Articles: opioid-analgesics.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of metoclopramide and ondansetron for the prevention of nausea and vomiting after intrathecal morphine.
Nausea and vomiting remain unpleasant side effects of intrathecal (i.t.) morphine and of the numerous therapies tried, only prophylactic intravenous (i.v.) metoclopramide has been reported to be promising. Seventy-three patients, scheduled for orthopaedic prosthesis surgery of the hip or knee were studied. They received 4 mL of plain bupivacaine and 0.3 mg of preservative-free morphine i.t. for anaesthesia. ⋯ Incidences of severe vomiting were 24, 35 and 12% respectively. Eight patients in the saline group, seven in the metoclopramide and 10 in the ondansetron group did not need additional opioids for post-operative pain relief. We conclude that, metoclopramide and ondansetron were not better than saline in the prevention of post-operative emesis induced by intrathecal morphine.
-
Regional anesthesia · Mar 1997
Randomized Controlled Trial Clinical TrialDetection of intravascular epidural catheters using 2-chloroprocaine. Influence of local anesthetic dose and nalbuphine premedication.
Detecting the intravascular placement of epidural catheters is essential to avoid local anesthetic toxicity. Small doses of intravenous local anesthetics produce changes in sensorium and are often used to test newly placed epidural catheters. Many parturients receive nalbuphine for analgesia prior to epidural catheter placement. This study examines how nalbuphine premedication influences symptoms following intravenous 2-chloroprocaine. ⋯ This study suggests that patients who receive nalbuphine for analgesia prior to epidural placement will be more likely to report symptoms after receiving intravenous 2-chloroprocaine during epidural test dosing.
-
J. Pharmacol. Exp. Ther. · Mar 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparing the subjective, psychomotor and physiological effects of intravenous nalbuphine and morphine in healthy volunteers.
The purposes of this study were to characterize the subjective, psychomotor and physiological effects of nalbuphine in healthy non-drug abusing volunteers and to compare and contrast the effects of equianalgesic doses of nalbuphine and morphine. Subjects (12 males, 4 females) without histories of opiate dependence were injected in an upper extremity vein with 0, 2.5, 5.0 or 10 mg/70 kg nalbuphine, or with 10 mg/70 kg morphine, using a randomized, double-blind, crossover design. The 10-mg doses of nalbuphine and morphine are considered equianalgesic and are doses commonly given for relief of postoperative pain. ⋯ The results of the present study demonstrate that 2.5 to 10 mg nalbuphine had orderly, dose-related effects on subjective, psychomotor and physiological variables. The results also indicate that 10 mg of nalbuphine produces a profile of subjective, psychomotor and physiological effects similar to that of an equianalgesic dose of morphine (10 mg). The similarity in profiles between drugs at this dose is consistent with both infrahuman studies, which suggests that nalbuphine is a mu agonist, and studies with nondependent opioid abusers, in which relatively low doses of nalbuphine (such as 10 mg) produce morphine-like effects.
-
Acta Anaesthesiol Scand · Mar 1997
Randomized Controlled Trial Clinical TrialAnesthetic quality during cesarean section following subarachnoid or epidural administration of bupivacaine with or without fentanyl.
It is often assumed that subarachnoid administration of local anesthetics produces a more profound blockade than epidural anesthesia. Furthermore, the addition of fentanyl has been reported to increase preferentially intraoperative analgesia. In the present study we set out to study these two issues in a randomized and controlled study with respect to perceived pain and discomfort during surgery and postoperative pain. ⋯ We conclude that subarachnoidal (12.5 mg) and epidural (100 mg) injections with bupivacaine both produced adequate anesthetic quality in women undergoing elective cesarean section. The addition of fentanyl (10 micrograms subarachnoidally or 100 micrograms epidurally) did not significantly improve the quality of these already profound blockades.
-
Anesthesia and analgesia · Feb 1997
Randomized Controlled Trial Clinical TrialIntrathecal morphine for coronary artery bypass grafting and early extubation.
Aggressive control of pain during the immediate postoperative period after cardiac surgery with early tracheal extubation may decrease morbidity and mortality. This prospective, randomized, double-blinded, placebo-controlled clinical study examined the use of intrathecal morphine in patients undergoing cardiac surgery and its influence on early tracheal extubation and postoperative analgesic requirements. Patients were randomized to receive either 10 micrograms/kg of intrathecal morphine (n = 19) or intrathecal placebo (n = 21). ⋯ Although mean postoperative IV morphine use for 48 h was less in patients who received intrathecal morphine (42.8 mg) when compared to patients who received intrathecal placebo (55.0 mg), the difference between groups was not statistically significant. In conclusion, intrathecal morphine offers promise as a useful adjunct in controlling postoperative pain in patients after cardiac surgery. However, the optimal dose of intrathecal morphine in this setting, along with the optimal intraoperative baseline anesthetic that will provide significant analgesia, yet not delay extubation in the immediate postoperative period, remains to be elucidated.