Analgesic effect of intraarticular morphine. A controlled, randomised and double‐blind study

Christensen, Ole; Christensen, Peter; Sonnenschein, C.; Nielsen, Per Peetz; Jacobsen, Stig T.

doi:10.1111/j.1399-6576.1996.tb04543.x

Cited by 19 publications

(7 citation statements)

References 14 publications

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“…Studies conducted using single emission computed tomography (SPECT) and PET techniques have revealed cerebral perfusion and metabolic abnormalities in opiatedependent subjects (e.g., Christensen et al 1996;Danos et al 1998;Galynker et al 2000;Kaufman et al 1999;Krystal et al 1995;Levin et al 1995;London et al 1989;Rose et al 1996;Stapleton et al 1995). These abnormalities may contribute to the behavioral and functional deficits found in this population.…”

Section: Neuroimagingmentioning

confidence: 95%

“…Phosphorus magnetic resonance spectroscopy ( 31 P MRS) permits the quantification of high-energy phosphate compounds (e.g., phosphocreatine (PCr and nucleoside triphosphate (BNTP), which primarily reflects adenosine triphosphate (ATP) in brain); phospholipid metabolites (membrane anabolites and catabolites) and inorganic phosphate (Pi). This imaging technique has been used to detect abnormal cerebral bioenergetic and phospholipid metabolism in cocaine-and opiate-dependent subjects (Christensen et al 1996) and in opiate-dependent subjects examined after extended periods of MM (Christensen et al 1996;Kaufman et al 1999). The abnormalities included lower levels of PCr, which acts as buffer to maintain consistent levels of brain ATP, and elevated levels of phospholipid membrane precursors (phosphomonoesters) and break-down products (phosphodiesters).…”

Section: Neuroimagingmentioning

confidence: 99%

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Neuropsychological Consequences of Opiate Use

2007

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Approximately 3.7 million individuals have used heroin and other opiate substances in their lifetime. Despite increasing knowledge of the effects of heroin, it remains the most abused opiate and use among adults has recently increased. The empirical literature examining the neurocognitive effects of acute and chronic opioid use remains limited; however, findings to date suggest that the use of opiates has both acute and long-term effects on cognitive performance. Neuropsychological data indicate deficits in attention, concentration, recall, visuospatial skills and psychomotor speed with both acute and chronic opioid use. The long-term effects of opiate use appear to have the greatest impact on executive functions, including the ability to shift cognitive set and inhibit inappropriate response tendencies. Factors that contribute to addiction and recovery are also discussed, as it is difficult to disentangle the effects of opiate use on cognitive performance from other factors that may affect neurobehavioral measures.

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Section: Neuroimagingmentioning

confidence: 95%

Section: Neuroimagingmentioning

confidence: 99%

Neuropsychological Consequences of Opiate Use

2007

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“…Anmerkung: Seit der Fertigstellung des Manuskriptes wurden 3 weitere Arbeiten zum Thema in die Literaturdatenbank "Medline ® on SilverPlatter" aufgenommen (1997 edition) [8,12,33]. Diese Arbeiten bieten keinen Anlaß, die im Manuskript getroffenen Aussagen zu revidieren.…”

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“…Allerdings konnte eine weitere Arbeit aus China (gleiche Arbeitsgruppe, s. [18]) Opioidwirkungen nach Spinalanästhesie zeigen [33]. Die beiden anderen Arbeiten nach Allgemeinanästhesie waren einmal "pro" [12] und einmal "contra" [8].…”

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Klinische Studien zur peripheren Wirksamkeit von Opioiden nach Kniegelenk-Operationen

Meiser

Laubenthal

1997

Der Anaesthesist

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In this article 34 randomized controlled trials examining peripherally mediated opioid effects after knee surgery are discussed. All studies examined small doses of morphine injected intraarticularly at the end of knee surgery, but not all studies did show an analgesic effect of the peripheral opioid. Because of differing study designs a meta-analysis of the data is not possible. Some important factors like those that the respective authors try to explain the contradictory results with are discussed here: The used concentrations, volumes and doses of morphine are not of major importance. An addition of adrenaline to the study drug, as well as the use of a tourniquet and the time interval between the intra-articular injection and tourniquet release do not seem crucial either. The use of intra-articular drainage (which is opened 10 min after injection of the study drug) and of patient-controlled analgesia as an evaluative method also do not seem to play a major role. But it is remarcable that peripheral opioid effects have often been described after general and local anesthesia but only once after regional anaesthesia. It may be that the activation or expression of peripheral opioid receptors is inhibited by the blockade of input to the central nervous system. Animal experiments are needed to clarify this issue. But it may also be that postoperative pain after regional anaesthesia does not reach a level high enough to make an analgesic effect measurable. If patients after regional anesthesia are not considered, 20 studies out of 29 were able to demonstrate opioid effects whereas 9 were not: The work of Heard and coll. as well as Ruwe and coll. must be criticized because of methodological shortcomings. In the remaining 7 studies the patients of the comparative groups only show low pain scores which may make it impossible to measure an analgesic effect by intraarticular morphine. In summary it can be concluded that very small doses of morphine injected intra-articularly after knee surgery do exert an analgesic effect. In some studies this effect lasted even up to 48 h. But at least during the first two hours the effect is small or else doubtfull. Therefore a combination with bupivacain, a local anesthetic which acts rapidly but only for some hours can be recommended. Most authors testing this combination found it most useful.

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“…O conhecimento do metabolismo dos opioides é de fundamental importância para a segurança do paciente quando da utilização destes (TEGEDER et al, 2003), o que pode explicar a eficácia desta classe de medicamento em pacientes submetidos a cirurgia ortopédica quando da sua administração por via intra-articular (HRISTENSEN et al, 1996;REUBEN et al, 1998;HANNA et al, 2005;BINNING et al, 2003).…”

Section: Metabolismo Dos Opioidesunclassified

Comparação dos efeitos do sufentanil e da clonidina administrados por via endovenosa para sedação em pacientes submetidos a cateterismo cardíaco

Rocha¹

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A A A Aquele que possui a sinceridade não se limita a quele que possui a sinceridade não se limita a quele que possui a sinceridade não se limita a quele que possui a sinceridade não se limita a realizar a perfeição de si mesmo. Com essa realizar a perfeição de si mesmo. Com essa realizar a perfeição de si mesmo. Com essa realizar a perfeição de si mesmo. Com essa qualidade completa também os outros homens e qualidade completa também os outros homens e qualidade completa também os outros homens e qualidade completa também os outros homens e coisas. O completar coisas. O completar coisas. O completar coisas. O completar----se a si mesmo mostra a sua se a si mesmo mostra a sua se a si mesmo mostra a sua se a si mesmo mostra a sua perfeita virtude. O completar aos outros homens e perfeita virtude. O completar aos outros homens e perfeita virtude. O completar aos outros homens e perfeita virtude. O completar aos outros homens e coisas m coisas m coisas m coisas mostra o seu conhecimento. Estas são duas ostra o seu conhecimento. Estas são duas ostra o seu conhecimento. Estas são duas ostra o seu conhecimento. Estas são duas virtudes que correspondem à natureza, este o modo virtudes que correspondem à natureza, este o modo virtudes que correspondem à natureza, este o modo virtudes que correspondem à natureza, este o modo pelo qual se efetua uma união no exterior e no pelo qual se efetua uma união no exterior e no pelo qual se efetua uma união no exterior e no pelo qual se efetua uma união no exterior e no interior. AGRADECIMENTOSA realização deste trabalho só foi possível graças a colaboração direta ou indireta de muitas pessoas. Manifesto a todas elas a minha gratidão e, em particular:• aos meus irmãos, Antonio Miranda Rocha Júnior, Anício MarcelCarvalho Rocha e Aparecida Gabriela Carvalho Rocha, que me ensinaram a compartilhar e a dividir todas as minhas conquistas;• aos meus mestres que confiaram em mim e me incentivaram a buscar o melhor, particularmente ao Prof. Lino Lemônica e ao amigo Jedson da Silva Nascimento;• a todos os amigos e funcionários do Hospital Santa Izabel que ajudaram na realização deste trabalho, principalmente a equipe da hemodinâmica;• aos amigos do Grupo de Anestesiologia do Hospital Santa Izabel, pela compreensão e auxílio nos momentos que precisei me ausentar das minhas atividades profissionais em Salvador para a realização deste trabalho;• à amiga Lilian Mendes de Vasconcelos pela amizade e por todo o tempo que esteve envolvida na realização desta pesquisa;• aos funcionários da secretaria e do serviço de computação do Introdução e Literatu Introdução e Literatu Introdução e Literatu Introdução e Literatura ra ra ra 10 10 10 10 LISTA DE FIGURAS ABSTRACTBackground and objectives -Sedation for cardiac catheterization, although

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Analgesic effect of intraarticular morphine. A controlled, randomised and double‐blind study

Abstract: The clinical analgesic effect of 5 mg morphine given intraarticularly is equal to 5 mg morphine given intramuscularly. The occurrence of villous synovitis seems to be of no clinical importance concerning the local effect of morphine.

Cited by 19 publications

References 14 publications

Neuropsychological Consequences of Opiate Use

Neuropsychological Consequences of Opiate Use

Klinische Studien zur peripheren Wirksamkeit von Opioiden nach Kniegelenk-Operationen

Comparação dos efeitos do sufentanil e da clonidina administrados por via endovenosa para sedação em pacientes submetidos a cateterismo cardíaco

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