Multiple intramuscular injections: A major source of variability in analgesic response to meperidine

Austin, K. L.; Stapleton, J.V.; Mather, Laurence E.

doi:10.1016/0304-3959(80)90089-5

Cited by 212 publications

(37 citation statements)

References 21 publications

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“…There is also large inter-individual variation in drug requirements and little correlation is seen between body weights with blood concentration after intramuscular injection. 5,6 Published literatures on use of only diclofenac and paracetamol suppositories in post cesarean section pain management are limited. 7,8,9 Purpose of our study was to compare the analgesic effectiveness between regimen using rectal suppositories only (rectal diclofenac sodium and paracetamol) and regimen using conventional (fixed dose schedule) intramuscular pethidine.…”

Section: 2mentioning

confidence: 99%

Non opioid rectal suppositories in post cesarean delivery pain management - a randomized trial

Murshed

Haque

Islam

et al. 2015

J. Soc. Anesth. Nep.

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Background: Frequent administration of intravenous or intramuscular analgesics is cumbersome in developing countries where skilled nursing staffs are at scarcity. We compared analgesic efficacy between regimen using rectal suppositories only (diclofenac and paracetamol) and regimen using conventional (fixed dose schedule) intramuscular pethidine in patients undergoing cesarean section.Methods: This prospective randomized single blind study included 144 patients undergoing both emergency and elective cesarean section. Suppositories group received diclofenac (50 mg) and paracetamol (1000 mg) suppositories regimen eight hourly for the first 24 hours. Pethidine group received intramuscular pethidine (75mg) eight hourly for the 24 hours. Effectiveness of analgesic regimen was inferred from visual pain score and satisfaction score.Results: Mean visual pain score in two groups was not statistically significant. But higher satisfaction score (Mean ±SD 6.36±1.306 vs 5.83±1.061; p<0.05) and less consumption of rescue analgesic (p < 0.001) was observed in suppositories group than pethidine group. No incidences of abnormal lochia /post-partum hemorrhage or other side effects were found in any study patient.Conclusions: The analgesic regimen using suppositories has not only enhanced patient satisfaction also reduced opioid consumption, thus reduced frequency of intramuscular injection in postoperative ward following cesarean sections.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 56-61

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Section: 2mentioning

confidence: 99%

Non opioid rectal suppositories in post cesarean delivery pain management - a randomized trial

Murshed

Haque

Islam

et al. 2015

J. Soc. Anesth. Nep.

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“…They are morphine sparing 77 and have useful properties as far as highly inaccurate dosage calculations based on lean body weight are not necessary. [51][52][53] Some degree of as a reduction in inflammation and stress inhibition are concerned. 29 anxiolysis is built into the system in that the patient is put in control.…”

Section: -74mentioning

confidence: 99%

Prevention of respiratory complications after abdominal surgery

Richardson¹,

Sabanathan²

1997

Thorax

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Objective. To evaluate the prevention of respiratory complications after abdominal surgery by a comparison of a global policy of incentive spirometry with a regimen consisting of deep breathing exercises for low risk patients and incentive spirometry plus (BMJ 1996;312:148-53) Postoperative respiratory morbidity continues to be a tention), a stiffened abdominal wall and, possibly, diaphragmatic dysfunction. 1 These pathophysiological major factor in the utilisation of resources and maintenance of hospitalisation after major surgery. The inchanges underpin the events in the immediate postoperative period and morbidity and mortality depend troductory article draws attention to this but, as the aetiology, prevention and management are multiupon their severity. The main factor behind all these events, and the one which is most amenable to modfactorial, the approach of this review to this subject has been broadened. ulation, is severe postoperative pain. This discussion paper will review the effects of an The incidence of pulmonary complications is higher after upper abdominal or chest surgery than operations abdominal incision, its analgesic management, and postoperative physiotherapy on the generation of poston other parts of the body. These wounds produce a severe and prolonged alteration in pulmonary mechoperative respiratory complications. anics.1 Impaired ventilation and ineffective expectoration result in a postoperative failure of expansion or progression of collapse of lung segments, thereby encouraging infection. The ensuing shunt with venous Effects of anaesthesia and an abdominal incision on pulmonary physiology admixture results in hypoxaemia. Postoperative oxygen supply may therefore falter while oxygen demands are Some great minds have pondered the problem of postoperative complications. Pasteur, Haldane and Beecher increased due to metabolic hypermetabolism and hypercatabolism of the neuroendocrine stress response to were all convinced of the importance of active collapse of the lung after abdominal operations with shallow trauma.2 At the same time the work of breathing is increased due to the need for increased alveolar ventbreathing as the major cause of postoperative hypoxia and pulmonary complications.3-5

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“…The usual approach is to order a preconceived dose of some narcotic, to be given at some arbitrarily chosen time interval. Due to variable absorption from the injection site, the blood concentration of the drug fluctuates in phase with the dosing intervals [19]. As a result, the patient experiences alternating periods of severe pain, relative comfort, and somnolence/ unconsciousness [15,20].…”

Section: Systemic Administration Of Analgesicsmentioning

confidence: 99%

Postoperative Pain Management: An Anesthesiologists'Opportunity and Challenge

Sami

1991

Ann Saudi Med

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Multiple intramuscular injections: A major source of variability in analgesic response to meperidine

Cited by 212 publications

References 21 publications

Non opioid rectal suppositories in post cesarean delivery pain management - a randomized trial

Non opioid rectal suppositories in post cesarean delivery pain management - a randomized trial

Prevention of respiratory complications after abdominal surgery

Postoperative Pain Management: An Anesthesiologists'Opportunity and Challenge

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