Epidural diamorphine and fentanyl for postoperative pain

Houlton, P.G.; Reynolds, F.

doi:10.1111/j.1365-2044.1981.tb08706.x

Cited by 29 publications

(3 citation statements)

References 13 publications

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“…A wide range of opioid dosages have been used either alone or in combination with bupivacaine via the epidural route. Most studies have given an opioid bolus and assessed the analgesic effect and the duration of action [3,4,7,9,14,[16][17][18][19][20][21][22][23]. From these data we calculated approximately equipotent 24-h dosages for each drug.…”

Section: Discussionmentioning

confidence: 99%

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Gedney

Liu

1998

Anaesthesia

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SummaryThe incidence of side-effects occurring with epidural diamorphine (0.05 mg.ml ¹1 ), fentanyl (2.0 mg.ml ¹1 ), methadone (0.1 mg.ml ¹1 ), morphine (0.05 mg.ml ¹1 ) and pethidine (1.0 mg.ml ¹1 ) used by infusion in combination with bupivacaine has been compared. One hundred and sixty patients were studied, 32 receiving each opioid. The incidence of nausea and vomiting was significantly greater with morphine than fentanyl (p ¼ 0.0097) and pethidine (p ¼ 0.0021). The incidence of pruritis was significantly greater with morphine and diamorphine than with methadone (p ¼ 0.012) and pethidine (p ¼ 0.027). Morphine was also associated with a significantly greater incidence of urinary retention than pethidine (p ¼ 0.012) and methadone (p ¼ 0.025).

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Section: Discussionmentioning

confidence: 99%

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Gedney

Liu

1998

Anaesthesia

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“…Onset of motor blockade was assessed at 5-minute intervals till 30 mins (i.e. B5, B10, B15, B20, B25 and B30) accordingtotheModifiedBromageScale [6]…”

Section: Time For Maximum Sensory Blockadementioning

confidence: 99%

Comparative Evaluation of Tramadol and Fentanyl for Epidural Analgesia in Lower Limb Surgeries

Singhl¹,

Jindal²,

Singh³

2020

IJAR

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Background:Epiduralandspinalblocksaremajorregionaltechniques with along history of effectiveuseforavarietyofsurgicalprocedures and pain relief. Epidural block with the catheter technique gives a better control of the level of analgesia and can be used for providingpost-operativepainreliefbyopioidsorlocalanaestheticagents.The purposeofthepresentstudywastocomparethe safetyandefficacyofepiduraltramadolversusepiduralfentanylas adjuvantstobupivacaineforlowerlimbsurgeries. Materials and methods:100 patients werer an domisedin to two groups with50 patient sineach group: Group BB-epidural administration of 20mL 0.5% plain bupivacaine with [50 mg (1 mL) tramadol + 1 mL NS= 2 mL].Group BF- epidural administration of 20 mL 0.5% plain bupivacainewith100mcg(2mL)of fentanyl.Settings and Design- Randomised double-blind trial. Results:The mean onset of sensory blockade and time for maximum sensory blockade was observed to be significantly reduced with the addition of fentanyl to bupivacaine as compared to tramadol and bupivacaine. The results showed statistically significant increase in the duration of analgesia with the addition of fentanyl to bupivacaine as compared to tramadol and bupivacaine. Conclusion:We can conclude that tramadol and fentanyl were effective adjuvants to bupivacaine when used epidurally in patients undergoing lower limb surgery. Although, epidural fentanyl with bupivacaine produces significantly faster onset of sensory blockadecompared to epiduralhowever,epiduraltramadolwithbupivacaineproducessignificantlyprolonged durationofanalgesiacomparedtoepiduralfentanyl.

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“…Although the abuse liability of the p opiate receptors is a major complication in using these substances as analgesics, their efficacy in producing sedation and analgesia has resulted in their continued clinical effectiveness in treating severe pain (i.e., postoperative surgical procedures; oncologically derived pain) (Houlton and Reynolds, 1983). The fentanyl derivatives are widely used in surgical procedures because of their short-term effectiveness, lack of respiratory depression, and rapid patient recovery.…”

Section: L3hlcarfentanil Autoradiographymentioning

confidence: 99%

Quantitative autoradiographic analysis of [³H]carfentanil binding to mu opiate receptors in the rat brain

Fitzgerald

Teitler

1993

Synapse

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Fentanyl and its derivatives are considered among the most potent opiate analgesic/euphoriants. The pharmacological literature generally supports a mu opiate receptor site of action for the fentanyl derivatives, but some observations suggest that other sites of action may be involved in producing the extremely potent fentanyl effects. In order to investigate the mechanism of action of fentanyl-like drugs further, [3H]carfentanil was used as a radioligand to image high-affinity carfentanil binding sites in slidemounted sections of the rat brain (receptor autoradiography). In parallel studies the prototypical mu opiate agonist radioligand [3H]DAMGO ([D-Ala2-MePhe4-Gly-ol5]enkephalin) was also used. The working hypothesis was that if carfentanil was acting through another high-affinity site besides the mu opiate receptor, the distribution pattern of the autoradiographic image produced by [3H]carfentanil should be significantly different than the autoradiographic pattern displayed by the well-characterized and selective mu opiate [3H]DAMGO. Thirty-five brain regions were examined for specific [3H]carfentanil and [3H]DAMGO binding. The absolute and relative densities of the sites were essentially identical. The highest levels of binding were observed in the "patch" areas of the striatum (131 +/- 5 fmol/mg T.E. for [3H]carfentanil; 162 +/- 13 fmol/mg T.E. for [3H]DAMGO). The lowest levels were observed in the cerebellum where no specific binding of either radioligand was observed. The overall distribution pattern of the two radioligands produced a correlation coefficient of 0.95; the distribution pattern was prototypical for the mu opiate receptor as reported previously by other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

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Epidural diamorphine and fentanyl for postoperative pain

Cited by 29 publications

References 13 publications

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Comparative Evaluation of Tramadol and Fentanyl for Epidural Analgesia in Lower Limb Surgeries

Quantitative autoradiographic analysis of [³H]carfentanil binding to mu opiate receptors in the rat brain

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Epidural diamorphine and fentanyl for postoperative pain

Cited by 29 publications

References 13 publications

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Side‐effects of epidural infusions of opioid bupivacaine mixtures

Comparative Evaluation of Tramadol and Fentanyl for Epidural Analgesia in Lower Limb Surgeries

Quantitative autoradiographic analysis of [3H]carfentanil binding to mu opiate receptors in the rat brain

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Quantitative autoradiographic analysis of [³H]carfentanil binding to mu opiate receptors in the rat brain