Benefits of continuous infusion epidural analgesia throughout vaginal delivery.

Two groups of nulliparous women with fetuses in singleton vertex presentation received continuous infusion epidural analgesia (EDA) with bupivacaine: group A (90 parturients) without infusion analgesia in the second stage of labor and group B (90 parturients) with infusion analgesia throughout delivery. The groups were compared regarding pain relief, duration of the second stage, persistent malrotation of the fetal head, and rate of instrumental vaginal delivery. The continuous infusion EDA gave satisfactory pain relief in 93.3% of the parturients in group A and 97.8% in group B. The duration of second stage was the same in both groups. There were more persistent malrotations of the fetal head in group A, but the malrotation did not affect the mode of delivery. The rate of instrumental vaginal delivery was 25.5% in both groups. The main cause of operative intervention was delay in the second stage. When the continuous infusion technique is used, it seems unreasonable to discontinue the EDA and thereby deprive the parturient of analgesia during the second stage.

A double-blind study of the effect of trimipramine in patients with the irritable bowel syndrome.

The study was performed in 428 patients, of whom 216 were women. The median age was 36.5 (16-75) years and the median weight 67 (42-118) kg. The complaints were registered on a 10-cm-long linear analogue scale by the patients and the physicians. The patients were given coded identical-appearing tablets of placebo and different doses of trimipramine (Surmontil, Rhône-Poulenc) and randomized into groups A-E. During the 6 weeks of treatment the grades of complaints were reduced to about the half of pretreatment levels. The groups treated with trimipramine (groups A-D) felt significantly more improved than the group receiving placebo (group E). The side effect of tiredness was somewhat more pronounced 1-2 weeks after start with 50 mg trimipramine in the evening than in the groups receiving placebo and lower dose schedules of trimipramine.

Psychopharmacologic drugs in the treatment of the irritable bowel syndrome. A double blind study of the effect of trimipramine.

In the present multicentre double blind study of 428 patients with the irritable bowel syndrome a significant beneficial effect was found on abdominal pain, nausea, sleeplessness and depression by using 50 mg of the antidepressive drug, trimipramine, in the evening, as well as 10 mg three times daily. A significant effect was also recorded for the total score of wellbeing during the treatment period of 6 weeks. No side effects were recorded except tiredness in the morning in some patients during the first two weeks.