Sex- and Age-related Differences in Morphine Requirements for Postoperative Pain Relief

Aubrun, Frédéric; Salvi, Nadège; Coriat, Pierre; Riou, Bruno

doi:10.1097/00000542-200507000-00023

Cited by 231 publications

(156 citation statements)

References 33 publications

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“…Interestingly such difference was no more present for patients older than 60 y [10]. Study by Auburn F et al, [11] with 4,317 patients, intravenous morphine titration was administered as a bolus of 2 (body weight <or= 60 kg) or 3 mg (body weight > 60 kg) during the immediate postoperative period at 5 minutes interval. The mean morphine dose required to obtain pain relief was 11.9 +/-6.8 mg. Women had a higher initial VAS score and required a greater dose.…”

Section: Discussionmentioning

confidence: 99%

Influences of Gender on Postoperative Morphine Consumption

Periasamy

Poovathai

Pondiyadanar

2014

JCDR

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Section: Discussionmentioning

confidence: 99%

Influences of Gender on Postoperative Morphine Consumption

Periasamy

Poovathai

Pondiyadanar

2014

JCDR

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“…Elderly patients require lower doses of opioids compared to young patients [7]. Thus for their careful titration it is necessary to avoid unwanted side effects such as: increased sedation, confusion, nausea, vomiting, ileus, hypotension, and respiratory depression [8].…”

Section: Doi: 102478/prilozi-2014-0011mentioning

confidence: 99%

Continuous Femoral Nerve Block Versus Fascia Iliaca Compartment Block as Postoperative Analgesia in Patients with Hip Fracture

Temelkovska-Stevanovska

Durnev

Jovanovski-Srceva

et al. 2014

Prilozi

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Introduction: Systemic postoperative analgesia is inefficient in most patients with hip fracture, which is the reason for pain, especially during leg movement. Peripheral and plexus nerve blocks are an efficient option for postoperative pain relief. The aim of this study was to compare the effect and duration of continuous FNB versus a single FIC block as a postoperative analgesia in patients with hip fracture. Methods: Sixty patients with hip fracture were included and were randomly assigned to two groups of 30 patients: FNB group -patients with continuous femoral nerve block; and FIC group -patients with a single fascia iliaca compartment block. In all patients, pain intensity was measured at rest and in passive leg movement by using VDS (0-4) at several intervals: 1, 2, 12, 24, 36 and 48 hours after intervention. The amount of supplemental analgesia was measured, together with the time when the patient needed it for the first time, as well as the side effects. Results: The values of VDS were significantly lower in patients with FNB block versus patients with FIC block in rest and movement at the 24-hour intervals (46.67% vs 0% felt moderate pain), after 36 hours (43.33% vs 0% felt moderate pain) and 48 hours after intervention (46.67% vs 3.33% felt moderate to severe pain) for p < 0.05. Patients with FNB block received a significantly lower amount of supplemental analgesia, 23.3% of the FNB group vs 50% of the FIC group (p < 0.05). Registered side effects were were nausea, dizziness and sedation, and they were statistically significantly more frequent in the FIC group (p < 0.05). Conclusion: Pain relief in the postoperative period was superior in the FNB group versus the FIC group at rest and in movement in patients with hip fracture.

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“…For example, women experience more severe post-operative pain and require more morphine than men to achieve a similar degree of analgesia (Cepeda and Carr, 2003;Aubrun et al, 2005). This may be due, in part, to a decrease in µ-opioid receptor availability and suppression of endogenous opioid responses to pain during low oestrogen states (Zubieta et al, 2002;Smith et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Negative affect, pain and sex: The role of endogenous opioids

Frew

Drummond

2007

Pain

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Opioid neurotransmission modulates pain and negative affect during psychological stress.To determine whether these effects differ between men and women, the opioid receptor antagonist naltrexone or placebo was administered double-blind to 21 men and 22 women before they completed 30 minutes of difficult mental arithmetic. To heighten negative affect, participants received seven moderately noxious electric shocks during the math task, which were believed to be contingent upon performance. Before and after the math task, participants rated pain intensity and unpleasantness while their left hand was immersed in 2 o C water for up to 4 minutes. Anxiety, discouragement and anger were also rated before, during and after the math task. Tolerance of cold-induced pain was greater in men, whereas discouragement during the math task was greater in women. Opioid blockade did not influence ratings of negative affect, which increased in line with the intensity and unpleasantness of shock-induced pain. The intensity and unpleasantness of cold-induced pain increased after the math task only in women administered naltrexone.Within the naltrexone condition, pain ratings increased most in the most discouraged subjects. However, this relationship was absent in placebo recipients, implying that the hyperalgesic effect of psychological distress was tempered by opioid release. Greater stress-evoked discouragement in women than men may explain why cold-induced pain increased after the math task only in women administered naltrexone.

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Sex- and Age-related Differences in Morphine Requirements for Postoperative Pain Relief

Cited by 231 publications

References 33 publications

Influences of Gender on Postoperative Morphine Consumption

Influences of Gender on Postoperative Morphine Consumption

Continuous Femoral Nerve Block Versus Fascia Iliaca Compartment Block as Postoperative Analgesia in Patients with Hip Fracture

Negative affect, pain and sex: The role of endogenous opioids

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