A Double-Blind Controlled Study of the Effects on Respiration of Pentazocine, Phenoperidine, and Morphine in Normal Man

Jennett, Sheila; Barker, J.; Forrest, J. B.

doi:10.1097/00132586-197004000-00015

Cited by 14 publications

(24 citation statements)

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“…In the present investigation expired minute volume changed little from the control value. Our results are at variance with those of Jennet, Barker and Forrest (1968), who found a significant reduction of 30% in the expired minute volume in healthy volunteers following morphine 10 mg/70 kg given i.v. A difference in the rate of injection of morphine may partially explain this difference; Jennett and her colleagues injected the morphine over 2.5 min and the same quantity of the drug was injected over 5 min in the present study.…”

Section: Effects On Respirationcontrasting

confidence: 56%

“…However, the effects of morphine on breathing have been related to metabolism (Orkin, Egge and Rovenstine, 1955;Smith et al, 1967). Jennet, Barker and Forrest (1968) showed that a reduction in ventilation alone does not necessarily indicate respiratory depression, since ventilation could be expected to decrease if metabolic rate were to decrease. They found an average reduction of 20-30% in oxygen consumption within 10 min of the injection of morphine 10 mg/70 kg.…”

Section: Effects On Respirationmentioning

confidence: 99%

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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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Section: Effects On Respirationcontrasting

confidence: 56%

Section: Effects On Respirationmentioning

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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“…1) [Forrest & Bellville 1964]. The reduction in slope of ventilatory response to C02 is in a comparable range of around 40% for 1M injections of morphine lOmg (Jennett et al 1968), pethidine (meperidine) 75mg and pentazocine 60mg (Engineer & Jennett 1972).…”

Section: Respiratory Depressionmentioning

confidence: 83%

“…It is also difficult to apply the conventional tests for respiratory depression to patients in clinical settings, for they require not only familiarisation with the equipment, but also cooperation, and may be potentially hazardous. Finally, it must be considered that decreased ventilation does not necessarily indicate that ventilation is really depressed, but may also reflect reduced oxygen consumption, as shown by the injection of morphine lOmg (Jennett et al 1968). Therefore, blood gas estimations are crucial; adequacy of ventilation in a patient must be assessed by measurements of arterial partial C02 pressure, since p02 measurements depend on other factors such as the alveolar-arterial difference and ventilation-perfusion coefficient and are not as useful (Jordan 1982).…”

Section: Respiratory Depressionmentioning

confidence: 99%

Adverse Effects of Systemic Opioid Analgesics

Schug¹,

Zech²,

Grond³

1992

Drug Safety

143

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Adverse effects of opioids are multiple. They are most often receptor-mediated and inseparable from their desired effects. The most severe mishaps with opioids are related to their respiratory depressant effect, which is widely influenced by factors such as pain, previous opioid experience and awareness. Other relevant central nervous system effects of opioids include cough suppression, nausea and vomiting, rigidity, pruritus and miosis. The cardiovascular adverse effects of opioids are mainly related to histamine release and differ widely between agonists and agonist-antagonists. Gastrointestinal effects such as constipation, reflux and spasms of the bile duct are well described. Adverse effects on endocrine, immunological and haematological functions are possible, while allergic reactions are extremely rare. The adverse effects of long term use are overestimated. Systemic toxicity is negligible and development of tolerance is minimal while treating pain. In the clinical setting of pain control, addiction and withdrawal do not pose significant problems. Nevertheless, the possible effects of opioids on the unborn child should always be considered. Overall, opioids show a good record of safety. Their use should not be unduly limited by unfounded fears of adverse effects, but these effects should be avoided by anticipation and prevention.

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“…Many authors report that analgesic doses of narcotics cause a decrease in the slope of the VE,Co2 when measured by the RB technique (Jennett, Barker & Forest, 1968;Rebuck, 1976;Rigg, 1978). Our experience and that of others indicates that when measured by the SS technique, narcotics cause a parallel right shift in the VE,C02 (Prescott, Ransom, Thorp & Wilson, 1949;Loescheke, Sweel, Kough & Lambertsen, 1953;Jordan, 1982 RB determinations of the VE,C02 were made using a modification of Read's method (Rebuck, 1976).…”

Section: Introductionmentioning

confidence: 79%

The steady‐state and rebreathing methods compared during morphine administration in humans.

Bourke

Warley

1989

The Journal of Physiology

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SUMMARY1. We examined the quantitative and qualitative differences between the steadystate and rebreathing methods of determining C02-response curves before and after each of two doses of intravenous morphine (0 07 and 0-14 mg kg-') in four healthy male humans.2. During each study session steady-state and rebreathing C02-response curves were determined as an ordered pair (separated by 15 min). Carbon dioxide-response curves were determined for control, after 0 07 mg kg-' morphine, and after a total of 0-21 mg kg-1 morphine. Each subject was studied on a second occasion when the order of the C02-response pairing was reversed.3. The results are discussed and related to a model that may account for the differences based on the step increase in CO2 at the onset of rebreathing, the rate of rise of CO2 during rebreathing and the time constant for the central chemoreflex.4. Our empirical conclusion is that morphine causes a parallel right shift of the steady-state CO2-response curve and causes a non-specific decrease in the slope of the rebreathing C02-response curve. We suggest that the parallel shift of the steadystate C02-response curve is specific to drugs acting on opioid receptors.

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A Double-Blind Controlled Study of the Effects on Respiration of Pentazocine, Phenoperidine, and Morphine in Normal Man

Cited by 14 publications

References 0 publications

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

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

Adverse Effects of Systemic Opioid Analgesics

The steady‐state and rebreathing methods compared during morphine administration in humans.

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