Delayed postoperative gastric emptying following intrathecal morphine and intrathecal bupivacaine.
Affiliation
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Ireland.Issue Date
2012-02-03T15:13:35ZMeSH
AbsorptionAcetaminophen/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
Metadata
Show full item recordCitation
Can J Anaesth. 1999 Jun;46(6):544-9.Journal
Canadian journal of anaesthesia = Journal canadien d'anesthesieDOI
10.1007/BF03013544PubMed ID
10391601Abstract
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
engISSN
0832-610X (Print)0832-610X (Linking)
ae974a485f413a2113503eed53cd6c53
10.1007/BF03013544
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