The effects of preoperative epidural morphine and systemic nifedipine on general anaesthesia and postoperative period PREOPERATIF EPIDURAL MORFIN VE SISTEMIK NIFEDIPININ GENEL ANESTEZI ALAN HASTALARDA PEROPERATUAR VE POSTOPERATUAR ETKILERI
Turk Anesteziyoloji ve Reanimasyon, cilt.24, sa.10, ss.444-449, 1996 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 24 Sayı: 10
- Basım Tarihi: 1996
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.444-449
- Anahtar Kelimeler: Epidural morphine, Postoperative analgesia, Sublingual nifedipine
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
The examined the effects of preoperative epidural morphine associated with sublingual nifedipine on intra- and postoperative cardiovascular function and analgesic requirements. Forty patients were submitted to major intraabdominal surgery and divided into 4 groups. Premedication consisted of 0.15 mg/kg diazepam administered intramuscularly. Before anesthesia induction, group I (n=10) received epidural morphine (0.5 mg), group II (n=10) received epidural morphine (0.5 mg) and sublingual nifedipine (10 mg), group III (n=10) received only sublingual nifedipine (10 mg), group IV (n=10) received only placebo and named as control group. Induction consisted of 5 mg/kg intravenous (IV) thiopentone, 2 mcg/kg fentanyl and 0.08 mg/kg pancuronium. Anaesthesia was maintained with halothan (0.5 %) in O2 (30 %) and N2O (70 %). When signs of pain were observed fentanyl was added. The morphine and morphine+nifedipine groups required less fentanyl during surgery than group III and group IV. The recovery period in control group was significantly shorter than other groups (p<0.05). The postoperative requirements of total analgesic drug doses for the periods of 0-24 h. were also significantly higher in the group III and group IV. In these groups the mean periods of analgesia was found shorter significantly. The requirements of antiemetic drug was significantly higher in the group I and group IV. The fall in the blood pressure was easily controlled in nifedipine group by intravenous infusion of drug-free saline. This study shows that postoperative pain relief produced by preoperative epidural morphine may be enhanced by sublingual administration of nifedipine with minimal and easily controlled side effects.