Patient-controlled epidural analgesia with morphine or morphine plus ketamine for post-operative pain relief.

Abstract:

:Sixty patients were randomly assigned to two equal groups. Group I received epidural morphine 1 mg after surgery and used a patient-controlled analgesia device programmed to deliver morphine 0. 2 mg h-1, 0.2 mg per bolus. Group II received an epidural loading dose of morphine 1 mg plus ketamine 5 mg and used a patient-controlled analgesia device programmed to deliver morphine 0. 2 mg+ketamine 0.5 mg h-1, morphine 0.2 mg+ketamine 0.5 mg per bolus with a lockout time of 10 min. The mean morphine consumption was 8. 6+/-0.7 mg for group I and 6.2+/-0.2 mg for group II. Although group II utilized significantly less morphine (P < 0.05), pain relief was significantly better in group II than in group I (P < 0.05) in the first 3 h. Vomiting occurred more frequently in group I (26%) than in group II (13%). The frequency and severity of pruritus and level of sedation were similar in the two groups. These findings suggest that patient-controlled epidural analgesia with morphine plus ketamine may provide effective analgesia with a lesser dose of morphine and fewer subsequent side effects, compared with patient-controlled epidural analgesia with morphine alone after lower abdominal surgery.

journal_name

Eur J Anaesthesiol

authors

Tan PH,Kuo MC,Kao PF,Chia YY,Liu K

doi

10.1046/j.1365-2346.1999.00592.x

subject

Has Abstract

pub_date

1999-12-01 00:00:00

pages

820-5

issue

12

eissn

0265-0215

issn

1365-2346

pii

eja592

journal_volume

16

pub_type

临床试验,杂志文章,随机对照试验
  • Development of a specific algorithm to guide haemostatic therapy in children undergoing cardiac surgery: a single-centre retrospective study.

    abstract:BACKGROUND:Although rotational thromboelastometry (ROTEM) is increasingly used to guide haemostatic therapy in a bleeding patient, there is a paucity of data guiding its use in the paediatric population. OBJECTIVE:The objective of this study is to develop an algorithm on the basis of ROTEM values obtained in our paedi...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000000179

    authors: Faraoni D,Willems A,Romlin BS,Belisle S,Van der Linden P

    更新日期:2015-05-01 00:00:00

  • Implementation of patient blood management remains extremely variable in Europe and Canada: the NATA benchmark project: An observational study.

    abstract:BACKGROUND:Preoperative anaemia is associated with increased postoperative morbidity and mortality. Patient blood management (PBM) is advocated to improve patient outcomes. OBJECTIVES:NATA, the 'Network for the advancement of patient blood management, haemostasis and thrombosis', initiated a benchmark project with the...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/EJA.0000000000000519

    authors: Van der Linden P,Hardy JF

    更新日期:2016-12-01 00:00:00

  • Advanced trauma life support.

    abstract::From a family tragedy 20 years ago, ATLS has truly become an international trauma care program. Its success is demonstrated not only in the large number of physicians that have been trained, but also in the appearance of a number of affiliated courses with a similar structure, aimed at training medical, nursing, civil...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:10.1046/j.1365-2346.1996.00939.x

    authors: Gwinnutt CL,Driscoll PA

    更新日期:1996-03-01 00:00:00

  • The use of cuffed tracheal tubes for paediatric tracheal intubation, a survey of specialist practice in the United Kingdom.

    abstract:BACKGROUND AND OBJECTIVE:For more than 50 yr, uncuffed tracheal tubes have been the gold standard for intubation in children under the age of 8 yr. However, recently there has been interest in the use of cuffed tubes in paediatric practice. This survey aimed to benchmark UK practice with regard to tracheal intubation w...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021508003839

    authors: Flynn PE,Black AE,Mitchell V

    更新日期:2008-08-01 00:00:00

  • Effects of isovolaemic haemodilution on oxygenation of liver and skeletal muscle.

    abstract:BACKGROUND AND OBJECTIVE:Hydroxyethyl starch is frequently used for volume substitution during surgical procedures and for isovolaemic haemodilution. Haemodilution has also been shown to improve tissue oxygen tension in skeletal muscle: However, effects of this volume substitute on tissue oxygen tension of the liver du...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/s0265021505000323

    authors: Gottschalk A,Standl TG,Freitag M,Radtke P,Rempf C,Burmeister MA,Horn EP,Strate T,Schulte am Esch J

    更新日期:2005-03-01 00:00:00

  • Cerebral aneurysm surgery in a patient with phaeochromocytoma.

    abstract::This case report describes the peri-operative management of a 48-year-old woman with three cerebral aneurysms and phaeochromocytoma. The pharmacological and anaesthetic management of such patients is complex, and needs to be managed carefully by titrating anaesthetic agents and vasoactive drugs. The primary concern is...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.1998.00285.x

    authors: Sahin A,Erçelen O,Aypar U,Erbengi A

    更新日期:1998-05-01 00:00:00

  • Dantrolene plasma and urine concentrations after oral pretreatment for malignant hyperthermia: report of a case.

    abstract::Dantrolene plasma concentrations and renal clearance calculations in a patient undergoing major surgery are reported. The family history was positive for malignant hyperthermia. Following oral pretreatment the plasma concentrations in this patient were not noticeably different from values obtained in a study in awake ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Wuis EW,Driessen JJ,Evers J,Vree TB,van der Kleyn E

    更新日期:1986-05-01 00:00:00

  • Role of Toll-like receptor 4 for the pathogenesis of acute lung injury in Gram-negative sepsis.

    abstract:BACKGROUND AND OBJECTIVE:Proinflammatory cytokines as well as nitric oxide (NO) play a major role in mediating the response to lipopolysaccharide (LPS). The present study tested the hypothesis that LPS induces proinflammatory cytokines in the lung via the Toll-like receptor 4 (TLR4)/CD14 signalling cascade. METHODS:Co...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021506001098

    authors: Baumgarten G,Knuefermann P,Wrigge H,Putensen C,Stapel H,Fink K,Meyer R,Hoeft A,Grohé C

    更新日期:2006-12-01 00:00:00

  • Early experience with remote pressure sensor respiratory plethysmography monitoring sedation in the MR scanner.

    abstract:BACKGROUND AND OBJECTIVE:The importance of monitoring the breathing pattern during sedation of children undergoing magnetic resonance scans is indicated in guidelines, but no appropriate magnetic resonance-compatible devices are available. We report preliminary findings from a technique referred to as remote pressure s...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021507000312

    authors: Caldiroli D,Minati L

    更新日期:2007-09-01 00:00:00

  • Drotrecogin alfa (activated): diffusion from clinical trials to clinical practice.

    abstract:BACKGROUND AND OBJECTIVE:Although the PROWESS trial demonstrated a mortality benefit, subsequent studies in different patient populations have not reproduced the effect. As a result, concerns have been expressed about the clinical effectiveness of drotrecogin alfa (activated). Therefore the aim of this audit was to rev...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021507002992

    authors: Ridley S,Lwin A,Wyncoll D,Lippett S,Watson D,Gunning K,Higgins D

    更新日期:2008-03-01 00:00:00

  • Comparison of three modes of patient-controlled epidural analgesia during labour.

    abstract:BACKGROUND AND OBJECTIVES:This study compares three modes of patient-controlled epidural analgesia in parturients during labour. METHODS:Eighty-four women were randomized to one of three groups. The epidural solution used in all the three groups was 0.1% bupivacaine with fentanyl 2 microg mL(-1). Patients were able to...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1017/s0265021505000074

    authors: Siddik-Sayyid SM,Aouad MT,Jalbout MI,Zalaket MI,Mouallem MR,Massouh FM,Rizk LB,Maarouf HH,Baraka AS

    更新日期:2005-01-01 00:00:00

  • Complications associated with 27 031 ultrasound-guided axillary brachial plexus blocks: a web-based survey of 36 French centres.

    abstract:BACKGROUND:Ultrasound guidance improves the efficacy of peripheral nerve blocks, reducing performance time and local anaesthetic doses. It should also reduce the risk of systemic toxicity of local anaesthetic and nerve injuries. OBJECTIVE:The primary objective of this prospective study was to estimate the incidence of...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/EJA.0000000000000063

    authors: Ecoffey C,Oger E,Marchand-Maillet F,Cimino Y,Rannou JJ,Beloeil H,SOS French Regional Anaesthesia Hotline.

    更新日期:2014-11-01 00:00:00

  • Thrombogenicity of central venous catheters: prospective study of polyethylene, silicone and polyurethane catheters with phlebography or post-mortem examination.

    abstract::The thrombogenicity of polyethylene, silicone and polyurethane central venous catheters was compared in a prospective clinical, phlebographic and post-mortem study in 52 patients. The incidence of central venous thrombosis was high with polyethylene catheters (70%), but much lower with silicone (20%) and with polyuret...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Pottecher T,Forrler M,Picardat P,Krause D,Bellocq JP,Otteni JC

    更新日期:1984-12-01 00:00:00

  • Malignant hyperthermia.

    abstract::Malignant hyperthermia is an autosomal-dominant inherited disorder of the skeletal muscle cell characterized by a hypermetabolic response to all commonly used inhalational anaesthetics and depolarizing muscle relaxants. The clinical syndrome includes muscle rigidity, hypercapnia, tachycardia and myoglobinuria as resul...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:10.1046/j.1365-2346.2001.00888.x

    authors: Wappler F

    更新日期:2001-10-01 00:00:00

  • Mode of blood pressure monitoring and morbidity after noncardiac surgery: A prospective multicentre observational cohort study.

    abstract:BACKGROUND:Control of blood pressure remains a key goal of peri-operative care, because hypotension is associated with adverse outcomes after surgery. OBJECTIVES:We explored whether increased vigilance afforded by intra-arterial blood pressure monitoring may be associated with less morbidity after surgery. DESIGN:A p...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001443

    authors: Abbott TEF,Howell S,Pearse RM,Ackland GL,VISION-UK Investigators.

    更新日期:2021-01-12 00:00:00

  • S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft surgery: A prospective observational study.

    abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE). OBJECTIVE:The study aims to evaluate the association between POCD and serum levels of S100B and NSE after ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000000450

    authors: Silva FP,Schmidt AP,Valentin LS,Pinto KO,Zeferino SP,Oses JP,Wiener CD,Otsuki DA,Tort AB,Portela LV,Souza DO,Auler JO Jr,Carmona MJ

    更新日期:2016-09-01 00:00:00

  • Preoperative oral dextromethorphan vs. clonidine to prevent tourniquet-induced cardiovascular responses in orthopaedic patients under general anaesthesia.

    abstract:BACKGROUND AND OBJECTIVE:Preoperative oral dextromethorphan and intravenous clonidine attenuate arterial pressure and heart rate increases during tourniquet inflation under general anaesthesia. The effect of preoperative oral clonidine on these variables has not been investigated. METHODS:We designed this study to com...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0265021506002055

    authors: Honarmand A,Safavi MR

    更新日期:2007-06-01 00:00:00

  • Bispectral index-controlled postoperative sedation in cardiac surgery patients: a comparative trial between closed loop and manual administration of propofol.

    abstract:BACKGROUND AND OBJECTIVE:Postoperative cardiac surgery patients are usually sedated according to clinical sedation scores. Electrophysiological data derived from electroencephalography, such as the bispectral index (BIS), have been reported to assess and quantify the level of sedation, although experience in these pati...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e328335b2d4

    authors: Solanki A,Puri GD,Mathew PJ

    更新日期:2010-08-01 00:00:00

  • Pharmacological study of BRS, a new bicarbonated Ringer's solution, in partially hepatectomized rabbits.

    abstract:BACKGROUND AND OBJECTIVE:The effects of bicarbonated Ringer's solution were evaluated and compared with those of acetated Ringer's, lactated Ringer's and Ringer's solutions in partially hepatectomized rabbits. METHOD:Animals were randomly divided into six groups (n = 6 in each group): a sham-operated group, an operate...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/s0265021505001043

    authors: Satoh K,Ohtawa M,Okamura E,Satoh T,Matsuura A

    更新日期:2005-08-01 00:00:00

  • Responsiveness to inhaled NO in isolated-perfused lungs from endotoxin-challenged rats is dependent on endogenous nitrite/nitrate synthesis.

    abstract:BACKGROUND AND OBJECTIVES:In isolated-perfused lungs of lipopolysaccharide (LPS)-challenged rats, vasodilatation to inhaled nitric oxide (NO) is impaired. Inhibition of nitric oxide synthase 2 (NOS2) by aminoguanidine (AG) prevented hyporesponsiveness to inhaled NO. Here, we investigated whether NOS2-mediated nitrite/n...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021506001463

    authors: Bopp Ch,Gust R,Taut F,Gries A,Martin E,Klein A

    更新日期:2007-04-01 00:00:00

  • The base excess gap is not a valid tool for the quantification of unmeasured ions in cardiac surgical patients: a retrospective observational study.

    abstract:BACKGROUND:The base excess gap (BE(gap)) method is commonly used for the quantification of unmeasured ions in critically ill patients. However, it has never been validated against the standard quantitative acid-base approach. OBJECTIVE:To compare the BE(gap) as a tool for the prediction of the excess of unmeasured ion...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e32836412db

    authors: Agrafiotis M,Sileli M,Ampatzidou F,Keklikoglou I,Panousis P

    更新日期:2013-11-01 00:00:00

  • Implications of the use of neuromuscular transmission monitoring on immediate postoperative extubation in off-pump coronary artery bypass surgery.

    abstract:BACKGROUND AND OBJECTIVE:When continuous infusions of neuromuscular blocking drugs are administered during lengthy interventions and no routine antagonism of their effects is applied, there is a dramatic incidence of residual curarization. We have examined whether the use of neuromuscular transmission monitoring result...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1017/s026502150300142x

    authors: Cammu G,De Keersmaecker K,Casselman F,Coddens J,Hendrickx J,Van Praet E,Deloof T

    更新日期:2003-11-01 00:00:00

  • Fractured cervical spine and aortic transection.

    abstract::A 17-year-old victim of a road traffic accident presented. Following investigation diagnoses of fractured first cervical vertebra, aortic transection, diffuse cerebral oedema, fractured right ribs 2-4 and pubic rami were made. Management of this case presented a number of anaesthetic dilemmas: management of the airway...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.1998.00315.x

    authors: Griffin MJ,Harnett M,Kenefick P

    更新日期:1998-07-01 00:00:00

  • Pulmonary lipiodol embolism during transcatheter arterial chemoembolization for hepatoblastoma under general anaesthesia.

    abstract::We present a case of pulmonary embolism that occurred during the injection of lipiodol during transcatheter arterial chemoembolization under general anaesthesia. A 7-year-old child suffering from a large hepatoblastoma was admitted for arterial chemoembolization and carcinostatic administration. Pulmonary embolism due...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.2000.00759.x

    authors: Yamaura K,Higashi M,Akiyoshi K,Itonaga Y,Inoue H,Takahashi S

    更新日期:2000-11-01 00:00:00

  • Preconditioning and protection against ischaemia-reperfusion in non-cardiac organs: a place for volatile anaesthetics?

    abstract::There is an increasing body of evidence that volatile anaesthetics protect myocardium against ischaemic insult by a mechanism termed 'anaesthetic preconditioning'. Anaesthetic preconditioning and ischaemic preconditioning share several common mechanisms of action. Since ischaemic preconditioning has been demonstrated ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:10.1017/S0265021507000531

    authors: Minguet G,Joris J,Lamy M

    更新日期:2007-09-01 00:00:00

  • Effects of magnesium chloride on rocuronium-induced neuromuscular blockade and sugammadex reversal in an isolated rat phrenic nerve-hemidiaphragm preparation: An in-vitro study.

    abstract:BACKGROUND:Magnesium potentiates the effects of nondepolarising muscle relaxants. However, few studies have used magnesium chloride (MgCl2). Sugammadex reverses neuromuscular block by steroidal nondepolarising muscle relaxants. OBJECTIVES:To assess the effects of MgCl2 on rocuronium-induced neuromuscular blockade and ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000000714

    authors: Sung TY,You HJ,Cho CK,Choi HR,Kim YB,Shin YS,Yang HS

    更新日期:2018-03-01 00:00:00

  • Propofol sedation with fentanyl or midazolam during oesophagogastroduodenoscopy in children.

    abstract:BACKGROUND AND OBJECTIVE:Sedation is commonly used to facilitate diagnostic procedures in children. The aim of our study was to investigate sedation in children using propofol alone or combined with fentanyl or midazolam with regard to efficacy, adverse reactions or side-effects related to the drugs, ease of operation ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0265021505001432

    authors: Disma N,Astuto M,Rizzo G,Rosano G,Naso P,Aprile G,Bonanno G,Russo A

    更新日期:2005-11-01 00:00:00

  • General anaesthesia combined with bilateral paravertebral blockade (T5-6) vs. general anaesthesia for laparoscopic cholecystectomy: a prospective, randomized clinical trial.

    abstract:BACKGROUND AND OBJECTIVE:The efficiency of bilateral paravertebral blockade combined with general anaesthesia (active) vs. general anaesthesia alone (control) in reducing postoperative pain following laparoscopic cholecystectomy was evaluated using a prospective randomized study design. METHODS:Patients were randomly ...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1017/s026502150400612x

    authors: Naja MZ,Ziade MF,Lönnqvist PA

    更新日期:2004-06-01 00:00:00

  • Relationship of the internal jugular vein to the common carotid artery: implications for ultrasound-guided vascular access.

    abstract:BACKGROUND AND OBJECTIVE:For cannulation of the internal jugular vein (IJV), ultrasound increases the number of first pass successes and reduces the rate of mechanical complications. A frequent complication of IJV access is the accidental injury of the common carotid artery (CCA), which can be dangerous in some circums...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e328341a492

    authors: Maecken T,Marcon C,Bomas S,Zenz M,Grau T

    更新日期:2011-05-01 00:00:00

  • A comparison of propofol and isoflurane anaesthesia: the need for ephedrine and glycopyrrolate.

    abstract::Sixty patients, ASA I-III, presenting for elective colonic surgery were studied to assess the stability of blood pressure and heart rate during anaesthesia with three equally potent anaesthetic techniques. Patients in group I (n = 20) received thiopentone induction, isoflurane and nitrous oxide; patients in group II (...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Jensen AG,Granfeldt H,Kalman SH,Nyström PO,Eintrei C

    更新日期:1995-05-01 00:00:00