Abstract:
BACKGROUND:The primary goal of this study was to determine whether administration of intrathecal morphine reduces postoperative pain. The secondary goal was to determine the effect of intrathecal morphine upon circulating levels of the weakly analgesic endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), and the related lipids palmitoylethanolamide (PEA) and oleoylethanolamide (OEA). METHODS:Forty two total knee arthroplasty (TKA) patients were enrolled in a prospective, double-blinded, randomized study. The intervention consisted of intrathecal morphine (200 μg) or placebo administered at the time of the spinal anesthesia. Postoperative pain was measured during the first 4 h after surgery while serum levels of AEA, 2-AG, PEA, OEA, and cortisol were measured at baseline and 4 h after surgery. RESULTS:Administration of intrathecal morphine reduced postoperative pain 4 h after TKA surgery compared to placebo (p = 0.005) and reduced postoperative systemic opioid consumption (p = 0.001). At baseline, intrathecal morphine led to a significant reduction in AEA, 2-AG, and OEA levels but did not affect PEA or cortisol levels. In patients administered intrathecal placebo, 2-AG levels were elevated 4 h after surgery; whereas patients receiving intrathecal morphine showed reductions in AEA, PEA, and OEA when compared to placebo. At 4 h after TKA surgery cortisol levels were significantly elevated in the placebo group and reduced in those receiving morphine. CONCLUSIONS:These results indicate that intrathecal morphine reduces postoperative pain in TKA patients. Furthermore, activation of central opioid receptors negatively modulates the endocannabinoid tone, suggesting that potent analgesics may reduce the stimulus for production of peripheral endocannabinoids. This study is the first to document the existence of rapid communication between the central opioid and peripheral endocannabinoid systems in humans. TRIAL REGISTRATION:This trial was registered retrospectively. TRIAL REGISTRY:NCT02620631 . Study to Examine Pain Relief With Supplemental Intrathecal Morphine in TKA Patients, NCT02620631 , 12/03/2015.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Kaczocha M,Azim S,Nicholson J,Rebecchi MJ,Lu Y,Feng T,Romeiser JL,Reinsel R,Rizwan S,Shodhan S,Volkow ND,Benveniste Hdoi
10.1186/s12871-018-0489-5subject
Has Abstractpub_date
2018-02-27 00:00:00pages
27issue
1issn
1471-2253pii
10.1186/s12871-018-0489-5journal_volume
18pub_type
杂志文章,随机对照试验abstract:BACKGROUND:We report a case of severe upper airway obstruction due to a retropharyngeal hematoma that presented nearly one day after a precipitating traumatic injury. Retropharyngeal hematomas are rare, but may cause life-threatening airway compromise. CASE PRESENTATION:A 50 year-old man developed severe dyspnea with ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-7-2
更新日期:2007-03-12 00:00:00
abstract:BACKGROUND:In infants, securing the airway is time-critical because of anatomical and physiological differences related to airway management in children less than 1 year old. The aim of this study was to compare the time to ventilation using two different hyperangulated video laryngoscope blades with the time to ventil...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0580-y
更新日期:2018-08-31 00:00:00
abstract:BACKGROUND:There are growing concerns that anaesthetic exposure can cause extensive apoptotic degeneration of neurons and the impairment of normal synaptic development and remodelling. However, little attention has been paid to exploring the possible cytotoxicity of inhalation anaesthetics, such as isoflurane, in astro...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0420-5
更新日期:2017-09-05 00:00:00
abstract:BACKGROUND:The significance of intraoperative anesthesia handoffs on patient outcomes are unclear. One aspect differentiating the disparate results is the treatment of confounding factors, such as patient comorbidities and surgery time of day. We performed this study to quantify the significance of confounding variable...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0858-8
更新日期:2019-10-15 00:00:00
abstract:BACKGROUND:To determine the median effective concentration of sufentanil as an analgesic during wake-up tests after sevoflurane anesthesia during surgery for adolescent idiopathic scoliosis (AIS). METHODS:This is a randomised controlled trial. Sixty patients aged 13-18 years scheduled for AIS surgery were randomized i...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-015-0003-2
更新日期:2015-03-08 00:00:00
abstract:BACKGROUND:Topical anesthesia is a crucial step in awake endotracheal intubation for providing favorable intubation conditions. The standard of care technique for awake intubation at our institution, which consists of oropharyngeal tetracaine spray, can result in inadequate mucosal anesthesia. Therefore, we sought to c...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01210-8
更新日期:2020-12-14 00:00:00
abstract:BACKGROUND:Tramadol is an atypical centrally acting analgesic agent available as both oral and parenteral preparations. For patients who are unable to take tramadol orally, the subcutaneous route of administration offers an easy alternative to intravenous or intramuscular routes. This study aimed to characterise the ab...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-33
更新日期:2014-05-12 00:00:00
abstract:BACKGROUND:The effort to improve tracheal intubation process is clinically valuable. We hypothesized that a preoperative brief exercise therapy would increase mouth opening and neck extension, enhancing intubation conditions during general anesthesia. METHODS:Patients undergoing general anesthesia were randomized into...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12871-020-0939-8
更新日期:2020-01-29 00:00:00
abstract:BACKGROUND:The timing of laryngeal mask airway (LMA) removal remains undefined. This study aimed to assess the optimal timing for LMA removal and whether topical anesthesia with lidocaine could reduce airway adverse events. METHODS:This randomized controlled trial assessed one-to-six-year-old children with ASA I-II sc...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-021-01235-7
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:The peri-operative effectiveness of ultrasound-guided great auricular nerve block (GANB) in patients, especially in adult patients undergoing middle ear microsurgery remains unclear. We hypothesized that ultrasound-guided GANB would decrease the hemodynamic responsiveness to incision and opioid consumption i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
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更新日期:2020-09-15 00:00:00
abstract:BACKGROUND:Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus an...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0358-7
更新日期:2017-06-26 00:00:00
abstract:BACKGROUND:Conventionally, ultrasonographic assessment of diaphragm contractility has involved measuring respiratory changes in diaphragm thickness (thickening fraction) using B-mode or caudal displacement with M-mode. Two-dimensional speckle-tracking has been increasingly used to assess muscle deformation ('strain') i...
journal_title:BMC anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1186/s12871-016-0201-6
更新日期:2016-07-25 00:00:00
abstract:BACKGROUND:Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hy...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0114-9
更新日期:2015-10-06 00:00:00
abstract:BACKGROUND:The present study aimed to compare the intravenous bolus effect of oxycodone and fentanyl on hemodynamic response after endotracheal intubation and postoperative pain in patients undergoing closed reduction of nasal bone fracture. METHODS:In this prospective randomized double-blinded study, 64 patients unde...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0279-x
更新日期:2016-11-17 00:00:00
abstract:BACKGROUND:Since blood pressure tends to be unstable during induction of anesthesia in patients undergoing cardiovascular surgery, an artery catheter is often inserted before induction to continuously monitor arterial pressure during induction of anesthesia. ClearSight System™ enables noninvasive continuous measurement...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01091-x
更新日期:2020-07-20 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0448-6
更新日期:2017-12-08 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0887-3
更新日期:2019-11-19 00:00:00
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doi:10.1186/s12871-020-01212-6
更新日期:2020-11-30 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-05-12 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2253-11-2
更新日期:2011-02-16 00:00:00
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更新日期:2011-11-24 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2019-05-17 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
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更新日期:2019-05-22 00:00:00
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更新日期:2020-07-03 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
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更新日期:2014-02-21 00:00:00
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journal_title:BMC anesthesiology
pub_type: 杂志文章
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更新日期:2004-01-16 00:00:00
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journal_title:BMC anesthesiology
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更新日期:2019-07-04 00:00:00
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journal_title:BMC anesthesiology
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更新日期:2015-12-15 00:00:00