Articles: opioid.
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Int J Obstet Anesth · Oct 1997
Randomized Controlled Trial Clinical TrialNalmefene or naloxone for preventing intrathecal opioid mediated side effects in cesarean delivery patients.
This study was designed to evaluate the efficacy of nalmefene vs. naloxone in preventing side effects resulting from intrathecal opioids, in patients undergoing cesarean delivery. Eighty patients who were scheduled for elective cesarean delivery under spinal anesthesia were included in a double-blind, placebo-controlled study. ⋯ There was a significant difference among the groups with respect to the occurrence of vomiting (P < 0.03): both nalmefene groups had a higher rate of vomiting than did the control group; the 0.25 microg.kg(-1) nalmefene group had a higher rate than did the naloxone group. The use of narcotic antagonists does not result in improved comfort in obstetrical patients receiving intrathecal morphine and fentanyl.
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Int J Obstet Anesth · Jul 1997
Severe respiratory depression in the obstetric patient after intrathecal meperidine or sufentanil.
Two cases of severe respiratory depression in the obstetric population are presented. The first occurred after intrathecal injection of a modest dose (50 mg) of meperidine. The second followed intrathecal administration of 10 microg of sufentanil after intravenous fentanyl. These cases illustrate the potential gravity of this complication and highlight the need for caution when giving intrathecal opioid following parenteral opioid administration.
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J Back Musculoskelet Rehabil · Jan 1997
Pain, psychological status, and functional recovery in chronic pain patients on daily opioids: a case comparison.
Long-term opioid therapy for chronic benign pain remains controversial. Most studies on the effectiveness of such regimens have been case series or case comparisons and very few randomized placebo-controlled studies are available. Overall, this research has produced mixed results. ⋯ Statistical removal of the effects of pain differences did not alter the pattern of results for psychological and functional measures. Although the study design employed did not allow determination of causality, it is consistent with previous work which has failed to reveal any advantage to use of daily opioids in the chronic pain population with regard to analgesia, decreased adjunctive medication use, or functional recovery. Well-designed, prospective, randomized studies are needed, but the current results suggest continued caution in the use of daily opioids until such studies become available.