Morphine Anesthesia for Open-Heart Surgery

Hasbrouck, Jan D.

doi:10.1016/s0003-4975(10)65614-7

Cited by 66 publications

(3 citation statements)

References 6 publications

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“…However, an anti-diuretic hormone response remained during morphine anaesthesia (Philbin et al, 1976). Morphine also produced significant increases in plasma adrenaline and noradrenaline concentrations which correlate with increases in arterial pressure and heart rate (Hasbrouk, 1970). Therefore, morphine anaesthesia modifies, but does not abolish, the endocrine response to surgery.…”

Section: Discussionmentioning

confidence: 98%

Hormonal Responses to High-Dose Fentanyl Anaesthesia

Sebel¹,

Bovill²,

Schellekens

et al. 1981

British Journal of Anaesthesia

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The hormonal responses to anaesthesia and cardiac surgery were studied in 20 patients. Ten patients were anaesthetized with fentanyl 60 microgram kg-1 and nitrous oxide in oxygen and 10 with etomidate 0.3 mgkg-1 and nitrous oxide in oxygen plus halothane. There were no significant changes in cortisol, growth hormone or insulin concentrations in response to surgery in either group, although cortisol concentrations decreased during cardiopulmonary bypass. Both groups showed increases in prolactin concentrations. Patients anaesthetized with etomidate and halothane showed a significant increase in adrenaline and glucose concentrations not seen in the fentanyl group. Cardiopulmonary bypass was associated with marked increases in catecholamines in both groups.

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Section: Discussionmentioning

confidence: 98%

Hormonal Responses to High-Dose Fentanyl Anaesthesia

Sebel¹,

Bovill²,

Schellekens

et al. 1981

British Journal of Anaesthesia

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“…There are no observations to contradict this conclusion (Eckenhoff and Oech, 1960). On the contrary, when large doses of morphine (0.5-3.0 mg/kg) were given to patients with cardiac disease, remarkable circulatory stability was reported (Lowenstein et al, 1969;Hasbrouck, 1970) and detailed analysis of myocardial function showed no evidence of depression. These doses of morphine have now been recommended for use in patients with poor myocardial reserve and who are undergoing surgery.…”

Section: Direct Myocardial Depressionmentioning

confidence: 99%

Some Circulatory and Respiratory Effects of Morphine in Patients Without Pre-Existing Cardiac Disease

Samuel

Clarke

Dundee

1977

British Journal of Anaesthesia

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SUMMARYHaemodynamic and respiratory effects of i.v. morphine (10 mg/70 kg body weight) were studied in 10 adults with unimpaired circulatory function. There were significant changes in mean arterial pressure, mean heart rate, respiratory rate and tidal volume, at 10-, 30-and 60-min intervals. Transient changes in mean total systemic resistance and mean stroke volume were also seen at 10 min. The results strongly suggest a peripheral vasodilator response to morphine. Respiratory depression was not demonstrated.Although opium has been used from antiquity and despite the lack of knowledge of the precise haemodynamic effects of morphine, there are large amounts of data concerning the actions of narcotics on circulation and respiration (Kreuger, Eddy and Sumwalt, 1941;Eddy, Halbach and Braenden, 1957;Reynolds and Randall, 1957). Many published studies show lack of appreciation of the importance of standardization of patient population regarding such factors as their mental and emotional state, physical condition, intensity of pain and type of anaesthesia. In many instances, concomitant respiratory depression secondary to administration of morphine had not been taken into account while assessing the haemodynamic effects. Sufficient attention had not been given to standardization of the dose (in relation to body size), the rate or even the site of injection. Moreover, many studies were undertaken when methods of measuring circulatory and respiratory changes were less accurate than those available today. Results from animal experiments have even been taken to represent a human response, disregarding the species difference.Since a review of published data on the cardiorespiratory effects of morphine failed to reveal a consistent pattern of response, it was felt that a re-evaluation of its cardiovascular effects, under rigidly controlled clinical conditions, would be both relevant and justifiable. The present study, therefore, is to assess the haemodynamic effeas of a clinically used dose (10 mg/70 kg body weight) of morphine, in patients with unimpaired circulatory function. This investigation not only provides a "baseline" for studies on patients with impaired cardiovascular

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“…Se sabe poco de la anestesia de los comienzos de la cirugía cardiaca, pero posiblemente la primera referencia escrita se refiere a la anestesia para una comisurotomia mitral realizada en 1925 por RH. Ellis, en la que se utilizó morfina y atropina como premedicación, la inducción fue inhalatoria con una mezcla de alcohol-eter y cloroformo, y el mantenimiento con éter en respiración espontánea a través de una cánula traqueal[120] .En la década de los años 50 y 60, la "anestesia con morfina" fue técnica fundamental tanto para la "cirugía cardiaca a corazón abierto", como para el postoperatorio[121] .…”

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Estudio de los efectos térmicos de la sedación postoperatoria tras cirugía cardíaca con circulación extracorpórea: Estudio comparativo entre la sedación intravenosa con propofol versus inhalatoria con sevofluorano

Ramos¹

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Morphine Anesthesia for Open-Heart Surgery

Cited by 66 publications

References 6 publications

Hormonal Responses to High-Dose Fentanyl Anaesthesia

Hormonal Responses to High-Dose Fentanyl Anaesthesia

Some Circulatory and Respiratory Effects of Morphine in Patients Without Pre-Existing Cardiac Disease

Estudio de los efectos térmicos de la sedación postoperatoria tras cirugía cardíaca con circulación extracorpórea: Estudio comparativo entre la sedación intravenosa con propofol versus inhalatoria con sevofluorano

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