The effective duration of analgesia after intrathecal morphine in patients without additional opioid analgesia: a randomized double-blind multicentre study on orthopaedic patients.

Abstract:

BACKGROUND AND OBJECTIVE:To know whether the application of patient-controlled analgesia devices could be avoided if intrathecal morphine is given in combination with spinal anaesthesia. METHODS:In a randomized, double-blind multicentre study, 188 orthopaedic patients were randomized to receive intrathecally placebo, 0.1 mg morphine or 0.2 mg morphine in addition to 15 mg bupivacaine. The primary outcome parameter was the number of patients without any additional request for opioid during a period of 72 h after surgery. RESULTS:Patients with 0.1 or 0.2 mg morphine showed a significant reduction in opioid requests compared with placebo during 72 h after surgery (P = 0.0001). At 24 h after surgery, the rate of patients who required additional opioid analgesia was 71% in the placebo group, 51% in the 0.1 mg morphine group and 31% of the patients in the 0.2 mg morphine group. After 0.2 mg morphine, systemic opioid requirements at 24 h were significantly lower than those in patients with 0.1 mg morphine (P < 0.05). Intrathecal morphine was not associated with an increased frequency of respiratory depression. Forty per cent of patients with intrathecal morphine did not ask for systemic opioids. CONCLUSION:Intrathecal morphine in a dose of 0.1 and 0.2 mg provides effective analgesia for up to 48 h without any need for systemic opioids at all in many patients.

journal_name

Eur J Anaesthesiol

authors

Gehling MH,Luesebrink T,Kulka PJ,Tryba M

doi

10.1097/EJA.0b013e328329b045

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

683-8

issue

8

eissn

0265-0215

issn

1365-2346

journal_volume

26

pub_type

杂志文章,多中心研究,随机对照试验
  • Duration of fluid fasting and choice of analgesic are modifiable factors for early postoperative delirium.

    abstract:BACKGROUND AND OBJECTIVE:Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. METHODS:A total of 1002 patients were screened for deli...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e3283335cee

    authors: Radtke FM,Franck M,MacGuill M,Seeling M,Lütz A,Westhoff S,Neumann U,Wernecke KD,Spies CD

    更新日期:2010-05-01 00:00:00

  • Pre-operative anaemia and myocardial injury after noncardiac surgery: A retrospective study.

    abstract:BACKGROUND:Pre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated. OBJECTIVE:The association between pre-operative anaemia and MINS. DESIGN:A single-centre retrospective cohort study. ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001421

    authors: Kwon JH,Park J,Lee SH,Lee JH,Min JJ,Kim J,Oh AR,Seo W,Hyeon CW,Yang K,Choi JH,Lee SC,Kim K,Ahn J,Gwon HC

    更新日期:2021-01-04 00:00:00

  • Antiemetic efficacy of metoclopramide and diphenhydramine added to patient-controlled morphine analgesia: a randomised controlled trial.

    abstract:BACKGROUND AND OBJECTIVE:the objective of this study was to assess whether antiemetic drugs metoclopramide and diphenhydramine, administered together as opposed to alone, can have better efficacy in preventing postoperative nausea and vomiting when added to patient-controlled morphine analgesia. PATIENTS AND METHODS:d...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e32833f53b8

    authors: Lu CW,Jean WH,Wu CC,Shieh JS,Lin TY

    更新日期:2010-12-01 00:00:00

  • Effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in morbidly obese patients receiving laparoscopic gastric banding.

    abstract::We prospectively evaluated the effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in 20 ASA physical status II-III morbidly obese patients (body mass index > 35 kg m(-2)) undergoing laparoscopic gastric banding. After general anaesthesia was induced, patients' lungs were ventila...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1046/j.1365-2346.2000.00662.x

    authors: Casati A,Comotti L,Tommasino C,Leggieri C,Bignami E,Tarantino F,Torri G

    更新日期:2000-05-01 00:00:00

  • How to inform a morbidly obese patient on the specific risk to develop postoperative pulmonary complications using evidence-based methodology.

    abstract:BACKGROUND AND OBJECTIVE:Patients have the right to be informed about the expected benefits and risks of medical and surgical procedures. Ideally this information should be scientifically based and presented to the patient in time. In morbidly obese patient undergoing general anaesthesia, postoperative pulmonary compli...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,meta分析

    doi:10.1017/S0265021505002073

    authors: Flier S,Knape JT

    更新日期:2006-02-01 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

  • Dexmedetomidine and postoperative shivering in patients undergoing elective abdominal hysterectomy.

    abstract:BACKGROUND:Post-anaesthetic shivering is one of the most common complications, occurring in 5-65% of patients recovering from general anaesthesia and 33% of patients receiving epidural anaesthesia. Our objective was to investigate the efficacy of intraoperative dexmedetomidine infusion on postoperative shivering. METH...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0265021507003110

    authors: Elvan EG,Oç B,Uzun S,Karabulut E,Coşkun F,Aypar U

    更新日期:2008-05-01 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

  • Effects of continuous epidural administration of bupivacaine through a catheter in pigs.

    abstract::We studied whether long-term epidural catheter (nylon) placement for bupivacaine administration (morphine in 2 pigs) would cause any pathological changes in the epidural space and spinal cord of pigs. There were similar kinds of slight inflammatory changes in ligamentum flavum and dura mater in bupivacaine-treated (4 ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Kyttä J,Rosenberg PH,Wahlström TR

    更新日期:1986-11-01 00:00:00

  • The neuromuscular effects of 0.6 mg kg(-1) rocuronium in elderly and young adults with or without renal failure.

    abstract:BACKGROUND AND OBJECTIVES:The elderly represent a wide and increasing patient population and significant numbers of elderly patients have chronic renal disease. This study aimed to investigate the neuromuscular effects of 0.6 mg kg(-1) rocuronium under propofol anaesthesia in young adults and elderly patients with or w...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021508004717

    authors: Kocabas S,Yedicocuklu D,Askar FZ

    更新日期:2008-11-01 00:00:00

  • Sevoflurane potentiates and blocks GABA-induced currents through recombinant alpha1beta2gamma2 GABAA receptors: implications for an enhanced GABAergic transmission.

    abstract:BACKGROUND AND OBJECTIVE:The gamma-aminobutyric acidA receptor (GABAAR) is a target for anaesthetic agents. We investigated the interactions of sevoflurane with a recombinant GABAAR. Emphasis was on the mechanism of block, as relevant open-channel block by a volatile anaesthetic would possibly explain prolonged GABAerg...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.0265-0215.2001.00848.x

    authors: Hapfelmeier G,Schneck H,Kochs E

    更新日期:2001-06-01 00:00:00

  • The effect of anaesthesia on renal function.

    abstract::Anaesthesia and surgical stress can affect renal function and body fluid regulation indirectly as well as directly. The indirect effects, through influences on haemodynamics, sympathetic activity and humoral regulation, are more pronounced than the direct ones. Inhalational anaesthetics generally reduce glomerular fil...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:

    authors: Burchardi H,Kaczmarczyk G

    更新日期:1994-05-01 00:00:00

  • Effect of glucose-insulin-potassium on hyperlactataemia in patients undergoing valvular heart surgery: A randomised controlled study.

    abstract:BACKGROUND:Hyperlactataemia represents oxygen imbalance in the tissues and its occurrence during cardiac surgery is associated with adverse outcomes. Glucose-insulin-potassium (GIK) infusion confers myocardial protection against ischaemia-reperfusion injury and has the potential to reduce lactate release while improvin...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0000000000000250

    authors: Roh GU,Shim JK,Song JW,Kang HM,Kwak YL

    更新日期:2015-08-01 00:00:00

  • Advantageous effects of dexmedetomidine on haemodynamic and recovery responses during extubation for intracranial surgery.

    abstract:BACKGROUND AND OBJECTIVE:The anaesthetic method for intracranial neurosurgery must provide haemodynamic stability on emergence and allow early evaluation of the neurological status. In this study, we examined the effects of the alpha-2 agonist dexmedetomidine given at the end of the procedure to prevent hyperdynamic re...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0265021508004201

    authors: Turan G,Ozgultekin A,Turan C,Dincer E,Yuksel G

    更新日期:2008-10-01 00:00:00

  • Predicted end-tidal sevoflurane concentration for insertion of a Laryngeal Mask Supreme: a prospective observational study.

    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

    authors: Zaballos M,Bastida E,Jiménez C,Agustí S,López-Gil MT

    更新日期:2013-04-01 00:00:00

  • Neuromuscular block by vecuronium: simulation with a flow-volume model.

    abstract::The time profile of the neuromuscular block produced by a single bolus administration of vecuronium was simulated by a new model for the access of the relaxant to the receptors on the motor end plates. The receptors were assumed to be kinetically a part of the interstitial space of the muscle. The time course of the n...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Nigrovic V

    更新日期:1994-03-01 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

  • Systemic and regional cerebral perfusion in small infants undergoing minor lower abdominal surgery under awake caudal anaesthesia: An observational study.

    abstract:BACKGROUND:Infants undergoing general anaesthesia have an increased risk of severe respiratory and cardiovascular critical events. Awake caudal anaesthesia is an alternative for small infants undergoing minor lower abdominal surgery. While clinical experience has shown stable intra-operative haemodynamic conditions, th...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001150

    authors: Beck CE,Sümpelmann R,Nickel K,Keil O,Kuebler JF,Boethig D,Witt L,Dennhardt N

    更新日期:2020-08-01 00:00:00

  • Intravenous ketamine attenuates arterial pressure changes during the induction of anaesthesia with propofol.

    abstract:BACKGROUND AND OBJECTIVE:To investigate whether the administration of ketamine before induction with propofol produces a smaller decrease in arterial pressure. METHODS:Twenty-two patients were assigned to one of two groups to receive either propofol with ketamine (n = 11) or propofol alone (n = 11, control). Anaesthes...

    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.0265-0215.2000.00784.x

    authors: Furuya A,Matsukawa T,Ozaki M,Nishiyama T,Kume M,Kumazawa T

    更新日期:2001-02-01 00:00:00

  • Cerebral state index vs. bispectral index during sevoflurane-nitrous oxide anaesthesia.

    abstract:BACKGROUND AND OBJECTIVE:The cerebral state index (CSI) is a low-cost and compact electroencephalographic monitor alternative to the bispectral index (BIS). Although both indices are shown as the number between 0 and 100, owing to the different calculation algorithms, both indices might be different during anaesthesia....

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e328324e946

    authors: Nishiyama T

    更新日期:2009-08-01 00:00:00

  • Development and performance testing of the low-cost, 3D-printed, smartphone-compatible 'Tansen Videolaryngoscope' vs. Pentax-AWS videolaryngoscope vs. direct Macintosh laryngoscope: A manikin study.

    abstract:BACKGROUND:While videolaryngoscopes help in the management of difficult airways, they remain too expensive for those with limited resources. We have developed a robust, re-usable, low-cost videolaryngoscope at United Mission Hospital Tansen, Nepal, by combining a smartphone-compatible endoscope capable of capturing sti...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001264

    authors: Lambert CT,John SC,John AV

    更新日期:2020-11-01 00:00:00

  • Onset time of topical analgesia with EMLA 5%: no reduction with glyceryl trinitrate.

    abstract::Many adults are distressed by painful investigations or treatment, including venepuncture. The early effects of Eutectic Mixture of Local Anaesthetics (EMLA) 5%, on relief of pinprick pain in the antecubital area was investigated and compared with EMLA plus glyceryl trinitrate and with a placebo cream in 100 patients....

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00003643-199601000-00004

    authors: Nott MR,Clemson CJ,Peacock JL

    更新日期:1996-01-01 00:00:00

  • Gum elastic bougie, capnography and apnoeic oxygenation.

    abstract:BACKGROUND AND AIM:This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation. METHODS:Patients were randomly allocated to having the gum elastic bougie inserted, under anaesthesia, in the ...

    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.0265-0215.2000.00774.x

    authors: Millar FA,Hutchison GL,Glavin R

    更新日期:2001-01-01 00:00:00

  • Changes in resistances of endotracheal tubes with reductions in the cross-sectional area.

    abstract:BACKGROUND AND OBJECTIVES:Partial obstruction of endotracheal tubes due to accumulation of secretions and mucus plugs can increase the tube resistance and subsequently impose increased resistive load on the patient. This study was performed to determine the changes in the resistance of endotracheal tubes of sizes 7.5, ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021507003134

    authors: El-Khatib MF,Husari A,Jamaleddine GW,Ayoub CM,Bou-Khalil P

    更新日期:2008-04-01 00:00:00

  • Morphine administration at reperfusion fails to improve postischaemic cardiac function but limits myocardial injury probably via heat-shock protein 27 phosphorylation.

    abstract:BACKGROUND AND OBJECTIVES:We explored the effects of morphine administration during reperfusion period after an index ischaemia as well as potential molecular mechanisms underlying this response. This is of important clinical value, as morphine is used routinely in cardiovascular anaesthesia and in the emergency manage...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e32832a225a

    authors: Mourouzis I,Saranteas T,Perimenis P,Tesseromatis C,Kostopanagiotou G,Pantos C,Cokkinos DV

    更新日期:2009-07-01 00:00:00

  • Comparison of clonidine 1 microgram kg-1 with morphine 30 micrograms kg-1 for post-operative caudal analgesia in children.

    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

    authors: Luz G,Innerhofer P,Oswald E,Salner E,Hager J,Sparr H

    更新日期:1999-01-01 00:00:00

  • Anaesthesia for Sturge-Weber syndrome.

    abstract::A 6-month-old boy with Sturge-Weber syndrome was scheduled for congenital glaucoma and left buphthalmus surgery. Physical examination revealed haemangioma throughout the right trigeminal nerve, congenital glaucoma, left megalocornea and bilateral buphthalmus. Examination of the eye was performed under general anaesthe...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.1999.00472.x

    authors: Ceyhan A,Cakan T,Başar H,Bababalim M,Unal N

    更新日期:1999-05-01 00:00:00

  • Aetiology of convulsions due to stellate ganglion block: a review and report of two cases.

    abstract::Stellate ganglion block is a selective sympathetic block that affects the ipsilateral head, neck, upper extremity and upper part of the thorax. Convulsions are a recognized complication of intra-arterial injection during stellate ganglion block. As central nervous system toxicity depends ultimately on the concentratio...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:10.1017/s0265021502000613

    authors: Mahli A,Coskun D,Akcali DT

    更新日期:2002-05-01 00:00:00

  • Platelet function assessed by whole-blood aggregometry in patients undergoing non-cardiac surgery.

    abstract:BACKGROUND:The risk/benefit of continuing low-dose acetylsalicylic acid (aspirin) for secondary prevention in the perioperative period is still debated. The primary aim of this study was to determine the effect of acetylsalicylic acid compared with placebo on platelet function in the perioperative period. METHODS:This...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/EJA.0b013e32834448ed

    authors: Oscarsson A,Öster S,Fredrikson M,Lindahl TL,Eintrei C

    更新日期:2011-05-01 00:00:00

  • Evaluation of augmented pulse pressure variation using the Valsalva manoeuvre as a predictor of fluid responsiveness under open-chest conditions: A prospective observational study.

    abstract:BACKGROUND:Pulse pressure variation (PPV) is a well known dynamic preload indicator of fluid responsiveness. However, its usefulness in open-chest conditions remains controversial. OBJECTIVE:We evaluated whether augmented PPV during a Valsalva manoeuvre can predict fluid responsiveness after sternotomy. DESIGN:A pros...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/EJA.0000000000000613

    authors: Min JJ,Kim TK,Lee JH,Park J,Cho HS,Kim WS,Lee YT

    更新日期:2017-05-01 00:00:00