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Postoperative analgesic efficacy of intrathecal and epidural morphine with different doses in gynecological patients
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POSTOPERATIVEANALGESIC EFFICACY OF INTRATHFCALAND EPIDURALMORPHINE WITH DIFFERENTDOSES IN GYNECOLOGICALPATIENTS. K.Fukushimaand M.NakamurafDept of Anesthesiology,National Defense Medical College, Tokorozawa,Saitama, 359, Japan
Poster 259
1
BLUE Mon-Tues 1 ExhibitHall Abs No
302
AIM OF INVESTIGATION: There are still remainingmany controversial j questionsof benefit/ disadvantageratio on intraspinaland epidural opioid administration for managementof postoperativepain. This study was designed to investigatethe doseefficacy relationshipof spinal(S)and epidural(E)morphine for the treatmentof postoperativepain and to determine the optimal dose for obtainingadequate pain relief without side effects. METHODS: The studied population(451gynecologicalpatients)was divided into two groups which are spinal group(SG)and epidural group(EG).SG recieved O.O5mg, O.lmg, O.lmg, and 0.5mg morphine respectively,and EG recieved 0.5mg, l.Omg, 2.Omg, and 4.Omg morphine respectively.Pain score with 4 rank scale, dosage of pentazocinefor releif of postoperativepain, respiratoryrate, minute volume, arterial blood gas, blood pressure, heart rate, and side effect were observed.Also the concentrationof morphine in cerebrospinal fluid(CSF)was determinedby radioimmunoassay method. RESULTS: In SG pain score was significantlylower than that of control group(P
ANALGESIC POTENCIES RELATIVE TREATMENT OF ACUTE PAIN1 J. Chrubasik, F. Magora
OF
EPIDURAL
OPIATES
IN
Departments of Anestpesiology, University Hospital, CH 8091 Zurich Switzerland; Hadassah University, Jerusalm, Israel
Poster 260 BLUE Mon-Tues
ExhibitHall Abs No
303
Aim of Investigation. To evaluate the relative analgesic potencies (RAF) of various opiates in treatment of pain after abdominal surgery. Methods. In 270 patients (age range 25 - 83 yrs) following abdominal surgery under combined general and regional anesthesia, epidural opiates (morphine - mo, n = 107: buprenorphine - bup, n = 17; fentanyl - fen, n = 20; alfentanil - alf, n = 20; tramadol - tra, n = 21; methadone - meth, n = 85) titrated to the patient s individual need for analgesics. Opiate consumption (mg) up to 8 p.m. on the 2nd postoperative day was recorded. The opiate RAFs were calculated by the ratio opiate/morphine consumption. hup 8, The opiate RAFs (AP MO = 1) were calculated as follows: Results. fen 10, alf 1, tra 0.03, meth 0.5. significantly results show that the opiate RAFs differ Our Discussion. opiate lipophilicities and due to the morphinethe different due to varying opiate receptor affinities, opiate receptor specificities and opiate of the patients complained of None characteristics. bindings receptor
adverse effects which would warrant discontinuing the postoperative opiate titration treatments. The method is especially indicated when an epidural catheter has already been placed for intraoperative use.
,
POSTOPERATIVEANALGESIC EFFICACY OF INTRATHFCALAND EPIDURALMORPHINE WITH DIFFERENTDOSES IN GYNECOLOGICALPATIENTS. K.Fukushimaand M.NakamurafDept of Anesthesiology,National Defense Medical College, Tokorozawa,Saitama, 359, Japan
Poster 259
1
BLUE Mon-Tues 1 ExhibitHall Abs No
302
AIM OF INVESTIGATION: There are still remainingmany controversial j questionsof benefit/ disadvantageratio on intraspinaland epidural opioid administration for managementof postoperativepain. This study was designed to investigatethe doseefficacy relationshipof spinal(S)and epidural(E)morphine for the treatmentof postoperativepain and to determine the optimal dose for obtainingadequate pain relief without side effects. METHODS: The studied population(451gynecologicalpatients)was divided into two groups which are spinal group(SG)and epidural group(EG).SG recieved O.O5mg, O.lmg, O.lmg, and 0.5mg morphine respectively,and EG recieved 0.5mg, l.Omg, 2.Omg, and 4.Omg morphine respectively.Pain score with 4 rank scale, dosage of pentazocinefor releif of postoperativepain, respiratoryrate, minute volume, arterial blood gas, blood pressure, heart rate, and side effect were observed.Also the concentrationof morphine in cerebrospinal fluid(CSF)was determinedby radioimmunoassay method. RESULTS: In SG pain score was significantlylower than that of control group(P
ANALGESIC POTENCIES RELATIVE TREATMENT OF ACUTE PAIN1 J. Chrubasik, F. Magora
OF
EPIDURAL
OPIATES
IN
Departments of Anestpesiology, University Hospital, CH 8091 Zurich Switzerland; Hadassah University, Jerusalm, Israel
Poster 260 BLUE Mon-Tues
ExhibitHall Abs No
303
Aim of Investigation. To evaluate the relative analgesic potencies (RAF) of various opiates in treatment of pain after abdominal surgery. Methods. In 270 patients (age range 25 - 83 yrs) following abdominal surgery under combined general and regional anesthesia, epidural opiates (morphine - mo, n = 107: buprenorphine - bup, n = 17; fentanyl - fen, n = 20; alfentanil - alf, n = 20; tramadol - tra, n = 21; methadone - meth, n = 85) titrated to the patient s individual need for analgesics. Opiate consumption (mg) up to 8 p.m. on the 2nd postoperative day was recorded. The opiate RAFs were calculated by the ratio opiate/morphine consumption. hup 8, The opiate RAFs (AP MO = 1) were calculated as follows: Results. fen 10, alf 1, tra 0.03, meth 0.5. significantly results show that the opiate RAFs differ Our Discussion. opiate lipophilicities and due to the morphinethe different due to varying opiate receptor affinities, opiate receptor specificities and opiate of the patients complained of None characteristics. bindings receptor
adverse effects which would warrant discontinuing the postoperative opiate titration treatments. The method is especially indicated when an epidural catheter has already been placed for intraoperative use.
,