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This single-dose, double-blind, randomized, placebo-controlled study evaluated the analgesic efficacy of both 25 and 50 mg of flurbiprofen (Ansaid, Upjohn) compared with 650 mg of aspirin and placebo in 164 patients who had undergone dental impaction surgery. Using the highly sensitive dental pain model, flurbiprofen appears to be an effective, peripherally acting analgesic with a rapid onset of activity. In the current study, it was superior to aspirin in terms of peak effect and duration of action. Although flurbiprofen is much more potent than ibuprofen, its side-effect profile did not differ markedly from that of ibuprofen in this single-dose study.

Many recent reports indicate epidural morphine administration as effective method of treatment acute and chronic pain. This clinical application of morphine is based on the works of Snyder, Yaksh and Rudy [6,9]. They demonstrated specific opiate receptors that are distributed in the posterior horns of the spinal cord. Opiates administered into the epidural space have selective analgetic effect in respective segmental levels without affecting the motor or sympathetic systems. Following numerous clinical reports [1, 2, 5, 7–9] we decided to use epidural morphine injections for postoperative pain relief. Our test carried out in two steps. First we examined the effect of epidural morphine in postsurgical pain treatment. In the second place we studied respiratory response of epidural morphine.

Objectif: Evaluer la douleur postoperatoire et les experiences d'analgesie des Canadiens. Methode : Trois cent cinq sujets canadiens operes au cours des trois annees precedentes ont repondu a un questionnaire sur l'experience de la douleur a l'unite de chirurgie et a la maison, sur l'efficacite de la medication analgesique et la satisfaction face au traitement. Resultats : A l'unite chirurgicale, 68 % des patients hospitalises en attente d'une operation ont eprouve des douleurs et 49 % des patients externes admis en chirurgie d'un jour Dans l'ensemble, 47 % des hospitalises et 15 % des externes ont signale des douleurs severes ou extremes comme seuil de douleur le plus eleve; 25 % des hospitalises et 9 % des externes ont rapporte des douleurs, en moyenne, severes ou extremes. Pendant les deux semaines qui ont suivi l'operation, 79 % et 74 % des hospitalises et des externes ont respectivement eu des douleurs. De retour a la maison, la survenue de douleurs severes ou extremes a ete subie par 25 % des hospitalises et 28 % des externes; en moyenne, les douleurs ont ete severes ou extremes chez 9 % des hospitalises et 12 % des externes. Un soulagement complet ou important a ete ressenti par 54 % a 72 % des patients qui ont recu une analgesie; les taux de satisfaction de la medication etaient plus eleves que les taux de soulagement de la douleur par la medication. Conclusion: De nombreux patients de chirurgie subissent des douleurs severes ou extremes. On peut ameliorer l'analgesie postchirurgicale des patients canadiens, qu'ils soient a l'unite de chirurgie ou de retour a la maison.

Data on chronic postsurgical pain (CPSP) after otorhinolaryngological surgery are sparse. Adult in-patients treated in 2017 were included into the prospective PAIN OUT registry. Patients’ pain on the first postoperative day (D1), after six months (M6) and 12 months (M12) were evaluated. Determining factor for CPSP was an average pain intensity ≥ 3 (numeric rating scale 0–10) at M6. Risk factors associated with CPSP were evaluated by univariate and multivariate analyses. 10% of 191 included patients (60% male, median age: 52 years; maximal pain at D1: 3.5 ± 2.7), had CPSP. Average pain at M6 was 0.1 ± 0.5 for patients without CPSP and 4.2 ± 1.2 with CPSP. Average pain with CPSP still was 3.7 ± 1.1 at M12. Higher ASA status (Odds ratio [OR] = 4.052; 95% confidence interval [CI] = 1.453–11.189; p = 0.007), and higher minimal pain at D1 (OR = 1.721; CI = 1.189–2.492; p = 0.004) were independent predictors of CPSP at M6. Minimal pain at D1 (OR = 1.443; CI = 1.008–2.064; p = 0.045) and maximal pain at M6 (OR = 1.665; CI = 1.340–2.069; p

This study aimed to determine the safest and most effective dose of sufentanil for epidural administration to relieve post-operative pain. Thirty healthy patients were treated following abdominal surgery. They received no opiates in premedication nor peroperatively. After surgery, upon occurrence of pain, they received a single epidural injection of sufentanil (30, 50 or 75 micrograms) according to a randomized protocol. Pain intensity was evaluated using a visual analogue scale (VAS). Arterial blood gases, peak flow (PF) and forced vital capacity (FVC) were measured before, and at 1, 2 and 4 h post-operatively. The onset of the analgesic effect was evident within 5 min, and was significantly faster with 75 micrograms sufentanil than with either of the other two doses (P less than 0.05). The maximal effect occurred at 30 min, and lasted for 4 h (VAS less than 5) irrespective of the dose injected. Respiratory rate decreased at most by 24% and post-operative sedation was increased for approximately 2 h, both effects being dose-related. Arterial PCO2, heart rate and mean arterial pressure remained normal. Two hours after the injection, there was a small increase in FVC and PF.

Sixty patients with moderate or severe postsurgical pain were randomly divided into three equal groups for a double-blind comparison of the analgesic effectiveness of intramuscular butorphanol (2 and 4 mg) and pentazocine (60 mg). The groups were demographically similar. Pain intensity and pain relief were scored at 10, 20, 30, 60, 120, 180, and 240 minutes after administration of the drug. All treatments provided significant analgesic activity (P less than .05) within ten minutes. However, both doses of butorphanol reached their peak effect at 30 minutes, in contrast to 60 minutes for pentazocine. The duration of effect appeared somewhat longer for butorphanol, though this did not achieve statistical significance. Butorphanol (4 mg) had a significantly greater (P less than .05) analgesic effect at ten minutes than pentazocine (60 mg), and both butorphanol treatments (2 and 4 mg) were significantly better than pentazocine, according to many parameters at 20 and 30 minutes. Side effects, chiefly sleepiness and dizziness, were seen in 15% of the patients, with no significant difference between the treatment groups.

This study was undertaken to determine the serum levels of free morphine base resulting from the epidural administration of morphine, and to correlate these serum levels with analgesic effect. Results from twenty-one patients are presented. Following major surgery with bupivicaine or lidocaine conti