Orthostatic hypotension during postoperative continuous thoracic epidural bupivacaine-morphine in patients undergoing abdominal surgery.

Abstract:

:Fifty patients undergoing colonic surgery received combined thoracic epidural and general anesthesia followed by continuous epidural bupivacaine 0.25% and morphine 0.05 mg/mL, 4 mL/h, for 96 h postoperatively plus oral tenoxicam 20 mg daily. Heart rate (HR) and arterial blood pressure (BP) were measured at supine rest, during orthostatic stress, and after walking prior to and 24, 48, and 72 h and 48 h postoperatively compared to preoperatively (P < or = 0.008); 16 vs 6 patients presented resting systolic BP values < 100 mm Hg (lower range, 70 mm Hg) post- versus preoperatively (P = 0.048). During orthostatic stress the decrease in systolic BP and concomitant increase in HR was similar post- versus preoperatively (BP, P > 0.3; HR, P > 0.34) and 12 vs 8 patient; (P = 0.45) experienced a systolic BP decrease > 20 mm Hg post- versus preoperatively. After walking, systolic BP was significantly lower postoperatively compared with preoperatively (P < or = 0.01). Epidural infusion was discontinued in three patients due to either persisting resting or orthostatic hypotension. There was no correlation between ASA classification, intraoperative bleeding, or postoperative dizziness and incidence of orthostatic hypotension. The results suggest that patients undergoing abdominal surgery and treated with continuous small-dose thoracic epidural bupivacaine-morphine are subjected to a decrease of BP at rest and during mobilization, but not to an extent that seriously impairs ambulation in most patients.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Crawford ME,Møiniche S,Orbaek J,Bjerrum H,Kehlet H

doi

10.1097/00000539-199611000-00022

subject

Has Abstract

pub_date

1996-11-01 00:00:00

pages

1028-32

issue

5

eissn

0003-2999

issn

1526-7598

journal_volume

83

pub_type

杂志文章
  • The effects of isoflurane and desflurane on cognitive function in humans.

    abstract:BACKGROUND:The etiology of postoperative cognitive decline (POCD) remains to be determined. Anesthetic isoflurane, but not desflurane, may induce neurotoxicity. However, the functional consequences of these effects have not been assessed. We therefore performed a pilot study to determine the effects of isoflurane and d...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1213/ANE.0b013e31823b2602

    authors: Zhang B,Tian M,Zhen Y,Yue Y,Sherman J,Zheng H,Li S,Tanzi RE,Marcantonio ER,Xie Z

    更新日期:2012-02-01 00:00:00

  • Clonidine treatment for agitation in children after sevoflurane anesthesia.

    abstract::Clonidine is effective in treating sevoflurane-induced postanesthesia agitation in children. We conducted a study on 169 children to quantify the risk reduction of clonidine agitation in patients admitted to our day-surgery pediatric clinic. Children were randomly allocated to receive clonidine 2 mug/kg or placebo bef...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000184204.81877.53

    authors: Tesoro S,Mezzetti D,Marchesini L,Peduto VA

    更新日期:2005-12-01 00:00:00

  • Activity changes in rat raphe magnus neurons at different concentrations of fentanyl in vitro.

    abstract::The nucleus raphe magnus (NRM) is an important descending pain inhibitory system. We postulated that the analgesic action of supraspinally administered opiates results from increased descending inhibitory control of the NRM. We tested whether fentanyl activates NRM neurons in the rat slice preparation using extra-cell...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199505000-00007

    authors: Ohta Y,Alojado ME,Kemmotsu O

    更新日期:1995-05-01 00:00:00

  • The Incidence of Transfusion-Related Acute Lung Injury at a Large, Urban Tertiary Medical Center: A Decade's Experience.

    abstract:BACKGROUND:While transfusion-related acute lung injury (TRALI) remains the primary cause of transfusion-related fatalities (37%), recent reports estimate the incidence of TRALI at 0.008% per unit of plasma transfused and 0.004% per all products transfused. Because blood banks have moved toward male-predominant plasma, ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003392

    authors: Meyer DE,Reynolds JW,Hobbs R,Bai Y,Hartwell B,Pommerening MJ,Fox EE,Wade CE,Holcomb JB,Cotton BA

    更新日期:2018-08-01 00:00:00

  • Small-dose hypobaric lidocaine-fentanyl spinal anesthesia for short duration outpatient laparoscopy. I. A randomized comparison with conventional dose hyperbaric lidocaine.

    abstract::A randomized, single-blind trial of two spinal anesthetic solutions for outpatient laparoscopy was conducted to compare intraoperative conditions and postoperative recovery. Thirty women (ASA physical status I and II) were assigned to one of two groups. Group I patients received a small-dose hypobaric solution of 1% l...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199701000-00011

    authors: Vaghadia H,McLeod DH,Mitchell GW,Merrick PM,Chilvers CR

    更新日期:1997-01-01 00:00:00

  • Hepatic clearance of lidocaine during N2O anesthesia in dogs.

    abstract::Lidocaine catabolism under N2O anesthesia was evaluated in 5 dogs given a lidocaine infusion of 2 mg/kg/min for 20 minutes. Comparison of results with those of a prior similar study with halothane to be significantly faster in the animals given N2O. The extraction ratio for lidocaine, which did not vary with its arter...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197605000-00007

    authors: Burney RG,DiFazio CA

    更新日期:1976-05-01 00:00:00

  • The time-dependent effects of midazolam on regional cerebral glucose metabolism in rats.

    abstract:BACKGROUND:Midazolam has hypnotic and sedative activities, which may be mediated by different neuronal structures. We investigated the time course effect of a hypnotic dose of midazolam on conscious motor behavior and on patterns of brain metabolism. METHODS:Loss of nociceptive reflexes and impairment of spontaneous l...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31816a64a8

    authors: Freo U,Dam M,Ori C

    更新日期:2008-05-01 00:00:00

  • One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography.

    abstract::Interscalene brachial plexus anesthesia for shoulder surgery routinely includes sensory anesthesia of the fourth and fifth cervical nerves. The authors reasoned that some degree of diaphragm paralysis should result from interscalene blocks that produce surgical C3-C5 sensory anesthesia. In this investigation, ultrason...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199104000-00014

    authors: Urmey WF,Talts KH,Sharrock NE

    更新日期:1991-04-01 00:00:00

  • Determination of Geolocations for Anesthesia Specialty Coverage and Standby Call Allowing Return to the Hospital Within a Specified Amount of Time.

    abstract:BACKGROUND:For emergent procedures, in-house teams are required for immediate patient care. However, for many procedures, there is time to bring in a call team from home without increasing patient morbidity. Anesthesia providers taking subspecialty or backup call from home are required to return to the hospital within ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003320

    authors: Epstein RH,Dexter F,Diez C,Potnuru P

    更新日期:2019-11-01 00:00:00

  • The effects of heparin, protamine, and heparinase 1 on platelets in vitro using whole blood flow cytometry.

    abstract:UNLABELLED:The effects of heparinization and the reversal of heparin activity on platelet function after cardiopulmonary bypass have not been well defined. Flow cytometry has become a convenient and powerful technique for characterizing platelets. We examined the expression of a secretion marker (P-selectin) and an agg...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200004000-00007

    authors: Kozek-Langenecker SA,Mohammad SF,Masaki T,Kamerath C,Cheung AK

    更新日期:2000-04-01 00:00:00

  • High-dose hydromorphone (Dilaudid) for coronary artery bypass surgery.

    abstract::The hemodynamic effects of high-dose hydromorphone hydrochloride (H), 1.25 mg/kg, were investigated in 10 patients with normal ventricular function undergoing coronary artery bypass graft (CABG) surgery. One patient with unstable angina was excluded from the study because of hypotension and facial flushing after a 6-m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Welti RS,Moldenhauer CC,Hug CC Jr,Kaplan JA,Holbrook GW

    更新日期:1984-01-01 00:00:00

  • The involvement of the mu-opioid receptor in ketamine-induced respiratory depression and antinociception.

    abstract:UNLABELLED:N-methyl-D-aspartate receptor antagonism probably accounts for most of ketamine's anesthetic effects; its analgesic properties are mediated partly via N-methyl-D-aspartate and partly via opioid receptors. We assessed the involvement of the mu-opioid receptor in S(+) ketamine-induced respiratory depression an...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200112000-00031

    authors: Sarton E,Teppema LJ,Olievier C,Nieuwenhuijs D,Matthes HW,Kieffer BL,Dahan A

    更新日期:2001-12-01 00:00:00

  • Use of analgesic, anesthetic, and sedative medications during pediatric hospitalizations in the United States 2008.

    abstract:BACKGROUND:The wide need for analgesia, anesthesia, and sedation in children and the lack of pediatric labeling leads to widespread off-label use of medications for pain and sedation in children. Any attempt to address the lack of labeling will require national estimates of the numbers of children using each medication...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31825b6fb2

    authors: Lasky T,Ernst FR,Greenspan J

    更新日期:2012-11-01 00:00:00

  • Anesthesia Capacity of District-Level Hospitals in Malawi, Tanzania, and Zambia: A Mixed-Methods Study.

    abstract:BACKGROUND:District-level hospitals (DLHs) are the main providers of surgical services for rural populations in Sub-Saharan Africa (SSA). Skilled teams are essential for surgical care, and gaps in anesthesia impact negatively on surgical capacity and outcomes. This study, from a baseline of a project scaling-up access ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000004363

    authors: Gajewski J,Pittalis C,Lavy C,Borgstein E,Bijlmakers L,Mwapasa G,Cheelo M,Le G,Juma A,Kachimba J,Marealle P,Mkandawire N,Chilonga K,Brugha R

    更新日期:2020-04-01 00:00:00

  • Perioperative goal-directed hemodynamic optimization using noninvasive cardiac output monitoring in major abdominal surgery: a prospective, randomized, multicenter, pragmatic trial: POEMAS Study (PeriOperative goal-directed thErapy in Major Abdominal Surg

    abstract:BACKGROUND:In this study, our objective was to determine whether a perioperative hemodynamic protocol based on noninvasive cardiac output monitoring decreases the incidence of postoperative complications and hospital length of stay in major abdominal surgery patients requiring intensive care unit admission. Secondary o...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1213/ANE.0000000000000295

    authors: Pestaña D,Espinosa E,Eden A,Nájera D,Collar L,Aldecoa C,Higuera E,Escribano S,Bystritski D,Pascual J,Fernández-Garijo P,de Prada B,Muriel A,Pizov R

    更新日期:2014-09-01 00:00:00

  • The effect of somatostatin on experimental inflammation in rats.

    abstract:UNLABELLED:The aim of the present study was to investigate the effect of somatostatin administration on experimentally induced inflammation in rats. Inflammation was induced by the intraplantar injection of carrageenan (50 microL) into the hind paw of the rat. Animals were treated intraplantarly with somatostatin in a ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199711000-00028

    authors: Corsi MM,Ticozzi C,Netti C,Fulgenzi A,Tiengo M,Gaja G,Guidobono F,Ferrero ME

    更新日期:1997-11-01 00:00:00

  • A strategy to decide whether to move the last case of the day in an operating room to another empty operating room to decrease overtime labor costs.

    abstract:UNLABELLED:We examined how to program an operating room (OR) information system to assist the OR manager in deciding whether to move the last case of the day in one OR to another OR that is empty to decrease overtime labor costs. We first developed a statistical strategy to predict whether moving the case would decreas...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200010000-00029

    authors: Dexter F

    更新日期:2000-10-01 00:00:00

  • Predicting the density of bupivacaine and bupivacaine-opioid combinations.

    abstract:IMPLICATIONS:Manipulating the density of local anesthetic solutions by using a simple formula may be clinically useful in producing optimal density solutions for spinal anesthesia under a variety of clinical conditions. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200206000-00048

    authors: Hallworth SP,Fernando R,Stocks GM

    更新日期:2002-06-01 00:00:00

  • Accidental intraneural injection into the musculocutaneous nerve visualized with ultrasound.

    abstract::Ultrasound has become a widely used tool within the practice of regional anesthesia, offering real-time visualization of the nerves, needle, and local anesthetic during performance of a block. A successful ultrasound-guided axillary block was performed on a healthy adult male undergoing wrist surgery. Postoperative re...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000287246.47283.0e

    authors: Russon K,Blanco R

    更新日期:2007-11-01 00:00:00

  • The preemptive analgesic effect of rofecoxib after ambulatory arthroscopic knee surgery.

    abstract:UNLABELLED:Nonsteroidal antiinflammatory drugs (NSAIDs) provide effective postoperative analgesia after arthroscopic knee surgery. Some investigators have suggested that the preemptive administration of NSAIDs may reduce postoperative analgesic requirements and hypersensitivity. We evaluated the analgesic effect of adm...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200201000-00010

    authors: Reuben SS,Bhopatkar S,Maciolek H,Joshi W,Sklar J

    更新日期:2002-01-01 00:00:00

  • The effects of intravenous almitrine on oxygenation and hemodynamics during one-lung ventilation.

    abstract:UNLABELLED:One-lung ventilation (OLV) induces an increase in pulmonary shunt sometimes associated with a decrease in PaO2 despite ventilation with 100% oxygen. PaO2 improvement has been reported in one-lung ventilated animals receiving IV almitrine, a pulmonary vasoconstrictor. We evaluated the ability of almitrine to ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200204000-00010

    authors: Moutafis M,Dalibon N,Liu N,Kuhlman G,Fischler M

    更新日期:2002-04-01 00:00:00

  • Association of preoperative risk factors with postoperative acute renal failure.

    abstract::We performed a systematic review of 28 studies that examined preoperative risk factors for postoperative renal failure. Included in the studies were 10,865 patients who underwent either vascular, cardiac, general, or biliary surgery. No two studies used the same criteria for acute renal failure. Variability in definit...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/00000539-199401000-00023

    authors: Novis BK,Roizen MF,Aronson S,Thisted RA

    更新日期:1994-01-01 00:00:00

  • Giving toys to children reduces their anxiety about receiving premedication for surgery.

    abstract::Children have increased anxiety during the preoperative period. The administration of oral premedication to children is often met with apprehension, reluctance, or refusal. We sought to determine whether giving a small toy to the children would decrease the anxiety associated with taking oral premedication. This was a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000198332.51475.50

    authors: Golden L,Pagala M,Sukhavasi S,Nagpal D,Ahmad A,Mahanta A

    更新日期:2006-04-01 00:00:00

  • Central nervous system effects of intrathecal muscle relaxants in rats.

    abstract::When given for a sufficient time and dose intravenously, neuromuscular blocking drugs eventually can enter the cerebrospinal fluid (CSF). To study the potential pharmacologic consequences of neuromuscular blocking drugs in the CSF, a model was developed in the rat by using an intrathecal infusion of these drugs. A can...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199306000-00020

    authors: Szenohradszky J,Trevor AJ,Bickler P,Caldwell JE,Sharma ML,Rampil IJ,Miller RD

    更新日期:1993-06-01 00:00:00

  • The effects of endotracheal suctioning on the accuracy of oxygen consumption and carbon dioxide production measurements and pulmonary mechanics calculated by a compact metabolic monitor.

    abstract:BACKGROUND:Open endotracheal suctioning (ETS), which is performed regularly in mechanically ventilated patients to remove obstructive secretions, can cause an immediate decrease in dynamic compliance and expired tidal volume and result in inadequate or inaccurate sidestream respiratory monitoring, necessitating prolong...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181b018ee

    authors: Briassoulis G,Briassoulis P,Michaeloudi E,Fitrolaki DM,Spanaki AM,Briassouli E

    更新日期:2009-09-01 00:00:00

  • Intrathecal morphine reduces infarct size in a rat model of ischemia-reperfusion injury.

    abstract:UNLABELLED:Systemically-administered morphine reduces infarct size in rat models of myocardial ischemia-reperfusion. We sought to determine whether much smaller doses of spinally-administered morphine offer a similar cardioprotective benefit. Barbiturate-anesthetized, open-chested, Wistar rats with chronic indwelling t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000105878.96434.05

    authors: Groban L,Vernon JC,Butterworth J

    更新日期:2004-04-01 00:00:00

  • Urine flow is a novel hemodynamic monitoring tool for the detection of hypovolemia.

    abstract:BACKGROUND:Noticeable changes in vital signs indicating hypovolemia occur only after 15% of the blood volume is lost. More sensitive variables (e.g., cardiac output, systolic pressure variation and its Δdown component) are invasive and difficult to obtain in the early phase of bleeding. Lately, a new technology for con...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e31820ad4ef

    authors: Shamir MY,Kaplan L,Marans RS,Willner D,Klein Y

    更新日期:2011-03-01 00:00:00

  • Carbon monoxide production from degradation of desflurane, enflurane, isoflurane, halothane, and sevoflurane by soda lime and Baralyme.

    abstract::Anecdotal reports suggest that soda lime and Baralyme brand absorbent can degrade inhaled anesthetics to carbon monoxide (CO). We examined the factors that govern CO production and found that these include: 1) The anesthetic used: for a given minimum alveolar anesthetic concentration (MAC)-multiple, the magnitude of C...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199506000-00021

    authors: Fang ZX,Eger EI 2nd,Laster MJ,Chortkoff BS,Kandel L,Ionescu P

    更新日期:1995-06-01 00:00:00

  • Decrease in vascular resistance in the isolated canine hindlimb after graded doses of alfentanil, fentanyl, and sufentanil.

    abstract::Under halothane anesthesia five dogs were prepared with both hindlimbs isolated from the systemic circulation to allow intermittent placement on extracorporeal perfusion at constant flow. One limb of each dog was surgically denervated. In this relatively anesthetic-free preparation, graded equivalent doses of alfentan...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199007000-00005

    authors: White DA,Reitan JA,Kien ND,Thorup SJ

    更新日期:1990-07-01 00:00:00

  • The frequency and magnitude of cerebrospinal fluid pulsations influence intrathecal drug distribution: key factors for interpatient variability.

    abstract:BACKGROUND:Intrathecal drug delivery is an efficient method to administer therapeutic molecules to the central nervous system. However, even with identical drug dosage and administration mode, the extent of drug distribution in vivo is highly variable and difficult to control. Different cerebrospinal fluid (CSF) pulsat...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e3182536211

    authors: Hsu Y,Hettiarachchi HD,Zhu DC,Linninger AA

    更新日期:2012-08-01 00:00:00