Articles: analgesics.
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The objectives of this study were to investigate the duration of analgesia and the development of tolerance following continuous intrathecal administration of morphine and norepinephrine alone, and morphine followed by norepinephrine via mini-osmotic pumps in the rat. Analgesia was assessed by the tail-flick test. In single pump experiments morphine 1 microliter (10 micrograms)/h (7 days) and 0.5 microliter (10 micrograms)/h (14 days) produced analgesia with tolerance by days 5-7. ⋯ Following continuous intrathecal morphine 1 microliter (10 micrograms)/h for 5 days, norepinephrine 1 microliter (15 micrograms)/h for 7 days failed to produce a significant increase in analgesia. This was in contrast to the increase in analgesia seen when the norepinephrine infusion followed a saline infusion. Determination of the norepinephrine concentration in the solution from the osmotic pumps verified that the norepinephrine is stable for the treatment period.
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Bull. Tokyo Med. Dent. Univ. · Jun 1985
Comparative StudyComparison of hemodynamic effects of morphine, butorphanol, buprenorphine and pentazocine on ICU patients.
Morphine and narcotic agonist-antagonists have been used to assist ICU patients in adapting to mechanical ventilation. In this study, 10 mg of morphine and the equipotent doses of synthetic analgesics, 2 mg of butorphanol, 0.6 mg of buprenorphine or 30 mg of pentazocine were administered intravenously to 29 patients requiring a ventilator. Hemodynamic effects on the heart rate, mean arterial pressure (MAP), cardiac index, stroke index, left ventricular stroke work index, mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP) and systemic and pulmonary vascular resistance (PVR) were measured. ⋯ These doses of the four drugs could be given safely even in critically ill patients. The hemodynamic effects of these analgesics showed a similarity between the administration of butorphanol and morphine, and between buprenorphine and pentazocine. This study demonstrates that morphine and butorphanol are preferred to the cases with hypertension, increased pulmonary arterial pressure or wedge pressure and that pentazocine and buprenorphine are more suitable for the cases with hypotension or hypovolemia.
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Acta Anaesthesiol Scand · May 1985
Comparative StudyFactors influencing the respiratory capacity after upper abdominal surgery.
The analgesic requirement and some factors influencing the respiratory capacity after upper abdominal surgery were studied during the first 2 days postoperatively in 417 patients, aged 17 to 84 years, undergoing surgery in the upper part of the abdomen. The operations were cholecystectomy or choledocholithotomy through a subcostal incision, partial gastric resection, repair of a diaphragmatic hernia or vagotomy through a midline incision. Pain relief was achieved in a random order either by intercostal block (i.c.b.) and centrally acting analgesics on demand, or by centrally acting analgesics alone. ⋯ Thus it decreased the demand for centrally acting analgesics and resulted in higher PEF values than without i.c.b. for cholecystectomy during the period of effective nerve block and for choledocholithotomy for 2 whole days postoperatively. Smokers seemed to benefit from i.c.b. for 2 postoperative days. The reduction of PEF after cholecystectomy also seemed to be related to the duration of treatment with centrally acting analgesics.