Clinical Experience with Epidural Morphine

Ta, Torda; Da, Pybus

doi:10.1177/0310057x8100900205

Cited by 30 publications

(5 citation statements)

References 18 publications

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“…The incidence of urinary retention in this study is comparable to that of others using extradural morphine [11,12]. Of those patients who reported nausea or vomiting, 0.9% (seven patients) had undergone orthopaedic procedures, and it was felt that prophylactic antiemetic treatment was unnecessary.…”

Section: Discussionsupporting

confidence: 66%

Extradural Diamorphine for Postoperative Analgesia: Audit of a Nurse-Administered Service to 800 Patients in a District General Hospital

Stuart‐Taylor¹,

Billingham²,

Barrett³

et al. 1992

British Journal of Anaesthesia

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We report the use of extradural diamorphine for postoperative analgesia as a nurse-based service on selected surgical wards in a district general hospital. Eight hundred patients received lumbar or thoracic extradural diamorphine analgesia for postoperative or traumatic pain. Diamorphine was administered in bolus form by suitably trained nursing staff. Satisfactory analgesia, recorded on a verbal rating scale at the conclusion of the service, was achieved in 94.6% of patients. The technique was considered by medical and nursing staff to be a safe and acceptable method of analgesia. Respiratory depression, defined as a ventilatory frequency of less than 10 b.p.m., occurred in seven patients (incidence of 0.9%). All occurred in the theatre recovery area or in the intensive care unit. Retrospectively, each was predictable and all responded to naloxone 0.4 mg.

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Section: Discussionsupporting

confidence: 66%

Extradural Diamorphine for Postoperative Analgesia: Audit of a Nurse-Administered Service to 800 Patients in a District General Hospital

Stuart‐Taylor¹,

Billingham²,

Barrett³

et al. 1992

British Journal of Anaesthesia

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“…Rudra (1985), [12] Harcus A.H. (1980), [24] T.A. torda (1981), [25] have shown Buprenorphine were remarkably free from any significant cardiovascular insults attributable to this drug from our study, we also confirm the same, we ahave considered bradycardia when pulse rate was less then 60/min. and hypotension when reduction in blood pressure was more 20% of basal level and we had found hypotension in 4 cases and bradycardia in 4 cases -intraoperatively and postoperatively no patient had bradycardia or hypotension in study group.…”

Section: Pain Scoringsupporting

confidence: 82%

“…T.A. Torda (1981), [18] administered morphine epidurally for postoperartive analgesia and achieved good analgesia in most of patients with duration ranged from 6 hours up. Lanz et al (1984), [19] observed that with 0.15 mg. Buprenorphine, men duration of analgesia was 6 hrs., while with 0.3. mg, it was about 12 hrs.…”

Section: Pain Scoringmentioning

confidence: 99%

Effectiveness of Mixture of Xylocaine, Bupivacaine and Buprenorphine for Lumbar Blockade by Epidural Approach

Mavani

Patel

2019

AAN

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Background: Pain is one of the most compelling experience for human beings. Pain is the most difficult one to define and assess, as it is a purely subjective sensation experienced only by the sufferer. Present study was done in which Buprenorphine was given epidurally along with Bupivacaine and Xylocaine as a single shot technique to evaluate its potency, duration of analgesia and other side effects. Subjects and Methods: Fifty adult patients of ASA risk I/II undergoing lower abdominal surgery, lower limb-orthopaedic surgery, surgery involving perineal region and gynaecological procedures were selected for our study. The patients were divided into two groups consisting of 25 patients each. In group I, patients were given Inj. Bupivacaine 0.5% 20 cc + xylacaine in lumbar epidural space. In group II, patients were given Bupivacaine 0.5% 20 cc + xylacaine 0.5% 20 cc mixed with Inj. Buprenorphine 0.2 mg (2 ml) in same syringe in lumbar epidural space. Duration of total analgesia was measured with help of pain scorre, which were measured throughout operative period and in postoperative period. All the statistical tests will be performed in SPSS version 15 software. Results: In study group majority patients complain of pain at around 16 to 20 hours. Most of the patients in group-I are in 0-4 hours and in group-II are 20-24 hours. Maximum respiratory depression was around 12% (2/min). It was observed that hypotension was seen in 4 cases and bradycardia in 4 cases-intraoperatively and postoperatively no patient had bradycardia or hypotension in study group. Conclusion: Buprenorphine if given epidurally along with local anesthetic solution for various surgical procedures can provide excellent pain free period lasting up to 24 hours without any disturbances to normal physiology life and notable side effects.

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“…In the reported clinical series the incidence varies widely. Torda and Pybus [186] noted that only one of 24 patients required catheterization, but in other series frequencies of 22% [158] and 39% [108] have been reported. Urinary retention occurred in 79% of patients undergoing ano-rectal surgery [86].…”

Section: Urinary Retentionmentioning

confidence: 92%