Narcotic Analgesics and Delayed Gastric Emptying During Labour

Nimmo, W.S.; Wilson, John A.; Prescott, L. F.

doi:10.1016/s0140-6736(75)91687-6

Cited by 272 publications

(75 citation statements)

References 8 publications

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“…For example, morphine prevents adequate absorption of an orally administered anti-arrhythmic drug in patients who have suffered myocardial infarction (Pottage & Prescott, unpublished observations). This action of narcotics appears to be shared by analogues such as pentazocine and is not reversible with metoclopramide (Nimmo et al, 1975). The present findings relate only to the period beginning 30 min after administration of the narcotic and may correspond to the later inhibitory phase of morphine's action on gastric motility observed by Crone & Ardran (1957).…”

Section: Discussionsupporting

confidence: 51%

“…The data imply that the slow absorption of paracetamol previously observed in women in labour (Nimmo et al, 1975) can almost certainly be attributed entirely to delayed gastric emptying produced by administration of narcotic analgesics. In previous reports describing delayed gastric emptying in women during labour, the role of narcotics has not been considered (Davison, Davison & Hay, 1970;Howard & Sharp, 1973).…”

Section: Discussionmentioning

confidence: 60%

See 1 more Smart Citation

Inhibition of gastric emptying and drug absorption by narcotic analgesics.

Nimmo¹,

Heading²,

Wilson³

et al. 1975

Brit J Clinical Pharma

254

115

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 60%

Inhibition of gastric emptying and drug absorption by narcotic analgesics.

Nimmo¹,

Heading²,

Wilson³

et al. 1975

Brit J Clinical Pharma

254

115

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show abstract

“…Metoclopramide is also a gastric prokinetic drug, but its efficacy in reversing the delay in gastric emptying due to opioids may be less (Nimmo et al, 1975a). No direct comparison has been made of the effect of cisapride and metoclopramide, when given with a morphine premedication, on the rate of gastric emptying shortly after the premedication.…”

Section: Introduction Methodsmentioning

confidence: 99%

Comparison of the effect of cisapride and metoclopramide on morphine‐ induced delay in gastric emptying.

Rowbotham

Bamber

Nimmo

1988

Brit J Clinical Pharma

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1. The effects of metoclopramide or cisapride on morphine‐induced delay in gastric emptying in patients before surgery were compared. 2. Forty patients were allocated randomly to receive one of four premedications i.m.: placebo only, morphine 10 mg alone, morphine 10 mg with metoclopramide 10 mg and morphine 10 mg with cisapride 10 mg. Gastric emptying after each premedication was assessed indirectly from the rate of absorption of oral paracetamol. 3. Cisapride 10 mg reversed the delay in gastric emptying due to morphine. Its effects were significantly greater than those of metoclopramide 10 mg.

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“…This study suggested an increase in vomiting during the medication compared with baseline. This finding is not surprising as it is known that opioid analgesia interferes with emptying of the stomach (Nimmo et al 1975). During the current studies, eating was not forbidden, but there is no record of what was actually ingested.…”

Section: Nausea Vomiting and Other Maternal Side Effectsmentioning

confidence: 58%

Intravenous patient-controlled analgesia with remifentanil in early labour

Volmanen¹

2011

Acta Anaesthesiologica Scandinavica

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Cover design Raimo Ahonen JUVENES PRINT TAMPERE 2010Volmanen, Petri, Intravenous patient controlled analgesia with remifentanil in early labour. AbstractIn four prospective clinical trials, 114 parturients used intravenous patient-controlled remifentanil analgesia during the 1 st stage of labour. The median effective dose per bolus was ascertained to be 0.4 μg/kg and the pain scores were reduced with this by a median of 2 on a numerical scale (0-10). Compared with nitrous oxide, 15 parturients included in a cross-over study reported a larger reduction in pain scores during remifentanil analgesia (1.5 vs. 0.5, p = 0.001) and better pain relief scores (2.5 vs. 0.5 on a ranked five point scale 0-4, p < 0.001). In a parallel study including 45 parturients, epidural analgesia (EDA, 20 ml bupivacaine 0.625 mg/ml and fentanyl 2 μg/ml) was associated with lower pain scores (5.2 vs. 7.3 with remifentanil, p = 0.004) but variables related to satisfaction with analgesia (pain relief score, proportion of mothers with desire to continue with the given medication and termination of the study due to inadequate pain relief) were similar. A comparison of two methods for timing the remifentanil bolus during the uterine contraction cycle suggested that delaying the bolus does not improve analgesia. A period effect was noted in the cross-over trial with higher pain scores and increased drug consumption during the second study period suggesting acute hyperalgesia.Side effects of remifentanil analgesia included respiratory depression warranting oxygen supplementation in 33% of parturients. Sedation was experienced by the parturients using remifentanil and this was scored as stronger than sedation during nitrous oxide and EDA. The number of parturients with nausea did not increase during remifentanil analgesia. Other maternal side effects included dizziness, a difficulty in visual focusing and itching. Foetal heart rate tracing abnormalities were noted. The incidence of abnormal tracings and decreased UapH were not different, however, from that observed during nitrous oxide or EDA. Apgar scores at 1 and 5 minute indicated no neonatal depression. Keywords

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Narcotic Analgesics and Delayed Gastric Emptying During Labour

Cited by 272 publications

References 8 publications

Inhibition of gastric emptying and drug absorption by narcotic analgesics.

Inhibition of gastric emptying and drug absorption by narcotic analgesics.

Comparison of the effect of cisapride and metoclopramide on morphine‐ induced delay in gastric emptying.

Intravenous patient-controlled analgesia with remifentanil in early labour

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