Postoperative analgesia after radical prostatectomy with high-dose intrathecal morphine and intravenous naloxone: A retrospective review

Journal of Opioid Management

Volumn 5, Issue 6, 2009, Pages 331-339

  Rebel, Annette ^a,b   Sloan, Paul ^a   Andrykowski, Michael ^a  

^a UNIVERSITY OF KENTUCKY MEDICAL CENTER   (United States)

^b Pikeville Medical Center   (United States)

Author keywords

Intrathecal morphine; Naloxone infusion; Neuraxial opioids; Opioid side effects; Postoperative analgesia; Radical prostatectomy

Indexed keywords

FENTANYL; KETOROLAC; MORPHINE; NALOXONE; OPIATE; NARCOTIC ANALGESIC AGENT; NARCOTIC ANTAGONIST; NONSTEROID ANTIINFLAMMATORY AGENT;

ADULT; ARTICLE; CLINICAL ARTICLE; CONTINUOUS INFUSION; CONTROLLED STUDY; DRUG EFFICACY; DRUG MEGADOSE; DRUG SAFETY; DRUG USE; HOSPITALIZATION; HUMAN; MALE; MOBILIZATION; NAUSEA; NAUSEA AND VOMITING; POSTOPERATIVE ANALGESIA; POSTOPERATIVE PAIN; PROSTATECTOMY; PRURITUS; RESPIRATION DEPRESSION; SEDATION; SIDE EFFECT; VISUAL ANALOG SCALE; VITAL SIGN; VOMITING; AGED; BLOOD PRESSURE; BREATHING MECHANICS; DRUG ADMINISTRATION; DRUG EFFECT; HEART RATE; INTRASPINAL DRUG ADMINISTRATION; INTRAVENOUS DRUG ADMINISTRATION; MIDDLE AGED; PAIN ASSESSMENT; RETROSPECTIVE STUDY; TIME; TREATMENT OUTCOME; WALKING;

AGED; AGED, 80 AND OVER; ANALGESICS, OPIOID; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; BLOOD PRESSURE; DRUG ADMINISTRATION SCHEDULE; HEART RATE; HUMANS; INFUSIONS, INTRAVENOUS; INJECTIONS, SPINAL; MALE; MIDDLE AGED; MORPHINE; NALOXONE; NARCOTIC ANTAGONISTS; PAIN MEASUREMENT; PAIN, POSTOPERATIVE; PROSTATECTOMY; RESPIRATORY MECHANICS; RETROSPECTIVE STUDIES; SEVERITY OF ILLNESS INDEX; TIME FACTORS; TREATMENT OUTCOME; WALKING;

EID: 75649135938     PISSN: 15517489     EISSN: None     Source Type: Journal    
DOI: 10.5055/jom.2009.0033     Document Type: Article

References (20)

1. Stevens RA, Mikat-Stevens M, Flanigan R, et al.: Does the choice of anesthetic technique affect the recovery of bowel function after radical prostatectomy? Urology. 1998; 52: 213-218.
2. Meylan N, Elia N, Lysakowski C, et al.: Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: Meta-analysis of randomized trials. Br J Anaesth. 2009; 102:156-167.
3. Stoelting RK: Intrathecal morphine: An underused combination for postoperative pain management. Anesth Analg. 1989; 68: 707-709.
4. Brown D, Hofer R, Patterson D, et al.: Intrathecal anesthesia and recovery from radical prostatectomy. Anesthesiology. 2004; 100: 926-934.
5. Gwirtz KH, Young JV, Byers RS, et al.: The safety and efficiency of intrathecal opioid analgesia for acute postoperative pain: Seven years' experience with 5969 patients at Indiana University Hospital. Anesth Analg. 1999; 88: 599-604.
6. Abouleish E: Apnea associated with the intrathecal administration of morphine in obstetrics. A case report. Br J Anaesth. 1988; 60: 592-594.
7. Davies GK, Tolhurst-Cleaver CL, James TL: Respiratory depression after intrathecal narcotics. Anesthesia. 1980; 35: 1080-1083.
8. Glynn CJ, Mather LE, Cousins MJ, et al.: Spinal narcotics and respiratory depression. Lancet. 1981; 2: 356-357.
9. Horlocker TT, Burton AW, Connis RT, et al.: Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration. Anesthesiology. 2009; 110: 218-230.
10. Rebel A, Sloan PA, Schumacher M: Postoperative analgesia with high-dose intrathecal morphine versus intravenous morphine. Anesth Analg. 2009; 108: S259.
11. Aldrete JA: The post-anesthesia recovery score revisited. J Clin Anesth. 1995; 7: 89-91.
12. Hanks GWC, Cherny NI, Fallon M: Opioid analgesic therapy. In Doyle D, Hanks GWC, Cherny NI, Caiman K (eds.): Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press, 2004: 316-341.
13. Jackson KC, Lipmann AG: Opioid analgesics. In Tollison CD (ed.): Practical Pain Management. Philadelphia: Lippincott, Williams & Wilkins, 2001: 224.
14. Ben-David B, Swanson J, Nelson J, et al.: Multinodal analgesia for radical prostatectomy provides better analgesia and shortens hospital stay. J Clin Anesth. 2007; 19: 264-268.
15. Wu C, Partin A, Rowlingson A, et al.: Efficacy of continuous local anesthetic infusion for postoperative pain after radical retropubic prostatectomy. Urology. 2005; 66: 366-370.
16. Gupta A, Fant F, Axelsson K, et al.: Postoperative analgesia after radical retropubic prostatectomy. Anesthesiology. 2006; 105: 784-793.
17. Katz J, Schmid R, Snijdelaar D, et al.: Pre-emptive analgesia using intravenous Fentanyl plus low-dose ketamine for radical prostatectomy under general anesthesia does not produce short-term or long-term reductions in pain or analgesic use. Pain. 2004;110:707-718.
18. Raffaeli W, Marconi G, Fanelli G, et al.: Opioid-related side-effects after intrathecal morphine: A prospective, randomized, double-blind dose-response study. Eur J Anaesthesiol. 2006; 23: 605-610.
19. Dailey PA, Brookshire GL, Shnider SM, et al.: The effects of naloxone associated with the intrathecal use of morphine in labor. Anesth Analg. 1985; 64: 658-666.
20. Jones RDM, Jones JG: Intrathecal morphine: Naloxone reverses respiratory depression but not analgesia. Br Med J. 1988; 281: 645-646.