Variation in the Disposition of Morphine After I.M. Administration in Surgical Patients

Rigg, J. R. A.; Browne, R. A.; Davis, C.; Khandelwal, J. K.; Goldsmith, C. H.

doi:10.1093/bja/50.11.1125

Cited by 28 publications

(5 citation statements)

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“…morphine in animals has not been extensively studied. The time to peak effect in our cats was comparable with that reported in the dog and in humans (Rigg et al ., 1978; Stanski et al ., 1978; Fisher et al ., 1987; Kentala et al ., 1998; Barnhart et al . 2000).…”

Section: Discussionsupporting

confidence: 91%

Morphine, pethidine and buprenorphine disposition in the cat

Taylor

Robertson

Dixon

et al. 2001

Vet Pharm & Therapeutics

106

105

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Pharmacokinetics of morphine, buprenorphine and pethidine were determined in 10 cats. Six cats received morphine (0.2 mg/kg) intravenously and four intramuscularly. Five received buprenorphine (0.01 mg/kg) intravenously and six intramuscularly. Six received pethidine (5 mg/kg) intramuscularly. Jugular venous blood samples were collected at time points to 24 h, and plasma morphine concentrations were measured by high performance liquid chromatograpy (HPLC), buprenorphine by radioimmunoassay (RIA) and pethidine by gas chromatography. Our data for morphine show elimination half-life (t1/2el) 76.3 min intravenous (i.v.) and 93.6 min intramuscular (i.m.); mean residence time (MRT) 105.0 and 120.5 min; clearance (Clp) 24.1 and 13.9 mL/kg/min; and volume of distribution (V(dss)) 2.6 and 1.7 L/kg, respectively. Comparable data for buprenorphine are t1/2el 416.8 and 380.2 min; MRT 417.6 and 409.8 min; Clp 16.7 and 23.7 mL/kg/min; and V(dss) 7.1 and 8.9 L/kg. For i.m. pethidine, t1/2el 216.4 min; MRT 307.5 min; Clp 20.8 mL/kg/min and V(dss) 5.2 L/kg. For i.m. dosing, the tmax for morphine, buprenorphine and pethidine were 15, 3 and 10 min, respectively. The pharmacokinetics of the three opioids in cats are broadly comparable with those of the dog, although there is a suggestion that the cat may clear morphine more slowly.

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Section: Discussionsupporting

confidence: 91%

Morphine, pethidine and buprenorphine disposition in the cat

Taylor

Robertson

Dixon

et al. 2001

Vet Pharm & Therapeutics

106

105

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“…However, there was a markedly greater delay with morphine and relatively less delay with nalbuphine. This cannot be attributed to differences in pharmacokinetics: the elimination half-life of morphine in females is 110 min (Rigg et al, 1978) and about 300 min for nalbuphine (Errick and Heel, 1983).…”

Section: Discussionmentioning

confidence: 99%

Effect of Premedication With Diazepam, Morphine or Nal-Buphine on Gastrointestinal Motility After Surgery

Shah

Rosen

Vickers

1984

British Journal of Anaesthesia

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“…This time-honoured method has little rational basis when drug effect is considered in relation to the pharmacokinetics of the disposition of drugs such as meperidine TM and morphine. 75 These studies showed that a standard intramuscular dose of these agents in surgical patients resulted in a wide spectrum of plasma concentration profiles and clinical effects. The threshold concentration for analgesia has been estimated to be 50 ng/ml for morphine TM and 680 ng/ml for meperidine, 77 although in both instances these estimations are crude and open to considerable doubt.…”

Section: Analgesiamentioning

confidence: 99%

Pulmonary atelectasis after anaesthesia: Pathophysiology and management

Rigg¹

1981

Canad. Anaesth. Soc. J.

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The pathophysiological basis of pulmonary atelectasis is reviewed and risk factors that enhance lung collapse are discussed. Management strategies to reduce or eliminate risk factors and to prevent collapse are discussed and the rational bases of these strategies are identified.Instability of lung alveoli is a consequence of surface tension and regional differences in alveolar size. The inherent tendency of alveoli to collapse is enhanced by the following risk factors; low lung volume, high closing volume, oxygen therapy, a rapid shallow ventilatory pattern, chronic lung disease, smoking, obesity, postoperative pain following abdominal or thoracic surgery, narcotic induced ventilatory depression, and neurological, neuromuscular, muscular and musculoskeletal diseases associated with mechanical impairment of respiratory function. The primary goal of perioperative respiratory management is prevention of atelectasis. Appropriate management strategies include physiotherapy and delay of elective surgery if substantial improvement in respiratory status can be achieved by specific treatments such as antibiotics, bronchodilators, steroids, and reduction of tobacco use and caloric intake. In selected cases, elective postoperative controlled ventilation may be indicated.KEY WORDS: ANAESTHESIA, COMPLICATIONS, atelectasis; LUNG, atelectasis.LUNG COLLAPSE and infection leading to acute respiratory failure is a major cause of post surgical morbidity and mortality. 1'2 Small area, of "silent" pulmonary atelectasis develop insidiously and frequently precede overt clinical evidence of lung collapse and other associated postanaesthetic pulmonary problems) It is the purpose of this paper to review the pathophysiology and pathogenesis of pulmonary atelectasis and the physiological basis for pulmonary management in the postoperative period. PATHOPHYSIOLOGY AND PATHOGENESIS OF ATELECTASISThe inflated lung is inherently unstable; in other words, it tends to collapse spontaneously, an observation that may be confirmed directly in the apnoeic lung at thoracotomy. The tendency to collapse results from two fundamental physical characteristics of the intact lung and is The first physical characteristic is the presence of surface tension at the gas liquid interface of the alveoli. In an isolated alveolus, assumed to be spherical in shape,* the pressure (P) tending to collapse that alveolus is given by the following expression of Laplace's Law-2T P= r where T = surface tension and r = radius of curvature of the alveolus: This relationship indicates that the pressure tending to collapse the alveolus is directly proportional to the surface tension at the alveolar lining and inversely proportional to the radius (or the size) of the alveolus. *It is recognised that the spherical balloon model is a considerable simplification of alveolar shape. A more precise equation to compute the collapsing pressure within non-spherical objects is given by P = T~/r~ + T2/r2, where r~ and r z are the principal radii of curvature and T~ and T2 correspondi...

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Variation in the Disposition of Morphine After I.M. Administration in Surgical Patients

Cited by 28 publications

References 0 publications

Morphine, pethidine and buprenorphine disposition in the cat

Morphine, pethidine and buprenorphine disposition in the cat

Effect of Premedication With Diazepam, Morphine or Nal-Buphine on Gastrointestinal Motility After Surgery

Pulmonary atelectasis after anaesthesia: Pathophysiology and management

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