Articles: opioid-analgesics.
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Br J Clin Pharmacol · Jun 1996
Randomized Controlled Trial Clinical TrialMorphine, morphine-6-glucuronide and morphine-3-glucuronide pharmacokinetics in newborn infants receiving diamorphine infusions.
1. The pharmacokinetics of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) were studied in 19 ventilated newborn infants (24-41 weeks gestation) who were given a loading dose of 50 micrograms kg-1 or 200 micrograms kg-1 of diamorphine followed by an intravenous infusion of 15 micrograms kg-1 h-1 of diamorphine. Plasma concentrations of morphine, M3G and M6G were measured during the accrual to steady-state and at steady state of the diamorphine infusion. 2. ⋯ We were unable to identify correlations between gestational age of the infants and any of the determined pharmacokinetic parameters. 7. M3G: morphine and M6G: morphine steady-state plasma concentration ratios were 11.0 +/- 10.8 and 0.8 +/- 0.8, respectively. 8. The metabolism of morphine in neonates, in terms of the respective contributions of each glucuronide pathway, was similar to that in adults.
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Anesthesia and analgesia · Jun 1996
Randomized Controlled Trial Clinical TrialOral clonidine premedication enhances the quality of postoperative analgesia by intrathecal morphine.
Since clonidine potentiates the analgesia by morphine, the current study was performed to investigate whether oral clonidine premedication would enhance the postoperative analgesia by intrathecal morphine. Twenty-six patients, aged 37-60 yr, schedule for abdominal total hysterectomy under spinal anesthesia, were studied. Patients were randomly allocated to one of two groups; the clonidine group (n = 13) received oral clonidine approximately 5 micrograms/kg, and the control group (n = 13) received no clonidine. ⋯ Although there was no difference in the total number of injections of supplemental analgesics (1.1 +/- 0.4 and 2.2 +/- 0.3 in the clonidine and control groups, respectively), the number of patients not requiring supplemental analgesics during the entire study period was larger in the clonidine group than the control group (six patients versus one patient; P < 0.05). There were no differences at any observation point between groups in visual analog pain scores, or the incidence of nausea and pruritus. Oral clonidine preanesthetic medication enhances the postoperative analgesia of intrathecal morphine plus tetracaine without increasing the intensity of side effects from morphine.
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British dental journal · May 1996
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind placebo-controlled study to assess the efficacy of a compound analgesic to prevent postoperative pain following oral surgery.
It has been suggested that small doses of opioid drugs given prior to surgery can reduce postoperative pain. This study was designed to compare the effectiveness of a paracetamol/codeine combination and paracetamol alone in preventing the pain following surgical removal of impacted third molar teeth under general anaesthesia. Analysis of the results showed no statistical differences between treatment groups when compared with placebo. We suggest that the opioids may not be the best drugs available to prevent the moderate to severe pain present following some oral surgery procedures.
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Acta Anaesthesiol Scand · May 1996
Randomized Controlled Trial Clinical TrialPatient-controlled analgesia with morphine and droperidol following caesarean section under spinal anaesthesia.
The addition of droperidol to morphine for patient-controlled analgesia reduces the incidence of nausea and vomiting, but may result in unwanted side effects. ⋯ The addition of droperidol 10 mg to morphine 60 mg for PCA following caesarean section under spinal anaesthesia reduces the incidence of nausea and emesis, but may result in drowsiness, limiting the usefulness of the technique.
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Anesthesia and analgesia · May 1996
Randomized Controlled Trial Comparative Study Clinical TrialA multidimensional comparison of morphine and hydromorphone patient-controlled analgesia.
Although patient-controlled analgesia (PCA) pumps have been in use for more than a decade, the optimal PCA analgesic has yet to be identified. Many drugs are used; however, morphine remains the "gold standard" of opioid analgesics worldwide. The present study evaluated morphine and hydromorphone (Dilaudid) PCA with respect to analgesic efficacy, side effects, mood, and cognitive function. ⋯ A similar incidence of side effects and dose medication can be anticipated with morphine and hydromorphone. When considering cognitive effects, morphine had less adverse consequences, while hydromorphone appeared to result in improved mood. We conclude that hydromorphone may provide a suitable alternative to morphine.