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Influence of naloxone infusion on analgesia and respiratory depression following epidural morphine.

Rawal, N; Schött, Ulf LU ; Dahlström, B; Inturrisi, C E; Tandon, B; Sjöstrand, U and Wennhager, M (1986) In Anesthesiology 64(2). p.194-201
Abstract
The influence of two different concentrations of iv naloxone infusion on the analgesia and adverse effects of epidural morphine were compared in a double-blind, placebo-controlled study. Forty-five patients undergoing gallbladder surgery were provided postoperative analgesia by 4 mg epidural morphine; they then received an iv infusion over a 12-h period consisting of either 5 micrograms X kg-1 X h-1 naloxone, 10 micrograms X kg-1 X h-1 naloxone, or saline. Pain relief was assessed by hourly visual analog scoring (VAS) and by direct questioning of the patient. Requirement of additional analgesia was noted. Respiratory frequency was monitored every 15 min and arterial blood gases were analyzed every 2 h for 24 h. Peak expiratory flow (PEF)... (More)
The influence of two different concentrations of iv naloxone infusion on the analgesia and adverse effects of epidural morphine were compared in a double-blind, placebo-controlled study. Forty-five patients undergoing gallbladder surgery were provided postoperative analgesia by 4 mg epidural morphine; they then received an iv infusion over a 12-h period consisting of either 5 micrograms X kg-1 X h-1 naloxone, 10 micrograms X kg-1 X h-1 naloxone, or saline. Pain relief was assessed by hourly visual analog scoring (VAS) and by direct questioning of the patient. Requirement of additional analgesia was noted. Respiratory frequency was monitored every 15 min and arterial blood gases were analyzed every 2 h for 24 h. Peak expiratory flow (PEF) was recorded 6 and 24 h postoperatively. Steady-state kinetics of naloxone were determined by a modified radioimmunoassay (RIA) method. All patients had good to excellent postoperative pain relief. Naloxone, 5 micrograms X kg-1 X h-1, did not appear to have any effect on epidural morphine analgesia. However, naloxone infusion at the rate of 10 micrograms X kg-1 X h-1 reduced the duration of analgesia by about 25%, and more frequent injections of epidural morphine were required to give effective analgesia. Complete reversal of analgesia was not seen in any patient. A dose-related stimulatory effect on respiratory frequency was noted in the groups receiving naloxone. PaCO2 values also were better in these groups as compared to values in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS) (Less)
Please use this url to cite or link to this publication:
author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Morphine: administration & dosage, Naloxone: pharmacology, Respiration: drug effects
in
Anesthesiology
volume
64
issue
2
pages
194 - 201
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:3946806
  • scopus:0022576624
ISSN
1528-1175
language
English
LU publication?
yes
id
c2a097a4-14ec-4172-bbdb-9df26e6be122 (old id 3634419)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/3946806?dopt=Abstract
date added to LUP
2013-07-02 13:02:15
date last changed
2017-08-06 04:47:36
@article{c2a097a4-14ec-4172-bbdb-9df26e6be122,
  abstract     = {The influence of two different concentrations of iv naloxone infusion on the analgesia and adverse effects of epidural morphine were compared in a double-blind, placebo-controlled study. Forty-five patients undergoing gallbladder surgery were provided postoperative analgesia by 4 mg epidural morphine; they then received an iv infusion over a 12-h period consisting of either 5 micrograms X kg-1 X h-1 naloxone, 10 micrograms X kg-1 X h-1 naloxone, or saline. Pain relief was assessed by hourly visual analog scoring (VAS) and by direct questioning of the patient. Requirement of additional analgesia was noted. Respiratory frequency was monitored every 15 min and arterial blood gases were analyzed every 2 h for 24 h. Peak expiratory flow (PEF) was recorded 6 and 24 h postoperatively. Steady-state kinetics of naloxone were determined by a modified radioimmunoassay (RIA) method. All patients had good to excellent postoperative pain relief. Naloxone, 5 micrograms X kg-1 X h-1, did not appear to have any effect on epidural morphine analgesia. However, naloxone infusion at the rate of 10 micrograms X kg-1 X h-1 reduced the duration of analgesia by about 25%, and more frequent injections of epidural morphine were required to give effective analgesia. Complete reversal of analgesia was not seen in any patient. A dose-related stimulatory effect on respiratory frequency was noted in the groups receiving naloxone. PaCO2 values also were better in these groups as compared to values in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)},
  author       = {Rawal, N and Schött, Ulf and Dahlström, B and Inturrisi, C E and Tandon, B and Sjöstrand, U and Wennhager, M},
  issn         = {1528-1175},
  keyword      = {Morphine: administration & dosage,Naloxone: pharmacology,Respiration: drug effects},
  language     = {eng},
  number       = {2},
  pages        = {194--201},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Anesthesiology},
  title        = {Influence of naloxone infusion on analgesia and respiratory depression following epidural morphine.},
  volume       = {64},
  year         = {1986},
}