Abstract:
BACKGROUND AND OBJECTIVE:The aim of this prospective, randomized, double-blind investigation was to assess the dose-effect characteristics of postoperative nausea and vomiting after intrathecal administration of small doses of morphine (from 0.015 to 0.25 mg) in opioid-naïve, non-surgical patients. METHODS:With Ethic Committee approval and written informed consent 144 opioid-naïve patients suffering from non-cancerous chronic back-pain, and receiving intrathecal morphine as diagnostic test for their chronic pain, were randomly allocated to receive intrathecal injection of 0.015 mg (Group I, n=25), 0.03 mg (Group II, n=30), 0.06 mg (Group III, n=31) or 0.25 mg (Group IV, n=33) morphine. The control group consisted in 25 further patients not included in the dose-effect study and receiving a placebo injection of normal saline in the interspinous ligament. A blinded observer recorded the occurrence of pruritus, nausea, vomiting, urinary retention and respiratory depression (respiratory rate<6 bpm) at 2, 4 and 24 h after injection. RESULTS:Clinically significant pain relief was observed in all patients receiving intrathecal morphine but only six patients (25%) of the control group (P=0.0005). The incidence of pruritus was lower in patients of Groups III (6%) and IV (3%) than in Groups I (12%) and II (20%) (P=0.002). The incidence of nausea and vomiting was higher at 2- and 4-h observation times, and decreased 24 h after intrathecal injection. Surprisingly, nausea was more frequent in Groups I (56%) and II (50%) than in Groups III (33%) and IV (24%) (P=0.0005). Vomiting was higher in patients receiving morphine than in control group, but without differences among the four doses. No urinary retention was observed in the control group, while 2 h after intrathecal injection urinary retention was observed in 20-40% of cases, and decreased to less than 10% 24 h after spinal injection without differences among the four doses. CONCLUSIONS:The onset and incidence of minor opioid-related side-effects after intrathecal morphine administration do not depend on its dose, occurring with even very small doses of morphine. Accordingly, they can be considered as a patient-dependent effect of the drug, suggesting the presence of a primary dose-independent excitatory component that might be related to the theory of the bimodal activation of opioid receptors. The very low incidence major respiratory depression prevents us from drawing any conclusion about the dose-effect relationship for this side-effect, and further properly powered studies should be advocated to evaluate major respiratory depression after spinal morphine.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Raffaeli W,Marconi G,Fanelli G,Taddei S,Borghi GB,Casati Adoi
10.1017/S026502150600038Xsubject
Has Abstractpub_date
2006-07-01 00:00:00pages
605-10issue
7eissn
0265-0215issn
1365-2346pii
S026502150600038Xjournal_volume
23pub_type
杂志文章,随机对照试验abstract::In a prospective randomized study in children, we compared caudal bupivacaine-clonidine with bupivacaine-morphine to evaluate whether clonidine can be used as an alternative to morphine in caudal anaesthesia. Caudal anaesthesia was administered in 36 children undergoing orchidopexy, hernia repair or circumcision, usin...
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.1365-2346.1999.00430.x
更新日期:1999-01-01 00:00:00
abstract::Sevoflurane has been reported to generate oxygen free radicals. We have investigated whether sevoflurane or isoflurane enhances oxygen free radical formation in the post-ischaemic reperfused heart. An isolated rat heart-lung preparation was used. Thirty male Wistar rats were allocated to four groups: control, no drug,...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00352.x
更新日期:1998-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To evaluate the efficacy of a single preoperative dose of 600 mg of gabapentin for reducing postoperative pain and tramadol consumption after minilap open cholecystectomy. METHOD:A total of 120 adult patients of either sex were randomly assigned to receive 600 mg of gabapentin or a matched placebo or...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328334de85
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Unilateral spinal anaesthesia is a useful anaesthesia technique in lower abdominal surgery, especially in an outpatient setting. Patient posture is pivotal in the achievement of unilateral anaesthesia. Nevertheless, no studies have elucidated the influence of patient posture during the anaesthe...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506000020
更新日期:2006-06-01 00:00:00
abstract::Although there is a continual improvement in the understanding of the pathophysiology of brain ischaemia and reperfusion, the pharmacological approach of treating or preventing brain ischaemic injury has had limited clinical impact so far. The great majority of clinical trials testing neuroprotectants for the treatmen...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32832fa606
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study compared the analgesic efficacy and safety of two preoperatively administered cyclo-oxygenase-2 inhibitors, celecoxib and rofecoxib. METHODS:Ninety adult patients undergoing thyroid surgery were divided into three groups (each n = 30). They were given a single oral dose of placebo, c...
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/s0265021503000796
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Work disruption in operating rooms hinders flow of patients and increases chances of error. Previous studies have largely considered the types of disruption occurring in operating rooms, but have not analysed systematically the objective impact of disruption. OBJECTIVE:The objective was to evaluate the impa...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000484
更新日期:2016-08-01 00:00:00
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
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Robot-assisted thoracoscopic thymectomy has brought new challenges to the anaesthesiologists. Here we present a study of 17 patients undergoing robotic thymectomy. PATIENTS AND METHODS:The present study was a prospective study, which included 17 patients with myasthenia gravis scheduled for robot-assisted t...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e3283309cea
更新日期:2010-05-01 00:00:00
abstract::Dynamic hyperinflation, also called intrinsic PEEP (PEEPi,) occurs particularly when high tidal volumes or high respiratory rates are used during mechanical ventilation, although the phenomenon does occur at normal tidal volumes. It is not identified using existing monitoring such as the airway pressure but can be ide...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::There is disagreement concerning the role of nitric oxide (NO) in general anaesthesia. The present study was conducted to determine whether the anaesthetic drug isoflurane alters levels of NO metabolites, NOx (NO2 and NO3), in the hippocampus of rats during and after anaesthesia. Results showed resting hippocampal NOx...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00459.x
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Arterial pressure monitoring using the a continuous noninvasive arterial pressure (CNAP) device during general anaesthesia is known to be interchangeable with continuous invasive arterial pressure (CIAP) monitoring. Agreement with invasive measurements in cardiovascular postsurgical intensive care patients h...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0000000000000136
更新日期:2015-01-01 00:00:00
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:
更新日期:1995-01-01 00:00:00
abstract::Competency frameworks are based on what are considered to be the general essential qualities of a doctor. Competencies, being behavioural descriptors, need a strong link to clinical practice to allow trainers to observe and then use them in assessing trainees' performance. The emerging concept of entrustable professio...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0000000000000109
更新日期:2015-02-01 00:00:00
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
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The current opioid epidemic highlights the urgent need for effective adjuvant therapies to complement postoperative opioid analgesia. Intra-operative ketamine infusion has been shown to reduce postoperative opioid consumption and improve pain control in opioid-tolerant patients after spinal fusion surgery. I...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000877
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Arterial pressure waveform analysis enables continuous, minimally invasive measurement of cardiac output. Haemodynamic instability compromises the reliability of the technique and a means of maintaining accurate measurement in this circumstance would be useful. OBJECTIVES:To investigate the accuracy, precis...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000160
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Continuous positive airway pressure (CPAP) prevents peri-operative atelectasis in adults, but its effect in children has not been quantified. OBJECTIVE:The aim of this study was to evaluate the role of CPAP in preventing postinduction and postoperative atelectasis in children under general anaesthesia. DES...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001351
更新日期:2021-01-01 00:00:00
abstract::In this review, we shall consider the oral and intravenous fluid management of pregnant women during labour and operative delivery in the context of neuroaxial blockade. We shall also discuss the use of blood transfusion in the peripartum period, especially during postpartum haemorrhage. Current management of military...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32833c30e3
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of this prospective study was to compare the effect of the administration of desflurane or sevoflurane to a fixed neuromuscular block. METHODS:After written consent, 12 patients were anaesthetized with propofol and sufentanil. Atracurium was administered via a continuous infusion in or...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506000706
更新日期:2006-09-01 00:00:00
abstract::A prospective observational study of 101 women having breast surgery under general anaesthesia was performed to assess the extent of postoperative nausea and vomiting in this group of women. The overall rate of postoperative nausea and vomiting was high, 56% and 41%, respectively, and was significantly associated with...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2346.2000.00637.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Propofol is an anaesthetic that resembles α-tocopherol and it has been suggested that it protects against ischaemia-reperfusion injury in liver transplantation. Living-donor liver transplantation (LDLT) presents an opportunity to test this hypothesis in both donors and recipients. OBJECTIVES:We compared cli...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000001018
更新日期:2019-09-01 00:00:00
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
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Lidocaine has actions potentially of benefit during ischaemia-reperfusion. Neutrophils and endothelial cells have an important role in ischaemia-reperfusion injury. METHODS:Isolated human neutrophil CD11b and CD18, and human umbilical vein endothelial cell (HUVEC) ICAM-1 expression and supernatant IL-1beta ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504000353
更新日期:2004-12-01 00:00:00
abstract::Pulmonary hypertension is usually treated with intravenous (i.v.) vasodilators, but their use is limited by systemic effects. In the current study, we compared the effects of inhaled nitric oxide and intravenous nitroglycerine on pulmonary and systemic haemodynamic responses as well as on gas exchange measurements in ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1996.d01-384.x
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The quality of combined spinal-epidural anaesthesia mainly depends on accurate identification of the epidural space. The real-time ultrasound control of the procedure for puncture was therefore evaluated. METHODS:Thirty parturients scheduled for Caesarean section were randomized to three equal...
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/s026502150400105x
更新日期:2004-01-01 00:00:00
abstract::The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric bandi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00510.x
更新日期:1999-06-01 00:00:00
abstract::The analgesic, respiratory and haemodynamic effects of epidural sufentanil 75 micrograms (Group 1) or sufentanil 75 micrograms with adrenaline 75 micrograms (Group 2) were studied in 20 patients following abdominal surgery in a double-blind randomized trial. Pain relief, assessed on a linear analogue scale, sedation, ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-05-01 00:00:00
abstract:CONTEXT:The single-use Laryngeal Mask Airway (LMA) Supreme is a new supraglottic airway device. It has been reported to be reliable and easy-to-use in clinical practice; however, the anaesthetic techniques for its insertion are not standardised. OBJECTIVES:The purpose of this study was to determine the ED50 of end-tid...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32835c5512
更新日期:2013-04-01 00:00:00
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
更新日期:2001-12-01 00:00:00