Abstract
800x600 800x600 Introduction Controlled trials in children and adolescents have shown that, small-dose naloxone infusions (0.25µg/kg/hour) can significantly reduce opioid induced side effects without affecting opioid-induced analgesia. Material and methods 84 elective thoracotomy patients having combined thoracic epidural and general anesthesia for thoracotomy surgeries were randomly assigned to one of the two study groups. All patients of Group A (n=42) received continuous intravenous infusion of naloxone at a calculated dose of 0.25µgkg -1 hr -1 and patients of Group B (n=42) received continuous intravenous infusion of normal saline at a fixed rate. All patients were premedicated with fentanyl 1 µg/kg i.v. After placement of epidural catheter at T 6-8 interspaces, all patients were administered morphine 0.1mg/kg with 0.125% bupivacaine immediately before induction of general anaesthesia. VAS was assessed immediately after extubation and a bolus dose of 0.01mg/kg epidural morphine was administered when VAS exceeded 3 in postoperative follow up period of 72hrs in all patients. We measured the incidence of side effects like vomiting, nausea, pruritus and respiratory depression and number of times rescue analgesic was required. Results Small dose naloxone infusion significantly reduced the opioid induced side effects without antagonizing opioid induced analgesia. Conclusion N aloxone reduces epidural morphine-induced side effects without significant alteration of its analgesic effects. DOI: http://dx.doi.org/10.4038/slja.v22i2.6231 Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4
Highlights
Controlled trials in children and adolescents have shown that, small-dose naloxone infusions (0.25μg/kg/hour) can significantly reduce opioid induced side effects without affecting opioid-induced analgesia
We measured the incidence of side effects like vomiting, nausea, pruritus and respiratory depression and number of times rescue analgesic was required
Demographic profile and haemodynamic parameters were comparable between the groups
Summary
Controlled trials in children and adolescents have shown that, small-dose naloxone infusions (0.25μg/kg/hour) can significantly reduce opioid induced side effects without affecting opioid-induced analgesia. Modern philosophy of pain management for trauma and surgery must provide more than mere humanitarian success to the distressed patient. A system for relieving pain must prove its positive influence on the processes of recovery and should be measurable both in terms of patient satisfaction, improved function and progressive effects on healing. There is experimental evidence of thoracic epidural analgesia (TEA) having a demonstrable superiority over other analgesic techniques in terms of effects on pulmonary function, stress reduction, myocardial function, O2 delivery, and reduction of myocardial irritability, when epidural techniques are used intra-operatively and extended to cover the postoperative period. Advent of neuraxial opioids provides the impetus to add TEA to the armamentarium of thoracic anaesthesiology and establish it as the gold standard.[1]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
