Delayed postoperative gastric emptying following intrathecal morphine and intrathecal bupivacaine.

Hdl Handle:
http://hdl.handle.net/10147/209150
Title:
Delayed postoperative gastric emptying following intrathecal morphine and intrathecal bupivacaine.
Authors:
Lydon, A M; Cooke, T; Duggan, F; Shorten, G D
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Ireland.
Citation:
Can J Anaesth. 1999 Jun;46(6):544-9.
Journal:
Canadian journal of anaesthesia = Journal canadien d'anesthesie
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209150
DOI:
10.1007/BF03013544
PubMed ID:
10391601
Abstract:
PURPOSE: A decrease in the rate of gastric emptying can delay resumption of enteral feeding, alter bioavailability of orally administered drugs, and result in larger residual gastric volumes, increasing the risk of nausea and vomiting. We compared the effects of 1) intrathecal bupivacaine (17.5 mg) and 2) the combination of intrathecal morphine (0.6 mg) and intrathecal bupivacaine (17.5 mg) on the rate of gastric emptying in patients undergoing elective hip arthroplasty. METHODS: Twenty four fasting ASA 1-3 patients were randomly assigned, in a double blind manner, to receive intrathecal hyperbaric bupivacaine (17.5 mg), either alone (group 1), or followed by intrathecal morphine (0.6 mg) (group 2). Gastric emptying was measured (using an acetaminophen absorption technique), twice in each patient; preoperatively, and approximately one hour postoperatively. Gastric emptying parameters are: AUC (area under the plasma acetaminophen concentration time curve), maximum plasma acetaminophen concentration (Cmax), and time to Cmax (tCmax), analyzed using paired Student's t tests. RESULTS: Gastric emptying rates were reduced in both group 1 (AUC = 14.98 (3.8) and 11.05 (4.6) pre- and postoperatively, respectively) and group 2 (AUC = 13.93 (3.59) and 6.4 (3.42) pre- and postoperatively, respectively); the magnitude of the reduction was greater in group 2 [AUC (P = 0.04), Cmax (P = 0.05), tCmax (P = 0.13)]. CONCLUSION: The combination of intrathecal morphine (0.6 mg) and intrathecal bupivacaine (17.5 mg) delays gastric emptying postoperatively.
Language:
eng
MeSH:
Absorption; Acetaminophen/administration & dosage/blood/pharmacokinetics; Administration, Oral; Aged; Analgesics, Non-Narcotic/administration & dosage/blood/pharmacokinetics; Analgesics, Opioid/*administration & dosage; *Anesthesia, Spinal; Anesthetics, Local/*administration & dosage; Area Under Curve; Biological Availability; Bupivacaine/*administration & dosage; Double-Blind Method; Enteral Nutrition; Female; Follow-Up Studies; Gastric Emptying/*drug effects; Humans; Injections, Spinal; Male; Morphine/*administration & dosage; Postoperative Nausea and Vomiting/etiology; Postoperative Period; Risk Factors; Time Factors
ISSN:
0832-610X (Print); 0832-610X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorLydon, A Men_GB
dc.contributor.authorCooke, Ten_GB
dc.contributor.authorDuggan, Fen_GB
dc.contributor.authorShorten, G Den_GB
dc.date.accessioned2012-02-03T15:13:35Z-
dc.date.available2012-02-03T15:13:35Z-
dc.date.issued2012-02-03T15:13:35Z-
dc.identifier.citationCan J Anaesth. 1999 Jun;46(6):544-9.en_GB
dc.identifier.issn0832-610X (Print)en_GB
dc.identifier.issn0832-610X (Linking)en_GB
dc.identifier.pmid10391601en_GB
dc.identifier.doi10.1007/BF03013544en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209150-
dc.description.abstractPURPOSE: A decrease in the rate of gastric emptying can delay resumption of enteral feeding, alter bioavailability of orally administered drugs, and result in larger residual gastric volumes, increasing the risk of nausea and vomiting. We compared the effects of 1) intrathecal bupivacaine (17.5 mg) and 2) the combination of intrathecal morphine (0.6 mg) and intrathecal bupivacaine (17.5 mg) on the rate of gastric emptying in patients undergoing elective hip arthroplasty. METHODS: Twenty four fasting ASA 1-3 patients were randomly assigned, in a double blind manner, to receive intrathecal hyperbaric bupivacaine (17.5 mg), either alone (group 1), or followed by intrathecal morphine (0.6 mg) (group 2). Gastric emptying was measured (using an acetaminophen absorption technique), twice in each patient; preoperatively, and approximately one hour postoperatively. Gastric emptying parameters are: AUC (area under the plasma acetaminophen concentration time curve), maximum plasma acetaminophen concentration (Cmax), and time to Cmax (tCmax), analyzed using paired Student's t tests. RESULTS: Gastric emptying rates were reduced in both group 1 (AUC = 14.98 (3.8) and 11.05 (4.6) pre- and postoperatively, respectively) and group 2 (AUC = 13.93 (3.59) and 6.4 (3.42) pre- and postoperatively, respectively); the magnitude of the reduction was greater in group 2 [AUC (P = 0.04), Cmax (P = 0.05), tCmax (P = 0.13)]. CONCLUSION: The combination of intrathecal morphine (0.6 mg) and intrathecal bupivacaine (17.5 mg) delays gastric emptying postoperatively.en_GB
dc.language.isoengen_GB
dc.subject.meshAbsorptionen_GB
dc.subject.meshAcetaminophen/administration & dosage/blood/pharmacokineticsen_GB
dc.subject.meshAdministration, Oralen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAnalgesics, Non-Narcotic/administration & dosage/blood/pharmacokineticsen_GB
dc.subject.meshAnalgesics, Opioid/*administration & dosageen_GB
dc.subject.mesh*Anesthesia, Spinalen_GB
dc.subject.meshAnesthetics, Local/*administration & dosageen_GB
dc.subject.meshArea Under Curveen_GB
dc.subject.meshBiological Availabilityen_GB
dc.subject.meshBupivacaine/*administration & dosageen_GB
dc.subject.meshDouble-Blind Methoden_GB
dc.subject.meshEnteral Nutritionen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshGastric Emptying/*drug effectsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInjections, Spinalen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMorphine/*administration & dosageen_GB
dc.subject.meshPostoperative Nausea and Vomiting/etiologyen_GB
dc.subject.meshPostoperative Perioden_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshTime Factorsen_GB
dc.titleDelayed postoperative gastric emptying following intrathecal morphine and intrathecal bupivacaine.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Ireland.en_GB
dc.identifier.journalCanadian journal of anaesthesia = Journal canadien d'anesthesieen_GB
dc.description.provinceMunster-
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