Low-Dose Infusion of Morphine Prevents Respiratory Depression

Chrubasik, J.; Scholler, K. L.; Wiemers, K; Weigel, K.; Friedrich, Gerhard

doi:10.1016/s0140-6736(84)91303-5

Cited by 12 publications

(1 citation statement)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11.14 This difference in severity of apnoeas or desaturations seen between the groups may be explained by the different pharmacokinetics of the drug with different modes of administration. Low-dose epidural infusion of morphine is known to keep the concentration of morphine near the respiratory centre at a low constant level compared with high-volume bolus epidural morphine 15 and is known to be associated with minimal side-effects. "to For the four patients who had numerous apnoeas and desaturation episodes, we found no correlation with any of the preoperative data or with duration of surgery.…”

Section: Discussionmentioning

confidence: 99%

Apnoea and Oximetric Desaturation in Patients Receiving Epidural Morphine after Gastrectomy: A Comparison of Intermittent Bolus and Patient Controlled Administration

Nozaki-Taguchi

Oka

Kochi

et al. 1993

Anaesth Intensive Care

View full text Add to dashboard Cite

The number of apnoeic episodes and arterial oxygen desaturations were measured preoperatively and for sixty hours postoperatively in twenty ASA status 1-2 patients scheduled for elective gastrectomy. Monitoring included continuous pulse oximetry, respiratory inductive plethysmography and repeated arterial blood gas analysis. The number and magnitude of apnoeas and desaturation episodes were compared between two postoperative analgesic regimens of epidural morphine; intermittent bolus injection (Group B, n = 10), and patient controlled administration with continuous infusion (Group P, n = 10). Morphine dose, P a C02 and mean Sp02 values were similar between the two groups. Although the number of central apnoeas with Sp02 < 90% was greater in Group B, other episodes of apnoea or desaturation were similarly seen preoperatively. In the postoperative period, central apnoeas with spa; < 90% were significantly increased in Group B, while no change was seen in Group P. Apnoeas with 51'02 < 80% were only seen in Group B. We conclude from these results that postoperative apnoeas and episodic desaturations are greatly influenced by the different modes of opioid administration.

show abstract

Section: Discussionmentioning

confidence: 99%

Apnoea and Oximetric Desaturation in Patients Receiving Epidural Morphine after Gastrectomy: A Comparison of Intermittent Bolus and Patient Controlled Administration

Nozaki-Taguchi

Oka

Kochi

et al. 1993

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

Cerebrospinal fluid pharmacokinetics of intrathecal morphine sulfate and D‐Ala²‐D‐Leu⁵‐enkephalin

Moulin

Inturrisi

Foley

1986

Annals of Neurology

View full text Add to dashboard Cite

Using an implantable pump system to deliver drugs and sample cerebrospinal fluid (CSF), we assessed rostral redistribution and systemic uptake after intrathecal bolus injection and steady-state infusion of morphine sulfate and the opioid peptide D-Ala2-D-Leu5-enkephalin (DADL) in two patients. Following bolus injection, the mean CSF elimination half-lives for morphine sulfate and DADL were 94 and 115 minutes, respectively. With the catheter tip at L2, the ratio of lumbar to cisternal (L/C) concentrations of morphine sulfate was about 7:1, and with the catheter tip at T10, the L/C ratios of morphine sulfate and DADL were approximately 2:1, indicating that this ratio is dependent in part on the level of intrathecal drug administration. CSF levels of morphine sulfate at steady state were three orders of magnitude higher than those in plasma. The CSF pharmacokinetics of morphine sulfate and DADL are similar, with supraspinal redistribution of these opioids via the CSF likely playing an important role in the generation of analgesia and central nervous system side effects.

show abstract

Injektions- und Infusionstechnik

Böhme¹

1993

Portkathetersysteme

View full text Add to dashboard Cite

Low-Dose Infusion of Morphine Prevents Respiratory Depression

Cited by 12 publications

References 4 publications

Apnoea and Oximetric Desaturation in Patients Receiving Epidural Morphine after Gastrectomy: A Comparison of Intermittent Bolus and Patient Controlled Administration

Apnoea and Oximetric Desaturation in Patients Receiving Epidural Morphine after Gastrectomy: A Comparison of Intermittent Bolus and Patient Controlled Administration

Cerebrospinal fluid pharmacokinetics of intrathecal morphine sulfate and D‐Ala²‐D‐Leu⁵‐enkephalin

Injektions- und Infusionstechnik

Contact Info

Product

Resources

About

Low-Dose Infusion of Morphine Prevents Respiratory Depression

Cited by 12 publications

References 4 publications

Apnoea and Oximetric Desaturation in Patients Receiving Epidural Morphine after Gastrectomy: A Comparison of Intermittent Bolus and Patient Controlled Administration

Apnoea and Oximetric Desaturation in Patients Receiving Epidural Morphine after Gastrectomy: A Comparison of Intermittent Bolus and Patient Controlled Administration

Cerebrospinal fluid pharmacokinetics of intrathecal morphine sulfate and D‐Ala2‐D‐Leu5‐enkephalin

Injektions- und Infusionstechnik

Contact Info

Product

Resources

About

Cerebrospinal fluid pharmacokinetics of intrathecal morphine sulfate and D‐Ala²‐D‐Leu⁵‐enkephalin