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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1983 Nov 5;287(6402):1335–1337. doi: 10.1136/bmj.287.6402.1335

Comparative trial of rectal indomethacin and cryoanalgesia for control of early postthoracotomy pain.

D J Keenan, K Cave, L Langdon, R E Lea
PMCID: PMC1549530  PMID: 6416399

Abstract

A randomised double blind trial was carried out over the first two days after thoracotomy to compare the analgesic effects of rectal indomethacin 100 mg administered eight hourly, cryoanalgesia, and a combination of both of these with the effects of conventional intramuscular opiate analgesia. Pain scores were significantly reduced with both rectal indomethacin alone and cryoanalgesia alone; these treatments had an additive effect when used in combination. Pain on movement was significantly increased, and indomethacin was more effective in reducing this than cryoanalgesia. Groups receiving either indomethacin alone or the combination treatment required significantly less opiate on the first day and exhibited improved peak flow values over the first two days. It is concluded that rectal indomethacin, in this dosage, can provide good, safe analgesia after thoracotomy with minimum administrative difficulty. When used as an adjunct to cryoanalgesia it has an additive effect. There are many potential uses for this drug in other branches of surgery.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aitken R. C. Measurement of feelings using visual analogue scales. Proc R Soc Med. 1969 Oct;62(10):989–993. [PMC free article] [PubMed] [Google Scholar]
  2. Bromage P. R. Extradural analgesia for pain relief. Br J Anaesth. 1967 Sep;39(9):721–729. doi: 10.1093/bja/39.9.721. [DOI] [PubMed] [Google Scholar]
  3. Huskisson E. C. Measurement of pain. Lancet. 1974 Nov 9;2(7889):1127–1131. doi: 10.1016/s0140-6736(74)90884-8. [DOI] [PubMed] [Google Scholar]
  4. Katz J., Nelson W., Forest R., Bruce D. L. Cryoanalgesia for post-thoracotomy pain. Lancet. 1980 Mar 8;1(8167):512–513. doi: 10.1016/s0140-6736(80)92766-x. [DOI] [PubMed] [Google Scholar]
  5. Loan W. B., Dundee J. W. The clinical assessment of pain. Practitioner. 1967 Jun;198(188):759–768. [PubMed] [Google Scholar]
  6. Maiwand O., Makey A. R. Cryoanalgesia for relief of pain after thoracotomy. Br Med J (Clin Res Ed) 1981 May 30;282(6278):1749–1750. doi: 10.1136/bmj.282.6278.1749. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Nayman J. Measurement and control of postoperative pain. Ann R Coll Surg Engl. 1979 Nov;61(6):419–426. [PMC free article] [PubMed] [Google Scholar]
  8. Nelson K. M., Vincent R. G., Bourke R. S., Smith D. E., Blakeley W. R., Kaplan R. J., Pollay M. Intraoperative intercostal nerve freezing to prevent postthoracotomy pain. Ann Thorac Surg. 1974 Sep;18(3):280–285. doi: 10.1016/s0003-4975(10)64357-3. [DOI] [PubMed] [Google Scholar]
  9. Orr I. A., Keenan D. J., Dundee J. W. Improved pain relief after thoracotomy: use of cryoprobe and morphine infusion. Br Med J (Clin Res Ed) 1981 Oct 10;283(6297):945–948. doi: 10.1136/bmj.283.6297.945. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. PARKHOUSE J., LAMBRECHTS W., SIMPSON B. R. The incidence of postoperative pain. Br J Anaesth. 1961 Jul;33:345–353. doi: 10.1093/bja/33.7.345. [DOI] [PubMed] [Google Scholar]
  11. Rutter P. C., Murphy F., Dudley H. A. Morphine: controlled trial of different methods of administration for postoperative pain relief. Br Med J. 1980 Jan 5;280(6206):12–13. doi: 10.1136/bmj.280.6206.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. SIMPSON B. R., PARKHOUSE J., MARSHALL R., LAMBRECHTS W. Extradural analgesia and the prevention of postoperative respiratory complications. Br J Anaesth. 1961 Dec;33:628–641. doi: 10.1093/bja/33.12.628. [DOI] [PubMed] [Google Scholar]

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