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Research article

Influence of naloxone on quality and duration of analgesia produced by thoracic epidural morphine and bupivacaine

Authors:

Sampa Dutta Gupta ,

IN
About Sampa
Associate  Professor, Dept.of Anaesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata,
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Anjana Pareek,

IN
About Anjana
Consultant Anaesthetist, Dept.of Anaesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata,
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Sunanda Maji,

IN
About Sunanda
Assistant Professor, Dept. of Anaesthesiology, Midnapur Medical College, Midnapur, West Bengal,
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Sudeshna Bhar Kundu,

IN
About Sudeshna
Assistant  Professor, Dept. of Anaesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata,
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Manjushree Ray

IN
About Manjushree
Principal, Burdwan Medical College, Burdwan, West Bengal
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Abstract

Introduction

Controlled trials in children and adolescents have shown that, small-dose naloxone infusions (0.25µg/kg/hour) can significantly reduce opioid induced side effects without affecting opioid-induced analgesia.

Material and methods

84 elective thoracotomy patients having combined thoracic epidural and general anesthesia for thoracotomy surgeries were randomly assigned to one of the two study groups. All patients of Group A (n=42) received continuous intravenous infusion of naloxone at a calculated dose of 0.25µgkg-1hr-1 and patients of Group B (n=42) received continuous intravenous infusion of normal saline at a fixed rate. All patients were premedicated with fentanyl 1 µg/kg i.v. After placement of epidural catheter at T6-8 interspaces, all patients were administered morphine 0.1mg/kg with 0.125% bupivacaine immediately before induction of general anaesthesia. VAS was assessed immediately after extubation and a bolus dose of 0.01mg/kg epidural morphine was administered when VAS exceeded 3 in postoperative follow up period of 72hrs in all patients. We measured the incidence of side effects like vomiting, nausea, pruritus and respiratory depression and number of times rescue analgesic was required. 

Results

Small dose naloxone infusion significantly reduced the opioid   induced side effects without antagonizing opioid induced analgesia.

Conclusion

Naloxone reduces epidural morphine-induced side effects without significant alteration of its analgesic effects.

 

DOI: http://dx.doi.org/10.4038/slja.v22i2.6231


 

How to Cite: Dutta Gupta, S. et al., (2014). Influence of naloxone on quality and duration of analgesia produced by thoracic epidural morphine and bupivacaine. Sri Lankan Journal of Anaesthesiology. 22(2), pp.44–49. DOI: http://doi.org/10.4038/slja.v22i2.6231
Published on 15 Jun 2014.
Peer Reviewed

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