Analgesic Action of Extradural Fentanyl

Wolfe, Melissa Joy; Davies, G.K.

doi:10.1093/bja/52.3.357-a

Cited by 60 publications

(12 citation statements)

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“…It could be argued that this was due to systemic absorption of sufentanil from the epidural depot. However, epidural fentanyl, with comparable lipid solubility and protein binding relieves pain at consistently lower serum levels than those known to be analgetic (27)(28)(29). Recent reports confirm similar findings after epidural sufentanil.…”

Section: Discussionmentioning

confidence: 70%

Epidural sufentanil for intra– and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil

Rosseel¹,

Broek²,

Boer³

et al. 1988

Acta Anaesthesiol Scand

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A comparative study was undertaken to evaluate the effectiveness of epidural sufentanil in providing intra- and postoperative analgesia during thoracic surgery. Sufentanil was chosen on the basis of its high lipid solubility and its potent opiate receptor binding. Epidural sufentanil was compared with intravenous sufentanil as the major intraoperative analgetic agent in an anesthesia regimen with midazolam and nitrous oxide. Epidural sufentanil significantly decreased the need for supplementary intravenous analgesia. In the epidural sufentanil group the immediate postoperative analgesia was found to be better, with a longer duration of action, compared with the intravenous sufentanil group. Postoperatively epidural sufentanil was compared with epidural morphine. Sufentanil provided good analgesia with a very fast onset and a mean duration of almost 7 h. Severe respiratory depression was observed in one patient within 1 h of extubation, probably due to the combined effects of the narcotic administration and residual midazolam. It is concluded that 50 micrograms of sufentanil administered in the thoracic epidural space provides valuable intraoperative analgesia which can easily be extended into the postoperative period, although all necessary precautions for epidural opiate administration should be taken.

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Section: Discussionmentioning

confidence: 70%

Epidural sufentanil for intra– and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil

Rosseel¹,

Broek²,

Boer³

et al. 1988

Acta Anaesthesiol Scand

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“…13,14 Rajni Gupta 2011. 4 Al-Ghanem SM 2009. 10 used dexmedetomidine and fentanyl as an adjuvant in subarachnoid block with Bupivacaine.…”

Section: Discussionmentioning

confidence: 99%

“…1 Dexmedetomidine, a more powerful and highly selective alpha-2 adrenoceptor agonist than clonidine and was introduced in clinical practice in 1999 and soon became popular for variety of indications in Anaesthesiology. 2,3,4 Various studies conducted that the addition of Dexmedetomidine or fentanyl to bupivacaine in epidural block offers acceptable level sedation and post-operative analgesia. It is important to compare post-operative analgesia and side effects of both drugs when administered by epidural route.…”

Section: Introductionmentioning

confidence: 99%

“…It is important to compare post-operative analgesia and side effects of both drugs when administered by epidural route. 4,5,6,7 The current prospective randomized double-blind study was undertaken in orthopaedic and pelvic surgical patients to evaluate the effectiveness of fentanyl and dexmedetomidine, acting by two different mechanisms administered by lumbar epidural route with 0.5% bupivacaine and complications associated with their use.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Effect of Fentanyl and Dexmedetomidine on Post-Operative Analgesia and Haemodynamics When Added to Bupivacaine 0.5% in Epidural Block for Pelvic and Lower Limb Orthopaedic Surgeries

Chakole¹,

Pandey²,

Joshi³

2016

jemds

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“…Since the introduction of epidural morphine for a long lasting relief of chronic and postoperative pain in human subjects (Behar et al 1979;Wang et al 1979) a large number of studies have been performed on the epidural application of other opiates (Wolfe & Davies 1980;Cousins et al 1979;Bromage et al 1980;Houlton & Reynolds 1981). However, the practice of this promising technique to achieve selective spinal analgesia has been limited by reports of several adverse reactions, the most alarming of which is a late occurring respiratory depression, and other side effects include pruritis and urinary retention (Davies et al 1980;Gjessing & Tomlin 1981;Reiz & Westberg 1980;Yaksh 1981).…”

mentioning

confidence: 99%

Intrathecal Morphine Induces Myoclonic Seizures in the Rat

Shohami

Evron

1985

Acta Pharmacologica et Toxicologica

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The development of myoclonic activity as a toxic effect of morphine application into the intrathecal space in rats is described. This syndrome resembled the human syndrome of action myoclonus by its spontaneous onset and its augmentation by initiation of movement or by an acoustic stimulus. It was not reversed or prevented by naloxone. This effect of morphine was associated with an increase in serotonergic activity in the spinal cord and was reduced by pretreatment with parachlorophenylalanine in doses which reduced spinal 5-HT by -60%. The dose which produced this syndrome was about ten times higher than the analgesic dose applied by the same route. Other commonly used opiates such as: methadone (0.5-2 mg/ kg), pethidine (2-10 mg/kg), fentanyl (2-10 pg/kg) and ketamine (2-10 mg/kg) did not produce myocloniclike activity, but methadone and pethidine at the highest doses caused respiratory arrest. Fentanyl appeared to be the safest of the drugs tested since a relatively high dose, administered into the intrathecal space did not cause any side effects, while morphine was least safe of the five drugs since it produced myoclonic activity in addition to the widely documented respiratory depression. We suggest that the production of the myoclonic activity is mediated by spinal serotonergic systems.

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Analgesic Action of Extradural Fentanyl

Cited by 60 publications

References 0 publications

Epidural sufentanil for intra– and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil

Epidural sufentanil for intra– and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil

Comparison of Effect of Fentanyl and Dexmedetomidine on Post-Operative Analgesia and Haemodynamics When Added to Bupivacaine 0.5% in Epidural Block for Pelvic and Lower Limb Orthopaedic Surgeries

Intrathecal Morphine Induces Myoclonic Seizures in the Rat

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