Journal ArticleDOI
Intrathecal morphine for the relief of post-hysterectomy pain - a double-blind, dose-response study
V. J. Sarma,U. V. Boström +1 more
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Pain scores, as assessed by using the visual analogue scale, revealed that intrathecal morphine provided long‐lasting pain relief, was most effective after 0.3 mg and significantly reduced the need for supplementary analgesics (P<0.05).Abstract:
Eighty patients undergoing total abdominal hysterectomy under general anaesthesia were randomly divided into four groups to study the dose-response relationship of intrathecal morphine (0, 0.1, 0.3 and 0.5 mg) for postoperative pain relief. Pain scores, as assessed by using the visual analogue scale, revealed that intrathecal morphine provided long-lasting pain relief, was most effective after 0.3 mg and significantly reduced the need for supplementary analgesics (P < 0.05). There was no difference as regards the quality of analgesia or the use of supplementary analgesics between the 0.3 and 0.5 mg groups. Adequate pain relief was not evident after a 0.1 mg dose. There was no incidence of respiratory depression in any of the patients in this study. The incidence of side effects was least following 0.3 mg intrathecal morphine, which we consider to be the optimum dose.read more
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Incidence, Reversal, and Prevention of Opioid-induced Respiratory Depression.
TL;DR: The clinical approach to severe opioid-induced respiratory depression is to titrate naloxone to effect and continue treatment by continuous infusion until chances for renarcotization have diminished.
Journal ArticleDOI
Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration.
Terese T. Horlocker,Allen W. Burton,Richard T. Connis,Samuel C. Hughes,David G. Nickinovich,Craig M. Palmer,Julia E. Pollock,James P. Rathmell,Richard W. Rosenquist,Jeffrey L. Swisher,Christopher L. Wu +10 more
TL;DR: This document updates the “Practice Guidelines for the Prevention, Detection and Management of Respiratory Depression Associated with Neuraxial Opioid Administration” adopted by ASA in 2007, and includes new survey data and recommendations pertaining to monitoring for respiratory depression.
Journal ArticleDOI
Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials
TL;DR: In conclusion, intrathecal morphine decreases pain intensity at rest and on movement up to 24 h after major surgery, and Morphine-sparing is more pronounced after abdominal than after cardiac-thoracic surgery.
Journal ArticleDOI
Multimodal therapy in perioperative analgesia
TL;DR: The current evidence for multimodal analgesic options for common surgical procedures is reviewed, finding many of these agents have decreased narcotic requirements, improved patient satisfaction, and decreased postanesthesia care unit (PACU) times, as well as morbidity in the perioperative period.
References
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Pain relief by intrathecally applied morphine in man.
TL;DR: Pain Relief by Intrathecally Applied Morphine in Man Josef Wang;Lee Nauss;Juergen Thomas; Anesthesiology.
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Rostral spread of epidural morphine.
TL;DR: Results suggest that epidural morphine travels cephalad in the cerebrospinal fluid to reach the brain stem and fourth ventricle by the sixth hour, and Hypalgesia and side effects were not related to serum concentrations of morphine.
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Adverse effects of extradural and intrathecal opiates: report of a nationwide survey in sweden
TL;DR: Patients aged 70 yr or more, those receiving thoracic extradural puncture and those with reduced ventilatory capacity seemed to be oyerrepresented, and the administration of extradural morphine was considered as a major contributory factor for the occurrence of Ventilatory depression.
Journal ArticleDOI
Pain Relief by Intrathecally Applied Morphine in Man
TL;DR: Wang et al. as mentioned in this paper used Intrathecally Applied Morphine (IAM) for pain relief in anesthesiology, which is a commonly used anesthetic drug.