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Anesth Analg 1985; 64:1065-1070
© 1985 International Anesthesia Research Society
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Morphine Kinetics and Kidney Transplantation

Morphine Removal is Influenced by Renal Ischemia

John Sear, PhD, FFARCS, Andrew Moore, DPhil, FRSC, Adrian Hunniset, BSc, Dene Baldwin, MLSO, Michael Allen, BSc, Christopher Hand, BSc, Henry McQuay, FFARCS, and Peter Morris, PhD, FRACS, FRCS

Nuffield Departments of Anaesthetics and Clinical Biochemistry, Radcliffe Infirmary, Oxford; Nuffield Department of Surgery, John Radcliffe Hospital, Oxford; and Renal Unit, Churchill Hospital, Oxford, United Kingdom.

Abstract

Morphine plasma concentrations were determined in six patients receiving kidney transplants from living-related donors, and nine patients receiving kidney transplants from cadavers. The total cold ischemic time was about 2 hr for kidneys from living-related donors and 14 hr for those from cadavers. After an intravenous bolus dose of morphine, plasma morphine concentrations decreased to a plateau that lasted for several hours; morphine elimination resumed when the transplanted kidney began to clear creatinine. The duration of the total cold ischemic time was significantly related to both the duration of the plateau in morphine concentration (P = 0.008) and the first postoperative day creatinine clearance (P = 0.021). Morphine elimination half-life after the plateau was related to first postoperative day creatinine clearance (P < 0.001). It was concluded that morphine elimination depended upon intact renal function.

Key Words: ANALGESICS—morphine • PHARMA-COKINETICS—morphine






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1985 by the International Anesthesia Research Society.