Controlled Comparison of the Efficacy of Fourteen Preparations in the Relief of Postoperative Pain

Morrison, J.D.; Loan, W.B.; Dundee, J. W.

doi:10.1136/bmj.3.5769.287

Cited by 41 publications

(8 citation statements)

References 17 publications

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“…ANALGESIA has been a relatively neglected subject in veterinary medicine, although with the current increasing public concern for animal welfare it is now receiving more attention. In particular, postoperative analgesia has been neglected, although in the human field it has been the subject of a large number of clinical investigations (Morrison, Loan and Dundee 1974; Kame1 and Geddes 1978; Harmer, Slattery, Rosen and Vickers 1983). According to human experience, postoperative pain can be a major problem and justifies considerable effort being made to relieve it (Anon 1978).…”

Section: Introductionmentioning

confidence: 99%

Effect of postoperative pethidine on the anaesthetic recovery period in the horse

Taylor

1986

Equine Veterinary Journal

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Section: Introductionmentioning

confidence: 99%

Effect of postoperative pethidine on the anaesthetic recovery period in the horse

Taylor

1986

Equine Veterinary Journal

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“…A positive result for analgesia was recorded only if patient’s and observer’s subjective estimate of decrease in pain coincided with an improvement in vital capacity and peak expiratory flow rate. 11 The use of levorphanol in this study was associated with successful analgesia in a greater percentage of patients when compared to the other analgesics.…”

Section: Levorphanol Use In the Perioperative Settingmentioning

confidence: 67%

“… “heart rate and blood pressure were more stable when levorphanol was used” Glazebrook et al (1952) 27 Post-Operative Pain 200 (14 post-op pain) 1.3–4mg “Will control postoperative pain as well or better than morphine.” Not specified to the 14 cases of postop pain Hunt et al (1953) 10 Post-Operative Pain 311 3mg Effective analgesia obtained in 97% of patients Side effects were less in levorphanol group vs morphine group Brown et al (1954) 20 Post-Operative Pain ‘‘several” 2+mg Found to provide an average of 7 hours of postoperative pain relief, once 4 mg had been administered, relief of pain could be maintained with the use of 0.5mg every 12 hours Not mentioned Rankin et al (1957) 17 Post-Operative Pain 27 2mg Slight or no pain in the first 6 hours was documented in 94.5%, average duration of analgesia was 10.1 hours. 50 4–5mg Nausea in 22%, Emesis in 8% of levorphanol 4–5mg Morrison et al (1971) 11 Post-Operative Pain 40 2mg Levorphanol at a dose of 2mg clearly emerged as the most effective agent in this trial Lower incidence of drowsiness than with morphine Banister et al (1974) 28 Post-Operative Pain 86 2mg Statistically equivalent to other medications Restlessness, vomiting, euphoria and dizziness were rarely induced by any of the drugs and never exceeded an incidence of 8%. …”

Section: Methodsmentioning

confidence: 99%

“…Medications were then ranked in order with respect to incidence of successful postoperative pain relief. 11 …”

Section: Levorphanol Use In the Perioperative Settingmentioning

confidence: 99%

“…In general, the use of postoperative levorphanol was associated with longer and more effective analgesia with overall less opioid requirements when compared to other medications including methadone and morphine. 10 , 11 , 27 …”

Section: Levorphanol Use In the Perioperative Settingmentioning

confidence: 99%

See 2 more Smart Citations

<p>Levorphanol in the Perioperative Setting: Decreasing Opioid Requirements While Improving Pain Management</p>

Page

Perez

Mavarez-Martinez

et al. 2020

JPR

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Single dose oral dihydrocodeine for acute postoperative pain

Moore

Edwards

Derry

et al. 2000

Cochrane Database of Systematic Reviews

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Background This is an updated version of the original Cochrane review published in Issue 2, 2000. Dihydrocodeine is a synthetic opioid analgesic developed in the early 1900s. Its structure and pharmacokinetics are similar to that of codeine and it is used for the treatment of postoperative pain or as an antitussive. It is becoming increasingly important to assess the relative efficacy and harm caused by different treatments. Relative efficacy can be determined when an analgesic is compared with control under similar clinical circumstances. Objectives To quantitatively assess the analgesic efficacy and adverse effects of single-dose dihydrocodeine compared with placebo in randomised trials in moderate to severe postoperative pain. Search methods Published reports were identified from electronic databases (MEDLINE, EMBASE, CENTRAL, the Oxford Pain Relief Database in December 2007, the original search was conducted in October 1999). Additional studies were identified from the reference lists of retrieved reports. Selection criteria Inclusion criteria: full journal publication, clinical trial, random allocation of participants to treatment groups, double blind design, adult participants, baseline pain of moderate to severe intensity, postoperative administration of study drugs, treatment arms which included dihydrocodeine and placebo and either oral or injected (intramuscular or intravenous) administration of study drugs. Data collection and analysis Data collection and analysis: summed pain intensity and pain relief data over four to six hours were extracted and converted into dichotomous information to yield the number of participants obtaining at least 50% pain relief. This was used to calculate relative benefit and number-needed-to-treat-to-benefit (NNT) for one participant to obtain at least 50% pain relief. Single-dose adverse effect data were collected and used to calculate relative risk and number-needed-to-treat-to-harm (NNH). Main results Fifty-two reports were identified in the original review as possible randomised trials which assessed dihydrocodeine in postoperative pain. Four reports met the inclusion criteria; all assessed oral dihydrocodeine. Three reports (194 participants) compared dihydrocodeine with placebo and one (120 participants) compared dihydrocodeine (30 mg or 60 mg) with ibuprofen 400 mg. For a single dose of dihydrocodeine 30 mg in moderate to severe postoperative pain the NNT for at least 50% pain relief was 8.1 (95% confidence interval 4.1 to 540) when compared with placebo over a period of four to six hours. Pooled data showed significantly more participants to have reported adverse effects with dihydrocodeine 30 mg than with placebo. When compared to ibuprofen 400 mg both dihydrocodeine 30 mg and 60 mg were significantly inferior. No additional studies were found for this update. Authors’ conclusions A single 30 mg dose of dihydrocodeine is not sufficient to provide adequate pain relief in postoperative pain. Statistical superiority of ibuprofen 400 mg over dihydrocodein...

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Controlled Comparison of the Efficacy of Fourteen Preparations in the Relief of Postoperative Pain

Cited by 41 publications

References 17 publications

Effect of postoperative pethidine on the anaesthetic recovery period in the horse

Effect of postoperative pethidine on the anaesthetic recovery period in the horse

<p>Levorphanol in the Perioperative Setting: Decreasing Opioid Requirements While Improving Pain Management</p>

Single dose oral dihydrocodeine for acute postoperative pain

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