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Anesth Analg 1986; 65:718-722
© 1986 International Anesthesia Research Society
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Intrathecal Morphine and Heroin in Humans

Six-Hour Drug Levels in Spinal Fluid and Plasma

H. I. M. Kotob, FFARCS, C. W. Hand, BSc, R. A. Moore, DPhil, FRSC, P. J. D. Evans, FFARCS, J. Wells, FFARCS, A. P. Rubin, FFARCS, and H. J. McQuay, FFARCS, DM

Department of Anaesthetics, Charing Cross Hospital, Fulham, London, United Kingdom, the Nuffield Departments of Clinical Biochemistry and Anaesthetics, Radcliffe Infirmary, Oxford, United Kingdom, and the Department of Anaesthetics, Assuit Medical School, Assuit, Egypt.

Abstract

Lumbar spinal fluid and plasma concentrations of morphine were measured by radioimmunoassay after intrathecal administration of 1 mg of morphine (n = 13) or heroin (n = 10). Plasma levels of morphine were measured regardless of whether heroin or morphine was injected intrathecally, because of the rapid biotransformation of heroin to morphine in plasma. Significant drug concentrations appeared in plasma after intrathecal heroin (peak concentration 47.8 ± 9.0 nmol/L, time to peak concentration 10 ± 2.4 min); after intrathecal morphine plasma drug concentrations were significantly lower (8.1 ± 1.0 nmol/L; P < 0.002) and significantly later (216 ± 39 min; P < 0.002). Elimination half-life of heroin from spinal fluid (43 ± 5 min) was significantly shorter than for morphine (73 ± 5 min; P < 0.02).

Key Words: ANALGESICS—morphine, heroin • ANESTHETIC TECHNIQUES—spinal • PHARMACOKI-NETICS—morphine, heroin




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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 © 1986 by the International Anesthesia Research Society.