ABSTRACT
INTRODUCTION: Recent studies for postoperative pain relief after arthroscopy by intraarticular morphine or bupivacaine showed controversial results. The aim of the study was to evaluate the analgesic effect of intraarticular morphine and ropivacaine. METHODS: 135 patients were randomized into 9 groups (n=15) after standardized knee-arthroscopy. They received either 1 mg or 5 mg morphine or 150 mg ropivacaine or a combination of 5 mg morphine and 75 mg ropivacaine. Drains were opened either after 10 or 30 minutes. A control-group received isotonic saline. Pain was assesed 1 h and 4 h after surgery, at 8 pm on the day of the operation and at 8am and 4 pm the following two days by a VAS scale. Tramadol consumption as rescue medication was registred. RESULTS: Ropivacaine showed the best pain relief after surgery. After 24 h the pain intensity approximated in all groups and after 48 h there was no difference. Tramadol consumption was highest in the control group and lowest in the ropivacaine group (p<0,05). Ropivacaine showed better pain reduction than morphine. An influence of the time, when drains were opened, could only be demostrated for the 75 mg ropivacain combination group. CONCLUSION: Intraarticular ropivacaine following elective knee-arthroscopy reduces postoperative analgetic consumption significantly and improves patient comfort.
Subject(s)
Amides/administration & dosage , Arthroscopy , Knee Injuries/surgery , Knee Joint/surgery , Morphine/administration & dosage , Osteoarthritis, Knee/surgery , Pain, Postoperative/drug therapy , Tibial Meniscus Injuries , Adult , Amides/adverse effects , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Drug Therapy, Combination , Female , Humans , Injections, Intra-Articular , Male , Morphine/adverse effects , Pain Measurement , Prospective Studies , RopivacaineABSTRACT
Sexual fantasies are seen as an important source of information and a modality for treatment procedures in sex therapy programs. While drive-reduction models view fantasy as a symptom of a deficiency state, cognitive-behavioral approaches take fantasies as an index of a satisfying sex life. While current data tend to support the behavioral position, no systematic comparison has been undertaken of men and women with and without sexual distress. This study compared written examples of sexual daydreaming, masturbatory and coital fantasies as well as habitual patterns of employing fantasies during sexual activities of the above mentioned groups. Other psychotherapy clients served as control. Sex differences were sparse and the comparison between distressed and nondistressed tended to support the behavioral position. Although sexual fantasizing is positively related to a satisfying sex life, fantasies are often used for reducing aversive emotions. Subjects older than 35 years showed fewer fantasies and lower correlations between daydreaming and sexual activity.
