Delayed postoperative gastric emptying following intrathecal morphine and intrathecal bupivacaine

Lydon, A.; Cooke, T.; Duggan, Finbarr; Shorten, George

doi:10.1007/bf03013544

Cited by 26 publications

(7 citation statements)

References 18 publications

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“…Sedation of preterm infants receiving invasive mechanical ventilation may affect alveolar formation directly, by altering lung cell-signaling, or indirectly by prolonging mechanical ventilation, or disrupting nutritional intake and/or absorption (18, 19, 22, 23, 33). In our study, preterm lambs in the NIS+ES group tolerated sheep colostrum and milk.…”

Section: Discussionmentioning

confidence: 99%

Alveolar formation is dysregulated by restricted nutrition but not excess sedation in preterm lambs managed by noninvasive support

et al. 2016

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Background Preterm birth and respiratory support with invasive mechanical ventilation frequently leads to bronchopulmonary dysplasia (BPD). A hallmark feature of BPD is alveolar simplification. For our preterm lamb model of BPD, invasive mechanical ventilation is associated with postnatal feeding intolerance (reduced nutrition) and sedation. In contrast, preterm lambs managed by non-invasive support (NIS) have normal alveolar formation, appropriate postnatal nutrition, and require little sedation. We used the latter, positive-outcome group to discriminate the contribution of reduced nutrition versus sedation on alveolar simplification. We hypothesized that, restricted nutrition, but not sedation, contributes to impaired indices of alveolar formation in preterm lambs managed by NIS. Methods Preterm lambs managed by NIS for 21d were randomized into three groups: NIS control, NIS plus restricted nutrition, and NIS plus excess sedation. We quantified morphological and biochemical indices of alveolar formation, as well as mesenchymal cell apoptosis and proliferation. Results Restricted nutrition impaired morphological and biochemical indices of alveolar formation, and reduced mesenchymal cell apoptosis and proliferation. Excess sedation did not alter these indices, although mesenchymal cell apoptosis was less. Conclusions Our results demonstrate that restricted nutrition, but not excess sedation, contributes to impaired alveolar formation during the evolution of BPD in chronically ventilated preterm lambs.

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Section: Discussionmentioning

confidence: 99%

Alveolar formation is dysregulated by restricted nutrition but not excess sedation in preterm lambs managed by noninvasive support

et al. 2016

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“…23,24 Evidence of delayed postoperative gastric emptying with a moderate dose (0.6 mg) of intrathecal morphine has been published recently. 25 Nevertheless, patients tended to be more satisfied in the IT+PCA group.…”

Section: Méthode : Soixante Patients Adultes Devant Subir Une Intervementioning

confidence: 94%

Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone

Devys

Mora

Plaud

et al. 2003

Can J Anesth/J Can Anesth

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“…Morphine and other µ‐opioid agonists slow gastric emptying of liquids and solids in humans and animal models 43–46 . Systemic and intrathecal routes of administration have the same effect 47,48 . Naloxone and other µ antagonists reverse the slowing of gastric emptying by morphine.…”

Section: Gastric Motilitymentioning

confidence: 99%

Function of opioids in the enteric nervous system

Wood

Galligan

2004

Neurogastroenterology Motil

324

300

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Alterations in gastrointestinal motility and secretion underlie the constipating action of therapeutically administered opiates. The prototype opiate is morphine, which acts to delay gastric emptying and intestinal transit, to suppress intestinal secretion of water and electrolytes and to suppress transport of bile into the duodenum. The effects of opiates, synthetic opioids and endogenously released opioid peptides on these organ-level gastrointestinal functions reflect actions on electrical and synaptic behaviour of neurones in the enteric nervous system. Adverse effects and positive therapeutic effects of administration of opioid-receptor-blocking drugs on the digestive tract must be understood in the context of the neurophysiology of the enteric nervous system and mechanisms of neural control of gastrointestinal smooth muscle, secretory glands and blood-lymphatic vasculature. We review here the integrated systems of physiology and cellular neurobiology that are basic to understanding the actions of opioid agonists and antagonists in the digestive tract.

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Delayed postoperative gastric emptying following intrathecal morphine and intrathecal bupivacaine

Cited by 26 publications

References 18 publications

Alveolar formation is dysregulated by restricted nutrition but not excess sedation in preterm lambs managed by noninvasive support

Alveolar formation is dysregulated by restricted nutrition but not excess sedation in preterm lambs managed by noninvasive support

Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone

Function of opioids in the enteric nervous system

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