PCEA shows superiorities in relieving pain and reducing postoperative nausea and vomiting in gynecologic and obstetric patients.

Effect of Patient-controlled Epidural Analgesia and Patient-controlled Intravenous Analgesia on Pulmonary Function after Thoracotomy / 中国康复理论与实践

@#ObjectiveTo compare the effect of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) on pulmonary function in post-thoracotomy patients.Methods33 ASA Ⅰ～Ⅱ patients undergoing selective esophagectomy were randomly divided into the PCEA group (n=16, treated with morphine plus bupivacaine) and PCIA group (n=17, treated with morphine plus droperidol) for 3 days postoperatively. Pulmonary function indices including respiratory rate (RR), tidal volume (Vt), vital capacity (Vc) and pulse oximetry (SpO2) were recorded before operation and on the first 2 days after operation. Pain scores with visual analogue scale (VAS) at rest, deep breathing and with cough, and adverse effects were also recorded.ResultsRR increased, Vt , Vc and SpO2 decreased markedly in both groups postoperatively compared with the base line (P<0.01), but there were no significant differences between two groups. VAS scores were much lower in PCEA group, especially, when the patient was at deep breathing or during coughing (P<0.001).ConclusionPCEA is superior to PCIA in pain relief, but contributes no more than PCIA in improving pulmonary function in post-thoracotomy patients.

Comparison of analgesic effect on patient-controlled intravenousanalgesia among different doses of buprenorphine and tramadol / 重庆医科大学学报

0.05).Conclusion:Analgesic effects on PCIA with three mixtures of different doses of buprenorphine and tramadol were satisfactory.Group Ⅰ shows the lower rate of side effects and the dose is preferred in clinical use for PCIA.

Clinical observation on the effects of xafon on patient-controlled Intravenous analgesia after cesarean delivery / 重庆医科大学学报

0.05).Breast feeding of the neonates as well as color of skin and lip,sleeping,movement response and regurgitation had no significant difference in both groups.Conclusions: PCIA using xafon after cesarean delivery can provide excellent analgesic effect but few side effects At the same time,it has no adverse effect on neonates.Xafon may be safely administered intravenously with other narcotics in parturients undergoing cesarean section.