A Prospective Random Comparison of Halothane and Morphine for Open–heart Anesthesia

Conahan, Thomas J.; Ominsky, Alan Jay; Wollman, Harry; Stroth, Ronald A.

doi:10.1097/00000542-197306000-00004

Cited by 30 publications

(7 citation statements)

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“…The authors raised concerns about the safety of using morphine in patients with ACS NSTE but pointed out that that could only be answered with a randomized trial . These data were in accord with a few other studies . In particular, Conahan et al.…”

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 72%

“…In particular, Conahan et al. demonstrated that morphine (2 mg/kg) caused severe hypertension and an increase in systemic vascular resistance in patients undergoing heart valve replacement . Later Lappas et al.…”

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 99%

“…Later Lappas et al. reported that the addition of 5% NO to morphine (2 mg/kg intravenously) decreased BP, cardiac index, stroke index and increased pulmonary capillary wedge pressure . Intravenous administration of morphine at a dose of 2.1 mg/kg can induce ST segment depression in patients with ischemic heart disease .…”

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 99%

“…Intravenous administration of morphine at a dose of 2.1 mg/kg can induce ST segment depression in patients with ischemic heart disease . However, we would like to draw readers’ attention to the fact that an extremely large dose of morphine (2 mg/kg) was used in these three studies . Indeed, in current cardiological guidelines, the recommended dose of morphine is 4–8 mg (0.05–0.1 mg/kg) .…”

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 99%

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Prospects for Creation of Cardioprotective and Antiarrhythmic Drugs Based on Opioid Receptor Agonists

Maslov

Khaliulin

Oeltgen

et al. 2016

Medicinal Research Reviews

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It has now been demonstrated that the μ, δ1, δ2, and κ1 opioid receptor (OR) agonists represent the most promising group of opioids for the creation of drugs enhancing cardiac tolerance to the detrimental effects of ischemia/reperfusion (I/R). Opioids are able to prevent necrosis and apoptosis of cardiomyocytes during I/R and improve cardiac contractility in the reperfusion period. The OR agonists exert an infarct‐reducing effect with prophylactic administration and prevent reperfusion‐induced cardiomyocyte death when ischemic injury of heart has already occurred; that is, opioids can mimic preconditioning and postconditioning phenomena. Furthermore, opioids are also effective in preventing ischemia‐induced arrhythmias.

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Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 72%

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 99%

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 99%

Section: Toxicity Of High‐dose Opioids and The Cardioprotective Effecmentioning

confidence: 99%

See 2 more Smart Citations

Prospects for Creation of Cardioprotective and Antiarrhythmic Drugs Based on Opioid Receptor Agonists

Maslov

Khaliulin

Oeltgen

et al. 2016

Medicinal Research Reviews

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“…In clinical studies, reductions in blood pressure and vascular resistance after morphine administration have been described (Sethna et al, 1982) but also hypertonic (Conahan et al, 1973;Kistner et al, 1979) or unchanged (Lee et al, 1976) haemodynamics. Animal experiments have also shown differing haemodynamic effects, depending on route of administration, dose, and the additional effects of anaesthetics (Fennessy & Rattray, 1971;Holaday, 1983).…”

Section: Morphine Effectsmentioning

confidence: 99%

Effects of morphine on catecholamine release and arrhythmias evoked by myocardial ischaemia in rats

Addicks

Hirche

McDonald

et al. 1987

British J Pharmacology

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1 The effects of morphine (10mgkg-' i.p.) on haemodynamics, arrhythmias and plasma and myocardial catecholamines (CA) were studied after coronary artery occlusion in anaesthetized rats. Myocardial intraneuronal CA were assessed histofluorimetrically and CA concentrations measured by high performance liquid chromatography. 2 Morphine increased blood pressure, presumably due to higher plasma noradrenaline (NA) concentrations found in morphine-treated rats. 3 Morphine increased the area ofcatecholamine-containing fluorescing neurones in the myocardium (as a percentage of total field area) 60 min after sham-operation (0.87 ± 0.07%) or occlusion (0.57 ± 0.05%) compared to untreated animals (0.67 ± 0.06 and 0.38 ± 0.03% respectively). Tissue NA content was not significantly affected by coronary occlusion and/or morphine within the first 60 min. 4 Morphine had no effect on ischaemia-induced arrhythmias. 5 Whether the higher intraneuronal NA content following morphine resulted from reduced central sympathetic outflow to the heart, presynaptic inhibition of NA release, or increased uptake due to higher plasma concentrations is unclear. Ischaemia-induced local NA release appears independent of these mechanisms, as it was unaffected by morphine.

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The Teaching of Statistics in the Biological, Medical and Health Sciences: Some Comments and a Selected Bibliography

1990

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IntroductionSince 1975 when a committee of the American Statistical Amciat.ion (ASA) published guidelines for a core curriculum in medical and health sciences (American Statistical Association, 1975), there has been a renewed surge of interest in the teaching of statistics in medical and health sciences. For example, the 1975 and 1977 surveys on the teaching of biostatistics in medical schools showed that only two thirds of the U.S. and Canadian schools required some biostatistical instruction (we COLTON, 1975; REED, 1977). A n earlier survey by HO~KINS (1958) had revealed that nearly 70 percent of the medical schools required biostatistical instruction. In contraat, the results of a recent survey show that 90 percent of the responding medical schools are currently imparting biostatistical instruction, though there is a wide variation in the topics being covered (see DAWSON-SAWN- DERS et al., 1987).In the decade since the ASA committee report and the subsequent curriculum surveys, when a major purpose for teaching biostatistics was identified as developing shlls necessary to evaluate the medical literature critically, there has been renewed attention and greater emphasis on teaching statistical and adjunct skills necessary to manage and evaluate information, make decisions under uncertainty, and read the medical literature critically. For example, at an international conference, jointly sponsored by World Health Organization and Pakistan, several new guidelines were developed for teaching of statistics in the medical and health sciences in order to achieve the aforementioned goals (Bee LOWE, 1980). Furthermore, a recent panel report on the general professional education of the physicians (GPEP) made recommendations for an educational process providing ski& which assist students to be independent problem solvers and self-learners rather than imparting purely factual information. The report further emphasized that instruction in the basic sciences and clinical hsciplines be integrated in order to aid and enhance learning of scientific principles and their applications (MULLER, 1984).From the recent articles in the literature one can also discern new trends and MULVIHILL et al., 1980; and KRAtL et al., 1983). In addition, many more schools are now offering some instruction in medical decision analysis and the use of computers (see, e.g., ELSTEM, A. A. et al., 1985 ; Organization of Student Affairs, 1985). In many European countries some form of formal statistical teaching and education for medical students and physicians was initjated in the fifties. Presently, biostatistics, biomathematics, or medical statistics is a required discipline for all medical students in most of the European universities, including Austria, Federal Republic of Germany, and German Democratic Republic. However, there is a trend toward more medicine specific teaching in statistics; and in postgraduate medical teaching and training, many special topics in biostatistics play an important role in different didactic forms. In addition, m...

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A Prospective Random Comparison of Halothane and Morphine for Open–heart Anesthesia

Cited by 30 publications

References 0 publications

Prospects for Creation of Cardioprotective and Antiarrhythmic Drugs Based on Opioid Receptor Agonists

Prospects for Creation of Cardioprotective and Antiarrhythmic Drugs Based on Opioid Receptor Agonists

Effects of morphine on catecholamine release and arrhythmias evoked by myocardial ischaemia in rats

The Teaching of Statistics in the Biological, Medical and Health Sciences: Some Comments and a Selected Bibliography

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