JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Combes, X.
Right arrow Articles by Dhonneur, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Combes, X.
Right arrow Articles by Dhonneur, G.
Anesth Analg 2000;90:156
© 2000 International Anesthesia Research Society


REGIONAL ANESTHESIA AND PAIN MANAGEMENT

The Effects of Residual Pain on Oxygenation and Breathing Pattern During Morphine Analgesia

X. Combes, MD, C. Cerf, MD, D. Bouleau, MD, P. Duvaldestin, MD, and Gilles Dhonneur, MD

Department of Anesthesia, Hôpital Henri Mondor, Créteil, France

Address correspondence and reprint requests to Dr. Gilles Dhonneur, Department of Anesthesia, Hôpital Henri Mondor, 51 av. du Mal de Lattre-de-Tassigny, 94010 Créteil cedex, France. Address e-mail to gilles.dhonneur{at}hmn.ap-hop-paris.fr

To determine the influence of pain on opioid-induced respiratory depression, we studied oxygenation and breathing patterns in 40 patients scheduled for knee surgery during postoperative patient-controlled analgesia (PCA). After 1 h of morphine PCA, patients were randomized to receive either 20 mL of placebo or bupivacaine 0.25% through a crural nerve catheter and allowed to use PCA for one more hour. Abnormal breathing events were identified and characterized by using the Edentrace II device (Nellcor, Jouy-en-Josas, France). The SpO2 below which the patient spent 25% and 50% of a studied period was calculated (SpO225, SpO250). Pain relief with regional analgesia increased the incidence of abnormal respiratory events associated with oxygen desaturation: during the second period, the pain score was lower in the bupivacaine group (0.7 ± 1 vs 4.1 ± 1.2), morphine consumption was larger in the placebo group (4.2 ± 1.3 vs 0.7 ± 1.4 mg), and there were more abnormal obstructive breathing events in the bupivacaine group (11 ± 16 vs 3.7 ± 4.3). SpO225 and SpO250 were lower in the bupivacaine than in placebo group (91.5% ± 2.8% vs 93.1% ± 2.1%, 92.9% ± 2.4% vs 94.2% ± 1.8%).

Implications: Pain relief with regional analgesia in patients previously treated with opioids increases the incidence of abnormal respiratory events associated with oxygen desaturation.




This article has been cited by other articles:


Home page
Br J AnaesthHome page
G. A. McLeod, K. Dell, C. Smith, and J. A. W. Wildsmith
Measuring the quality of continuous epidural block for abdominal surgery
Br. J. Anaesth., May 1, 2006; 96(5): 633 - 639.
[Abstract] [Full Text] [PDF]




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 © 2000 by the International Anesthesia Research Society.