Single Injection Spinal Anaesthesia with Amethocaine and Morphine for Transurethral Prostatectomy

Cunningham, A. J.; McKenna, Jocelyne; Skene, D.S.; Bridenbaugh, L. Donald

doi:10.1097/00132586-198402000-00053

Cited by 7 publications

(14 citation statements)

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“…[3][4][5][6][7][8][9][10] Cunningham et al demonstrated that intrathecal morphine was effective for analgesia after TURP. 11 On the other hand, intrathecal morphine is often accompanied by adverse effects such as pruritus, nausea and respiratory depression. Clinicians tend to use smaller doses to reduce the incidence of adverse effects.…”

Section: Méthode : L'étude Prospective Et à Double Insu Comportait 42mentioning

confidence: 99%

“…High-dose morphine caused late respiratory depression in some cases. 7,11 Therefore, lower doses of intrathecal morphine are widely used for analgesia following surgery to avoid late respiratory depression. 1,[3][4][5][6] However, intrathecal morphine is often associated with uncomfortable adverse effects, including pruritus and nausea.…”

Section: Méthode : L'étude Prospective Et à Double Insu Comportait 42mentioning

confidence: 99%

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Mini-dose (0.05 mg) intrathecal morphine provides effective analgesia after transurethral resection of the prostate

Sakai

Use

Shimamoto

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To determine the optimal dose of intrathecal morphine that produces satisfactory analgesia with minimum side effects in elderly patients undergoing transurethral resection of the prostate (TURP). M Me et th ho od ds s: :In this double-blind prospective study, 42 patients undergoing TURP with spinal anesthesia were allocated to one of three groups. Group A (n = 14) received tetracaine, 10 mg, alone. Group B (n = 13) and Group C (n = 15) received morphine 0.05 mg and 0.10 mg, respectively, in combination with tetracaine. Postoperative pain, nausea and pruritus were evaluated using visual analogue scales (VAS). SpO 2 and respiratory rate were also assessed.R Re es su ul lt ts s: : At three, five, seven and 24 hr after spinal anesthesia, the VAS scores for pain in Groups B and C were significantly less than in Group A. Group C experienced significantly greater VAS scores for pruritus as compared to Groups A and B. There was no significant difference in the intensity of nausea among the three groups. No patient experienced hypoxemia (SpO 2 < 90%) and respiratory depression (respiratory rate < 10 beats·min -1 ) in any group. C Co on nc cl lu us si io on n: : A dose of 0.05 mg in intrathecal morphine with spinal anesthesia would be optimal for elderly patients undergoing TURP. Objectif : Déterminer la dose optimale de morphine intrathécale pour obtenir une analgésie satisfaisante et le moins d'effets secondaires possibles chez des patients âgés devant subir la résection transurétrale de la prostate (RTUP). Méthode : L'étude prospective et à double insu comportait Résultats : À trois, cinq et 24 h après la rachianesthésie, les scores de douleur à l'EVA ont été significativement plus bas dans les groupes B et C que dans le groupe A. Dans le groupe C, les patients ont eu des scores de prurit significativement plus élevés que ceux des groupes A et B. Il n'y a pas eu de différence intergroupe significative quant à l'intensité des vomissements. Aucun patient n'a souffert d'hypoxémie (SpO 2 < 90 %) ou de dépression respiratoire (fréquence respiratoire < 10 respirations·min -1 ). Conclusion : Une dose de 0,05 mg de morphine intrathécale combinée à la rachianesthésie serait optimale chez des patients âgés qui subissent une RTUP.FTER transurethral resection of the prostate (TURP), patients often suffer from pain caused by detrusor muscle spasm. 1,2 Intrathecal morphine provides an excellent long-lasting analgesia and the addition of morphine to spinal anesthesia has been used for postoperative analgesia after many surgical procedures. [3][4][5][6][7][8][9][10] Cunningham et al. demonstrated that intrathecal morphine was effective for analgesia after TURP. 11 On the other hand, intrathecal morphine is often accompanied by adverse effects such as pruritus, nausea and respiratory depression. Clinicians tend to use smaller doses to reduce the incidence of adverse effects. This study was carried out to examine the efficacy and adverse effects associated with low-dose intrathecal morphine in patients undergoi...

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Section: Méthode : L'étude Prospective Et à Double Insu Comportait 42mentioning

confidence: 99%

Section: Méthode : L'étude Prospective Et à Double Insu Comportait 42mentioning

confidence: 99%

Mini-dose (0.05 mg) intrathecal morphine provides effective analgesia after transurethral resection of the prostate

Sakai

Use

Shimamoto

et al. 2003

Can J Anesth/J Can Anesth

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“…Six studies defined RD with both RR and ABGs, 8,14,20,74,103,109 while three used ABGs alone. 24,56,78 RR was the most common variable used to define RD.…”

Section: Discussionmentioning

confidence: 99%

Définitions de la “dépression respiratoire” de l’analgésie postopératoire réalisée avec de la morphine intrathécale : une revue documentaire

Goldstein

VanDenKerkhof

2003

Can J Anesth/J Can Anesth

108

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P Pu ur rp po os se e: : To review the postoperative intrathecal morphine (ITM) analgesia literature for their definitions of "respiratory depression" (RD).S So ou ur rc ce e: : Medline (1966 -June Week 5 2001) and reference lists were searched for original studies involving bolus-dose ITM for postoperative analgesia, which used "respiratory depression" or similar terms. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The search identified 209 studies. These were included if ITM use was appropriate (bolus dose, postoperative analgesia) and the term "respiratory depression" was used, which left 96 studies remaining. Forty-four (46%) did not define "RD" despite using this term. A further 24 (25%) defined RD with respiratory rate (RR) alone. Only 28 (29%) defined RD with more than RR alone. There was no statistically significant association between the presence of a definition for RD with study design, study size or publication period. Also, no significant association existed between rigorousness of RD definitions and the above factors.C Co on nc cl lu us si io on n: : The term "respiratory depression" has no clear definition from a review of the literature on ITM use for postoperative analgesia. While defining RD with bradypnea is superior to having no definition, this is still inadequate. In future research, the consistent use of terms with specific meanings will facilitate understanding the true incidence of ITM's respiratory effects. If "respiratory depression" is used, then an explicit definition of its meaning should be provided. Future research must also address what is clinically significant respiratory impairment from intrathecal opioids, and how to optimally monitor for this. Further delineating their risks vs benefits will allow for more optimal dosing. Objectif : Passer en revue les documents sur l'analgésie postopéra-toire, réalisée avec la morphine intrathécale (MIT), quant à leurs défi-nitions de la "dépression respiratoire" (DR). Source : La base Medline (1966 -Semaine 5, juin 2001) et les listes de lectures de référence ont été fouillées à la recherche d'études originales sur des bolus de MIT administrés comme analgésie postopéra-toire, et dans lesquelles on retrouve le terme "dépression respiratoire" ou des termes similaires. Constatations principales : La recherche nous a fourni 209 études. Les études (96) comportant un usage approprié de la MIT (dose en bolus, analgésie postopératoire) et l'utilisation du terme

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“…Hypovolemia may also be assisted by the block of the sympathetic nervous system due to spinal anesthesia [3,18].…”

Section: Physiopathologymentioning

confidence: 99%

The Pathophysiology, Diagnosis and Therapy of the Transurethral Resection of the Prostate Syndrome

Ficarra¹,

Bartoloni²,

Tallarigo³

et al. 2001

Urol Int

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Single Injection Spinal Anaesthesia with Amethocaine and Morphine for Transurethral Prostatectomy

Cited by 7 publications

References 0 publications

Mini-dose (0.05 mg) intrathecal morphine provides effective analgesia after transurethral resection of the prostate

Mini-dose (0.05 mg) intrathecal morphine provides effective analgesia after transurethral resection of the prostate

Définitions de la “dépression respiratoire” de l’analgésie postopératoire réalisée avec de la morphine intrathécale : une revue documentaire

The Pathophysiology, Diagnosis and Therapy of the Transurethral Resection of the Prostate Syndrome

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