A comparative study of patient-controlled epidural diamorphine, subcutaneous diamorphine and an epidural diamorphine/bupivacaine combination for postoperative pain.

Abstract:

:This randomized double blind study investigates the relative efficacies of controlled analgesia (PCA) regimens in three different patient groups: epidural diamorphine 2.5 mg followed by PCA bolus 1 mg with a 20-min lockout (Gp1), subcutaneous diamorphine 2.5 mg followed by PCA bolus with a 10-min lockout period (Gp2) and epidural diamorphine 2.5 mg in 4 mL of 0.125% (w/v) bupivacaine followed by a PCA bolus of 1 mg diamorphine in 4 mL 0.125% (w/v) bupivacaine with a 20-min lockout (Gp3). Patients were evaluated at 0, 1, 2, 3, 4, 8, 12, 16, 20, 24 and 48 h. Patients in Gp2 consumed significantly more diamorphine than those in Gp1 or Gp3 (P < 0.05), but their pain scores were higher only at 1, 2 and 3 h (P < 0.05) with respect to Gp3 and at 1 h with respect to Gp1. Fewer side effects (sedation, pruritus and nausea as assessed by anti-emetic requirements) occurred in Gp2 compared to Gp1 (P < 0.05). Fewer patients in Gp2 required catheterization than in Gp3 (P < 0.05). This study indicates that the use of PCA epidural diamorphine, either alone or in combination with bupivacaine, reduces the dose requirement for analgesia but offers little clinical advantage over subcutaneous PCA diamorphine.

journal_name

Eur J Anaesthesiol

authors

Gopinathan C,Sockalingham I,Fung MA,Peat S,Hanna MH

doi

10.1046/j.1365-2346.2000.00647.x

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

189-96

issue

3

eissn

0265-0215

issn

1365-2346

pii

eja647

journal_volume

17

pub_type

临床试验,杂志文章,随机对照试验
  • Effects of repeated anaesthesia on central cholinergic function in the rat cerebral cortex.

    abstract:BACKGROUND AND OBJECTIVE:General anaesthesia may contribute to postoperative cognitive decline in the elderly. The aim was to determine the effects of repeated pentobarbital anaesthesia throughout life on central cholinergic function in the rat. METHODS:Young Lewis rats were randomly allocated to two groups. The anaes...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/s0265021503000176

    authors: Hanning CD,Blokland A,Johnson M,Perry EK

    更新日期:2003-02-01 00:00:00

  • The effect of dexmedetomidine sedation on brachial plexus block in patients with end-stage renal disease.

    abstract:BACKGROUND AND OBJECTIVE:The study investigated the effect of intravenous dexmedetomidine on brachial plexus block in patients with end-stage renal disease sedated with dexmedetomidine or midazolam for the formation of arteriovenous fistula. METHODS:A supraclavicular brachial plexus block was performed in 68 patients ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e32832a2244

    authors: Rutkowska K,Knapik P,Misiolek H

    更新日期:2009-10-01 00:00:00

  • Antagonism of midazolam sedation by flumazenil: a placebo-controlled study in patients recovering from intravenous anaesthesia with high doses of midazolam.

    abstract::Twenty adult surgical patients were anaesthetized with high-dose midazolam and alfentanil by infusion, vecuronium, and intubated and ventilated with 50% N2O in O2. The midazolam and alfentanil infusions were stopped at the end of surgery. Residual neuromuscular blockade and ventilatory depression were antagonized and ...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Hennis PJ,van Haastert FA,Mulder AJ,Spierdijk J

    更新日期:1988-11-01 00:00:00

  • Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

    abstract:BACKGROUND AND OBJECTIVE:Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group)...

    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/s0265021503000899

    authors: Walsh KH,Murphy C,Iohom G,Cooney C,McAdoo J

    更新日期:2003-07-01 00:00:00

  • Factors independently associated with increased risk of pain development after ophthalmic surgery.

    abstract:BACKGROUND AND OBJECTIVE:Little has been documented about the development of pain after ophthalmic surgery. This study was designed to assess the incidence and severity of postoperative pain following ophthalmic surgery, and to identify key factors independently associated with development of such pain. METHODS:In a p...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/s0265021504002042

    authors: Henzler D,Kramer R,Steinhorst UH,Piepenbrock S,Rossaint R,Kuhlen R

    更新日期:2004-02-01 00:00:00

  • Propofol as a continuous infusion during cardiopulmonary bypass does not affect changes in serum free fatty acids.

    abstract::Perioperative myocardial infarction or ischaemia is a potential consequence of cardiac surgery and elevated free fatty acids can increase the severity of myocardial ischaemic damage. We investigated perioperative changes in serum free fatty acids, and other serum lipids, as a consequence of using propofol infusions fo...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.0265-0215.2000.00789.x

    authors: Inoue S,Takauchi Y,Kayamori Y,Kuro M,Furuya H

    更新日期:2001-02-01 00:00:00

  • Cardiovascular responses and airway complications following awake nasal intubation with blind intubation device and fibreoptic bronchoscope: a randomized controlled study.

    abstract:BACKGROUND AND OBJECTIVE:The blind intubation device (BID) was introduced for awake nasotracheal intubation recently. The aim of this study was to compare the cardiovascular responses and associated airway complications of fibreoptic bronchoscope (FOB) with those of BID. The intubation attempts and intubation time were...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e328332845a

    authors: Sun Y,Liu JX,Jiang H,Zhu YS,Xu H,Huang Y

    更新日期:2010-05-01 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

  • Intrathecal hydromorphone added to hyperbaric bupivacaine for postoperative pain relief after knee arthroscopic surgery: a prospective, randomised, controlled trial.

    abstract:BACKGROUND AND OBJECTIVE:Adding opioid to spinal anaesthetic provides additional analgesia during the postoperative period. The purpose of this study was to determine the dose of intrathecal hydromorphone necessary to achieve postoperative pain relief after arthroscopic knee surgery. METHODS:In a prospective, double-b...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e3283476055

    authors: Lee YS,Park YC,Kim JH,Kim WY,Yoon SZ,Moon MG,Min TJ

    更新日期:2012-01-01 00:00:00

  • Long-term outcome of patients who require renal replacement therapy after cardiac surgery.

    abstract:BACKGROUND AND OBJECTIVE:Acute renal failure is a serious complication of cardiac surgery. We studied the long-term survival and quality of life of patients requiring renal replacement therapy after cardiac surgery, since they represent a heavy burden on hospital resources and their outcome has never been adequately ev...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1017/S0265021505001705

    authors: Landoni G,Zangrillo A,Franco A,Aletti G,Roberti A,Calabrò MG,Slaviero G,Bignami E,Marino G

    更新日期:2006-01-01 00:00:00

  • Fentanyl pre-treatment does not affect the pharmacokinetic profile of an induction dose of propofol in adults.

    abstract::The initial disposition of propofol was reported to change when the administration was preceded by fentanyl. The pharmacokinetic profile of the induction dose of propofol (2 mg kg-1 body weight) was studied in 20 ASA I patients randomly allocated to receive fentanyl 1.5 microgram kg-1 (n = 12) or not (n = 8). Anaesthe...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: De Gasperi A,Cristalli A,Noé L,Sabbadini D,Mazza E,Prosperi M,Fantini G,Crespi AM,Rezzani S

    更新日期:1994-03-01 00:00:00

  • Molecular sites of general anaesthetic action on acetylcholine receptors.

    abstract::Mechanisms of anaesthetics still remain unclear. However, various attempts have been made to elucidate the effects of anaesthetics at the molecular level. The nicotinic acetylcholine receptor has proved to be a good model of membrane-bound ligand-gated ion channels. It is available in abundance from Torpedo electropla...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:

    authors: Tonner PH,Miller KW

    更新日期:1995-01-01 00:00:00

  • Epidemiology in anaesthesia: a method for predicting hospital mortality.

    abstract::Data on 13 043 operations were abstracted from 108 878 anaesthetic records in the Cardiff Anaesthetic Record System. Nine groups of surgical operations with high mortality in hospital were identified. These records were analysed using a logistic regression model to determine the probability of death in hospital. Varia...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Farrow SC,Fowkes FG,Lunn JN,Robertson IB,Sweetnam P

    更新日期:1984-03-01 00:00:00

  • Elimination of sevoflurane is reduced in plasma-tight compared to conventional membrane oxygenators.

    abstract:BACKGROUND AND OBJECTIVE:It has been demonstrated that volatile anaesthetics have cardioprotective properties during open-heart procedures, especially when administered continuously. European Council Directive 93/42/EEC concerning medical devices bans the supplementary incorporation of anaesthetic vaporizers in the byp...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0265021507001330

    authors: Prasser C,Zelenka M,Gruber M,Philipp A,Keyser A,Wiesenack C

    更新日期:2008-02-01 00:00:00

  • 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...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2346.1999.00592.x

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

    更新日期:1999-12-01 00:00:00

  • Effects of a single subanaesthetic dose of ketamine on pain and mood after laparoscopic bariatric surgery: A randomised double-blind placebo controlled study.

    abstract:BACKGROUND:When administered as a continuous infusion, ketamine is known to be a potent analgesic and general anaesthetic. Recent studies suggest that a single low-dose administration of ketamine can provide a long-lasting effect on mood, but its effects when given in the postoperative period have not been studied. OB...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0000000000000860

    authors: Wang J,Echevarria GC,Doan L,Ekasumara N,Calvino S,Chae F,Martinez E,Robinson E,Cuff G,Franco L,Muntyan I,Kurian M,Schwack BF,Bedrosian AS,Fielding GA,Ren-Fielding CJ

    更新日期:2019-01-01 00:00:00

  • Intra-operative norepinephrine administration and cancer-related outcomes following radical cystectomy for bladder cancer: A cohort study.

    abstract:BACKGROUND:The impact of anaesthetic techniques on recurrence of cancers is controversial. Elevated plasma catecholamine levels have been implicated in angiogenesis and metastasis in various cancers. OBJECTIVES:To assess the potential association between continuous intra-operative norepinephrine administration and tum...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001155

    authors: Löffel LM,Furrer MA,Favre A,Engel D,Gahl B,Burkhard FC,Wuethrich PY

    更新日期:2020-05-01 00:00:00

  • Tramadol suppositories are less suitable for post-operative pain relief than rectal acetaminophen/codeine.

    abstract::The suitability of tramadol suppositories for inclusion in our hospital formulary for the treatment of mild to moderate post-operative pain was evaluated. In an open randomized trial, rectal tramadol was compared with our standard treatment acetaminophen/codeine suppositories. We expected tramadol to be equally effect...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2346.1999.00520.x

    authors: Pluim MA,Wegener JT,Rupreht J,Vulto AG

    更新日期:1999-07-01 00:00:00

  • Cognitive decline after carotid endarterectomy: Systematic review and meta-analysis.

    abstract:BACKGROUND:Postoperative cognitive decline (pCD) occurs frequently (6 to 30%) after carotid endarterectomy (CEA), although there are no exact estimates and risk factors are still unclear. OBJECTIVE:The objective of this study was to determine pCD incidence and risk factors in CEA patients. DESIGN:We performed a syste...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001130

    authors: Aceto P,Lai C,De Crescenzo F,Crea MA,Di Franco V,Pellicano GR,Perilli V,Lai S,Papanice D,Sollazzi L

    更新日期:2020-11-01 00:00:00

  • Effects of glibenclamide on hydroxyl radical formation in the postischaemic reperfused heart with or without inhalation anaesthetics.

    abstract:BACKGROUND AND OBJECTIVE:We investigated whether glibenclamide (glyburide) affects myocardial metabolism and hydroxyl radical formation in the rat heart-lung preparation with or without inhalation anaesthetics. METHODS:Thirty-seven male Wistar rats were allocated to four groups: (a) control group (C), received vehicle...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.2001.00927.x

    authors: Kashimoto S,Furuya A,Kume M,Yamaguchi T,Kumazawa T

    更新日期:2001-12-01 00:00:00

  • Epidural anaesthesia for insertion of a femoral neck prosthesis in a patient with phaeochromocytoma.

    abstract::A hemiarthroplasty for femoral neck fracture was successfully performed under combined epidural anaesthesia and light general anaesthesia before phaeochromocytoma removal. Pre-operative therapy was managed with doxazosin, enalapril and diltiazem. Peri-operative management facilitated maintenance of stable haemodynamic...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Kato T,Takase H,Waguri Y,Ikeda K,Takahashi M

    更新日期:1993-11-01 00:00:00

  • Effects of different glucose concentrations on spinal anaesthesia with bupivacaine and tetracaine.

    abstract::The effects of 5% and 8% glucose in 0.5% tetracaine or bupivacaine on the anaesthetic spread were investigated in 80 urological patients requiring spinal anaesthesia for trans-urethral resection of the prostate. The local anaesthetic solutions were randomly administered, the patients being divided into four groups of ...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Janik R,Dick W,Stanton-Hicks MD

    更新日期:1989-05-01 00:00:00

  • Sevoflurane attenuates systemic inflammation compared with propofol, but does not modulate neuro-inflammation: A laboratory rat study.

    abstract:BACKGROUND:Septic encephalopathy is believed to be a result of neuro-inflammation possibly triggered by endotoxins, such as lipopolysaccharides (LPS). Modulation of the immune system is a property of volatile anaesthetics. OBJECTIVE:We aimed to investigate the systemic and cerebral inflammatory response in a LPS-induc...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000000668

    authors: Beck-Schimmer B,Baumann L,Restin T,Eugster P,Hasler M,Booy C,Schläpfer M

    更新日期:2017-11-01 00:00:00

  • Optimal regional anaesthesia for abdominal hysterectomy: combined subarachnoid and epidural block compared with other regional techniques.

    abstract::Regional anaesthesia for abdominal hysterectomy is commonly combined with heavy sedation or light general anaesthesia in order to avoid the occurrence of visceral pain. Our clinical experience has indicated that this pain can be controlled using regional anaesthesia techniques alone. In an effort to find the optimal t...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Mihic DN,Abram SE

    更新日期:1993-07-01 00:00:00

  • Comparison of a simplified nasal continuous positive airways pressure device with nasal cannula in obese patients undergoing colonoscopy during deep sedation: A randomised clinical trial.

    abstract:BACKGROUND:Continuous positive airways pressure (CPAP) with a CPAP machine and mask has been shown to be more effective at minimising hypoxaemia than other devices under deep sedation. However, the efficacy of a new and simple CPAP device for spontaneously breathing obese patients during colonoscopy is unknown. OBJECT...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0000000000001052

    authors: Bai Y,Xu Z,Chandrashekar M,St Jacques PJ,Liang Y,Jiang Y,Kla K

    更新日期:2019-09-01 00:00:00

  • Predictors of patient satisfaction with anaesthesia and surgery care: a cohort study using the Postoperative Quality of Recovery Scale.

    abstract:CONTEXT:Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. OBJECTIVES:We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domai...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/EJA.0b013e328357e584

    authors: Royse CF,Chung F,Newman S,Stygall J,Wilkinson DJ

    更新日期:2013-03-01 00:00:00

  • A rational approach to the control of sedation in intensive care unit patients based on closed-loop control.

    abstract::Optimal control of long-term sedation during therapy in the intensive care unit is difficult to achieve in a number of patients when based on commonly used clinical sedation scores alone. We therefore used the median frequency of the EEG power spectrum as a quantitative measure for closed-loop administration of propof...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.1999.00557.x

    authors: Albrecht S,Frenkel C,Ihmsen H,Schüttler J

    更新日期:1999-10-01 00:00:00

  • Pharmacokinetic-based total intravenous anaesthesia using remifentanil and propofol for surgical myocardial revascularization.

    abstract:BACKGROUND AND OBJECTIVE:We investigated the following aspects of pharmacokinetic-guided total intravenous anaesthesia with remifentanil and propofol in patients undergoing surgical myocardial revascularization: anaesthetic efficacy, haemodynamic effects, impact on extubation of the trachea and analgesia after operatio...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/s0265021503000589

    authors: Guarracino F,Penzo D,De Cosmo D,Vardanega A,De Stefani R

    更新日期:2003-05-01 00:00:00

  • The effect of ketamine on hypoventilation during deep sedation with midazolam and propofol: a randomised, double-blind, placebo-controlled trial.

    abstract:BACKGROUND:Hypoventilation is a major cause of morbidity and mortality in patients having procedures under sedation. Few clinical strategies have been evaluated to reduce intraoperative hypoventilation during surgical procedures under deep sedation. OBJECTIVE:The primary objective of this investigation was to examine ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0000000000000025

    authors: De Oliveira GS Jr,Fitzgerald PC,Hansen N,Ahmad S,McCarthy RJ

    更新日期:2014-12-01 00:00:00

  • Myocardial infarction and death after caesarean section in a woman with protein S deficiency and undiagnosed phaeochromocytoma.

    abstract::We describe the case of a 36-year-old woman, with a previous history of recurrent abortion due to protein S deficiency, undergoing an elective Caesarean section at 39-weeks gestation. During pregnancy no signs of hypertension or cardiovascular disease were reported, but at the end of the surgical procedure, the patien...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:10.1046/j.1365-2346.1999.00474.x

    authors: Zangrillo A,Valentini G,Casati A,Torri G

    更新日期:1999-04-01 00:00:00