Prior epidural lidocaine alters the pharmacokinetics and drug effects of extended-release epidural morphine (DepoDur®) after cesarean delivery.

Abstract:

BACKGROUND:A potential physicochemical interaction between epidural local anesthetics and extended-release epidural morphine (EREM) could negate the sustained release. In this study, we sought to determine the pharmacokinetic and drug effects of prior epidural lidocaine administration on EREM. METHODS:Thirty healthy women undergoing cesarean delivery were enrolled in this randomized study. Patients received 8 mg EREM 1 hour after either a combined spinal-epidural (intrathecal bupivacaine and fentanyl 20 μg with no epidural medication; group SE) or an epidural anesthetic (epidural 2% lidocaine with fentanyl 100 μg; group E). Maximal concentration (Cmax), time to Cmax (Tmax), and AUC(0-last) (area under the concentration-time curve until the last plasma concentration that was below the limit of quantitation) for morphine levels were determined from a plasma sample at 0, 5, 10, 15, and 30 minutes, and 1, 4, 8, 12, 24, 36, 48, and 72 hours. Drug effects including pain, analgesic use, and side effects were measured for 72 hours after cesarean delivery. RESULTS:Epidural lidocaine administration (20-35 mL) 1 hour before epidural EREM administration increased the Cmax in group E (11.1 ± 4.9) compared with group SE (8.3 ± 7.1 ng/mL) (P = 0.038). There were no significant effects on Tmax and AUC(0-last) of venous morphine between the groups (P > 0.05). There was an increased incidence in vomiting, oxygen use, and hypotension in group E (patients who received lidocaine before EREM). CONCLUSION:A large dose of epidural lidocaine 1 hour before EREM administration alters the pharmacokinetics and drug effects of EREM. Clinicians must apply caution when EREM is administered even 1 hour after an epidural lidocaine "top-up" for cesarean delivery.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Atkinson Ralls L,Drover DR,Clavijo CF,Carvalho B

doi

10.1213/ANE.0b013e318222f59c

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

251-8

issue

2

eissn

0003-2999

issn

1526-7598

pii

ANE.0b013e318222f59c

journal_volume

113

pub_type

杂志文章,随机对照试验
  • Vomiting after adenotonsillectomy in children: a comparison of ondansetron, dimenhydrinate, and placebo.

    abstract:UNLABELLED:We compared the effectiveness of ondansetron, dimenhydrinate, and placebo for the prevention of postoperative vomiting in children after adenotonsillectomy. In a randomized, placebo-controlled, double-blind study, 74 children, 2-10 yr of age scheduled for adenotonsillectomy as outpatients were given a single...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199803000-00008

    authors: Hamid SK,Selby IR,Sikich N,Lerman J

    更新日期:1998-03-01 00:00:00

  • Effect of ropivacaine and bupivacaine on uterine blood flow in pregnant ewes.

    abstract::The effects of ropivacaine, a new amide local anesthetic, on uterine blood flow and fetal well-being were compared with those of bupivacaine in 10 chronically instrumented pregnant ewes. In random sequence, animals received two intravenous infusions of each drug. The low infusion rate regimens were chosen to result in...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199201000-00011

    authors: Santos AC,Arthur GR,Roberts DJ,Wlody D,Pedersen H,Morishima HO,Finster M,Covino BG

    更新日期:1992-01-01 00:00:00

  • A Shared Opportunity for Improving Electronic Medical Record Data.

    abstract::With the recent rapid adoption of electronic medical records (EMRs), studies reporting results based on EMR data have become increasingly common. While analyzing data extracted from our EMR for a retrospective study, we identified various types of erroneous data entries. This report investigates the root causes of the...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000002134

    authors: Baier AW,Snyder DJ,Leahy IC,Patak LS,Brustowicz RM

    更新日期:2017-09-01 00:00:00

  • The effect of a perioperative clinical pathway for knee replacement surgery on hospital costs.

    abstract:UNLABELLED:Clinical pathways are being introduced by hospitals to reduce costs and control unnecessary variation in care. We studied 766 inpatients to measure the impact of a perioperative clinical pathway for patients undergoing knee replacement surgery on hospital costs. One hundred twenty patients underwent knee rep...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199805000-00012

    authors: Macario A,Horne M,Goodman S,Vitez T,Dexter F,Heinen R,Brown B

    更新日期:1998-05-01 00:00:00

  • The effect of graded hypothermia (36 degrees C-32 degrees C) on hemostasis in anesthetized patients without surgical trauma.

    abstract:UNLABELLED:The isolated effects of hypothermia on hemostasis have not been investigated in healthy humans. We cooled 16 anesthetized patients scheduled for elective intracranial surgery to 32 degrees C body core temperature and assessed prothrombin time (PT), activated partial thromboplastin time, thrombelastogram (TEG...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/01.ane.0000062520.65192.c9

    authors: Kettner SC,Sitzwohl C,Zimpfer M,Kozek SA,Holzer A,Spiss CK,Illievich UM

    更新日期:2003-06-01 00:00:00

  • A comparison of hemodynamic changes after endotracheal intubation by using the lightwand device and the laryngoscope in normotensive and hypertensive patients.

    abstract::We compared the effects of the lightwand technique on hemodynamic responses, time-to-intubation, number of attempts, and complications during tracheal intubation with those of direct-vision laryngoscopy in normotensive (LN and TN group; n = 20, respectively) and hypertensive (LH and TH group; n = 20, respectively) pat...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200005000-00038

    authors: Nishikawa K,Omote K,Kawana S,Namiki A

    更新日期:2000-05-01 00:00:00

  • Ethanol enhances the functional recovery of stunned myocardium independent of K(ATP) channels in dogs.

    abstract::Chronic, intermittent exposure to small amounts of ethanol reduces myocardial infarct size in vivo. We tested the hypothesis that acute administration of ethanol enhances the functional recovery of stunned myocardium and that adenosine triphosphate-dependent potassium (K(ATP)) channels mediate this beneficial effect. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200102000-00003

    authors: Gross ER,Gare M,Toller WG,Kersten JR,Warltier DC,Pagel PS

    更新日期:2001-02-01 00:00:00

  • Ultrasound-guided epidural catheter insertion in children.

    abstract:UNLABELLED:Epidural catheters (EC) are often used in pediatric patients for intraoperative and postoperative pain relief. The small anatomical structures and catheter insertion under general anesthesia make it more difficult to perform EC and to prevent damage. In this study we investigated the use of ultrasound (US) i...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000156579.11254.D1

    authors: Rapp HJ,Folger A,Grau T

    更新日期:2005-08-01 00:00:00

  • Supraventricular arrhythmias in intensive care unit patients: short and long-term consequences.

    abstract:BACKGROUND:Supraventricular arrhythmias (SVA), including atrial fibrillation and flutter, are common in surgical and nonsurgical intensive care unit (ICU) patients. There is increased mortality among surgical ICU patients who develop new-onset atrial arrhythmias after noncardiac, non-thoracic surgery. We sought to dete...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000255759.41131.05

    authors: Goodman S,Shirov T,Weissman C

    更新日期:2007-04-01 00:00:00

  • The potency of succinylcholine in obese adolescents.

    abstract:UNLABELLED:We constructed a single-dose response curve for succinylcholine in 30 obese adolescents during thiopental-fentanyl anesthesia administration by using 100 microg/kg, 150 microg/kg, or 250 microg/kg IV. The maximal response (percent depression of neuromuscular function) of the adductor pollicis to supramaximal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200003000-00015

    authors: Rose JB,Theroux MC,Katz MS

    更新日期:2000-03-01 00:00:00

  • FOCUS: the Society of Cardiovascular Anesthesiologists' initiative to improve quality and safety in the cardiovascular operating room.

    abstract::The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is suppo...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000359

    authors: Barbeito A,Lau WT,Weitzel N,Abernathy JH 3rd,Wahr J,Mark JB

    更新日期:2014-10-01 00:00:00

  • The Effect of the No Pain Labor & Delivery-Global Health Initiative on Cesarean Delivery and Neonatal Outcomes in China: An Interrupted Time-Series Analysis.

    abstract:BACKGROUND:The proportion of live births by cesarean delivery (CD) in China is significant, with some, particularly rural, provinces reporting up to 62.5%. The No Pain Labor & Delivery-Global Health Initiative (NPLD-GHI) was established to improve obstetric and neonatal outcomes in China, including through a reduction ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004805

    authors: Drzymalski DM,Guo JC,Qi XQ,Tsen LC,Sun Y,Ouanes JP,Xia Y,Gao WD,Ruthazer R,Hu F,Hu LQ

    更新日期:2020-04-22 00:00:00

  • Prepared endotracheal tubes: are they a potential source for pathogenic microorganisms?

    abstract:UNLABELLED:Prepared endotracheal tubes (PETTs) are frequently used for unanticipated difficult intubation, but their storage time is highly variable and institution-dependent. We sought to determine first, if open, unused PETTs are a potential source of pathogenic microorganisms, and second, if PETTs can provide a medi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000082241.56353.97

    authors: Rasic NF,Friesen RM,Anderson B,Hoban SA,Olson N,Kress J

    更新日期:2003-10-01 00:00:00

  • Cyclic adenosine monophosphate response element-binding protein phosphorylation and neuroprotection by 4-phenyl-1-(4-phenylbutyl) piperidine (PPBP).

    abstract:BACKGROUND:Previous studies show that the potent, prototypical sigma(1)-receptor agonist 4-phenyl-1-(4-phenylbutyl) piperidine (PPBP) prevents cell death after oxygen-glucose deprivation (OGD) in primary cortical neuronal cultures. We tested the hypothesis that PPBP protects neurons by a mechanism involving activation ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e318192442c

    authors: Yang S,Alkayed NJ,Hurn PD,Kirsch JR

    更新日期:2009-03-01 00:00:00

  • Mivacurium and bronchospasm.

    abstract:IMPLICATIONS:Because of case reports of severe bronchospasm after the use of mivacurium, we used the Food and Drug Administration MedWatch database to determine the frequency of bronchospasm as an adverse event after the use of nondepolarizing muscle relaxants. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000067433.05538.3d

    authors: Bishop MJ,O'Donnell JT,Salemi JR

    更新日期:2003-08-01 00:00:00

  • Pharmacologic basis of responses to midazolam in the isolated, cross-perfused, canine right atrium.

    abstract::The effects of midazolam on atrial rate and contractile force in the isolated canine atrium perfused with donor blood were investigated. When midazolam in a dose range of 100-1000 micrograms was injected directly into the sinus node artery of the isolated atrium, biphasic (negative followed by positive) chronotropic a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Saegusa K,Furukawa Y,Ogiwara Y,Takeda M,Chiba S

    更新日期:1987-08-01 00:00:00

  • Transversus Abdominis Plane Block Versus Wound Infiltration for Analgesia After Cesarean Delivery: A Randomized Controlled Trial.

    abstract:BACKGROUND:Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000001724

    authors: Tawfik MM,Mohamed YM,Elbadrawi RE,Abdelkhalek M,Mogahed MM,Ezz HM

    更新日期:2017-04-01 00:00:00

  • Convective warming therapy does not increase the risk of wound contamination in the operating room.

    abstract::Although convective warming therapy is effective in preventing hypothermia in anesthetized patients, little is known concerning the potential risks of its use. Hence, this balanced cross-over study was designed to determine if the use of convective warming therapy increased the risk of wound contamination. For 4 h, ei...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199301000-00009

    authors: Zink RS,Iaizzo PA

    更新日期:1993-01-01 00:00:00

  • Case report: bilateral angle closure glaucoma after general anesthesia.

    abstract::Acute angle closure glaucoma is a rare complication of general anesthesia. However, in case of delayed diagnosis, it may lead to blindness. We present a case of bilateral acute angle closure glaucoma after cervical spine surgery under general anesthesia in a hypermetropic patient. In this case, the most likely trigger...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182009ad6

    authors: Gayat E,Gabison E,Devys JM

    更新日期:2011-01-01 00:00:00

  • Tape-recorded hypnosis instructions as adjuvant in the care of patients scheduled for third molar surgery.

    abstract:UNLABELLED:As medical costs continue to escalate, there is willingness to consider the role played by nontraditional factors in health. We investigated the usefulness of tape-recorded hypnosis instruction on perioperative outcome in surgical patients in a prospective, randomized, and partially blinded study. Sixty pati...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200001000-00016

    authors: Ghoneim MM,Block RI,Sarasin DS,Davis CS,Marchman JN

    更新日期:2000-01-01 00:00:00

  • Muscle weakness and paresthesia associated with epidural analgesia in a patient with an intrathecal neurofibrolipoma as part of a tethered cord syndrome.

    abstract::We report a case of a 75-yr-old female patient in whom motor deficits and paresthesias occurred after lumbar epidural analgesia. These symptoms were eventually found to be due to a tethered cord syndrome. An epidural catheter was inserted for analgesia after colon surgery. The postoperative course was characterized by...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000120387.09339.d1

    authors: Jetzek-Zader M,Peterschulte G,Ludwig U,Lipfert P

    更新日期:2004-07-01 00:00:00

  • Recovery of the swallowing reflex after propofol anesthesia.

    abstract::The swallowing reflex is depressed by anesthetics. During recovery from anesthesia the rapid return of laryngeal and upper airway reflexes is important to protect the lower airway from aspiration. This study measures the recovery of the swallowing reflex after propofol anesthesia. Fifteen patients undergoing a colonos...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199411000-00007

    authors: Rimaniol JM,D'Honneur G,Duvaldestin P

    更新日期:1994-11-01 00:00:00

  • Perioperative changes in blood pressure and heart rate.

    abstract::In order to evaluate the possible physiologic significance of intra- and postoperative hypotension, we monitored arterial blood pressure and heart rate continuously for 36 hr starting the night before and ending the morning after operation in 34 gynecologic patients. The lowest pressures that occurred during physiolog...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Berger JJ,Donchin M,Morgan LS,van der Aa J,Gravenstein JS

    更新日期:1984-07-01 00:00:00

  • The effect of breath termination criterion on breathing patterns and the work of breathing during pressure support ventilation.

    abstract:UNLABELLED:With pressure support ventilation (PSV), each PSV breath is flow-cycled, and the breath termination criterion (TC) is usually nonadjustable. When TC does not match the interaction between the patient's inspiratory-expiratory efforts to the opening and closing of the inspiratory and expiratory valves, patient...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200101000-00031

    authors: Tokioka H,Tanaka T,Ishizu T,Fukushima T,Iwaki T,Nakamura Y,Kosogabe Y

    更新日期:2001-01-01 00:00:00

  • In vitro, inhibition of mitogen-activated protein kinase pathways protects against bupivacaine- and ropivacaine-induced neurotoxicity.

    abstract:BACKGROUND:Animal models show us that specific activation of the p38 mitogen-activated protein kinase (MAPK) may be a pivotal step in lidocaine neurotoxicity, but this has not been investigated in the case of two very widely used local anesthetics, bupivacaine and ropivacaine. We investigated the hypotheses that these ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e318168514b

    authors: Lirk P,Haller I,Colvin HP,Lang L,Tomaselli B,Klimaschewski L,Gerner P

    更新日期:2008-05-01 00:00:00

  • Ventilatory support using bilevel positive airway pressure during neuraxial blockade in a patient with severe respiratory compromise.

    abstract::In pregnant patients with myasthenia gravis and respiratory compromise, neuraxial anesthesia for lower abdominal surgery can risk further respiratory depression. We report the use of epidural anesthesia for dilation and curettage and tubal ligation in a 26-yr-old woman with a 12-wk intrauterine pregnancy with severe m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000198335.89760.ed

    authors: Warren J,Sharma SK

    更新日期:2006-03-01 00:00:00

  • Inhibition of postoperative pain by continuous low-dose intravenous infusion of lidocaine.

    abstract::Intravenous lidocaine has been reported previously to inhibit postoperative pain when given either as single injections or as short infusions in amounts usually causing adverse reactions. To determine the efficacy of a continuous low-dose (2 mg/kg) intravenous infusion of lidocaine, postoperative pain (visual analogue...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Cassuto J,Wallin G,Högström S,Faxén A,Rimbäck G

    更新日期:1985-10-01 00:00:00

  • A survey of anesthesiologists' views of operating room recycling.

    abstract:BACKGROUND:Operating rooms contribute significantly to the increasing volumes and costs of hospital waste. Little is known, however, about doctors' views of hospital waste recycling despite their potential influence in improving recycling programs. We surveyed the waste recycling views held by anesthesiologists in Aust...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31824d273d

    authors: McGain F,White S,Mossenson S,Kayak E,Story D

    更新日期:2012-05-01 00:00:00

  • Comparison of hypobaric, hyperbaric, and isobaric solutions of bupivacaine during continuous spinal anesthesia.

    abstract::This study was designed to compare the anesthetic properties of hypobaric bupivacaine with those of isobaric and hyperbaric solutions when administered in the supine position in an elderly population undergoing hip surgery using continuous spinal anesthesia. Plain bupivacaine (0.5%) was mixed with equal volumes of 10%...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199106000-00011

    authors: Van Gessel EF,Forster A,Schweizer A,Gamulin Z

    更新日期:1991-06-01 00:00:00

  • Epidural anesthesia for cesarean section in diabetic parturients: maternal and neonatal acid-base status and bupivacaine concentration.

    abstract::Acid-base status and blood levels of bupivacaine were determined in 16 diabetic parturients and their infants after epidural anesthesia for cesarean section. The newborn infants were divided into two groups based on umbilical artery pH at birth. Group A consisted of 10 infants who had a pH of less than 7.2 and group B...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Datta S,Brown WU Jr,Ostheimer GW,Weiss JB,Alper MH

    更新日期:1981-08-01 00:00:00