Epidural Morphine in Treatment of Pain

Behar, M; Olshwang, D.; Magora, F; Davidson, Julian M.

doi:10.1016/s0140-6736(79)90947-4

Cited by 592 publications

(116 citation statements)

References 7 publications

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“…5 * 2 6 Our findings that patients in group A had significantly higher end-tidal CO, concentrations and a persistent, albeit not significant, lower respiratory rate than patients in group B confirms this for fentanyl. It is our view that whenever the two routes of narcotic administration are combined, extremely careful monitoring of respiration is indicated.…”

Section: Discussionsupporting

confidence: 62%

Respiratory effects of epidural fentanyl

Ahuja

Strunin

1985

Anaesthesia

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Section: Discussionsupporting

confidence: 62%

Respiratory effects of epidural fentanyl

Ahuja

Strunin

1985

Anaesthesia

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“…Epidural morphine was first reported as an effective analgesic in humans by Behar et al 13 In 1979, reports of its use in obstetric patients were published.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Single Dose Epidural Morphine and Intermittent Dose Morphine with Bupivacaine in Post Cesarean Analgesia

Agarwal

Sharma

Agarwal

et al. 2013

Nepal j. obstet. gynaecol.

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AbstrActaims: Obstetric anesthesia presents a challenge to the anesthesiologist. The effective pain management allows the partu rient adequate degree of comfort and promotes physical reco very and a sense of well being.Methods: This randomized controlled study was designed to assess the analgesic efficacy and side effects of single dose direct epidural morphine (Group 1) versus intermittent 12 hourly epidural morphine with bupivacaine (Group2) for postoperative analgesia in lower segment caesarean section cases.results: Each group consisted of 36 patients. Demographic characteristics of two groups were comparable and differences among them were not statistically significant. Mean duration of analgesia was significantly longer in group one patients (16.5 ± 2.5) in comparison to group two patients (11.5 ± 1.5). Mean highest visual analogue scales (VAS scale) was significantly lower (3.2± 0.9) in group one patients in comparison of group two (6.7±0.8) patients. Only 43% patient in group one required supplementary analgesic (Inj Paracetamole/ Diclofenac) and 71% required Inj epidural Morphine / Inj bupivacaine in group two . Mean number of supplementary analgesic required in group one was 0.7 and it was 1.8 in group two. There was no significant difference in nausea, vomiting, itching and pruritis in two groups of patients.conclusions: our study showed that the use of single dose epidural morphine was associated with lower pain scores at rest and movement when compared to intermittent epidural morphine with bupivacaine in post-caesarean section analgesia. Single dose epidural morphine was found more convenient, less cumbersome and less costly as compared to intermittent epidural morphine for post-caesarean section analgesia.

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“…Further, it was proven by Yaksh et al, that direct application of morphine into the spine of rats by a chronic intrathecal (IT) catheter produced analgesia [6] and this practice became a reality when Wang et al, successfully used intrathecal morphine bolus dose injection in humans [7]. The publication by Behar et al, in 1979 was the fi rst paper on the use of epidural morphine at 2 mg doses for the treatment of acute and chronic pain [8]. The latter authors suggested that there was a direct spinal opioid effect on the specifi c receptors of the spinal cord.…”

Section: Introductionmentioning

confidence: 99%

Physiology of Spinal Opioids and its relevance for Pain Management Selection

Bujedo¹

2017

Open J Pain Med

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Epidural Morphine in Treatment of Pain

Cited by 592 publications

References 7 publications

Respiratory effects of epidural fentanyl

Respiratory effects of epidural fentanyl

Comparative Study of Single Dose Epidural Morphine and Intermittent Dose Morphine with Bupivacaine in Post Cesarean Analgesia

Physiology of Spinal Opioids and its relevance for Pain Management Selection

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