Oxyhaemoglobin saturation following elective abdominal surgery in patients receiving continuous intravenous infusion or intramuscular morphine analgesia.
Oxygen saturation was continuously measured using computerised pulse oximetry for 8 h overnight pre-operatively and for the first 24 h postoperatively in 40 patients receiving intermittent intramuscular morphine or continuous infusion of morphine following elective upper abdominal surgery. The proportion of time with an oxygen saturation less than 94% was used as an index of desaturation. Patients receiving continuous infusion analgesia received a larger morphine dose and achieved better analgesia than the intramuscular group. Postoperatively, the duration of desaturation increased 10-fold over pre-operative values, 'intramuscular' patients spending 39.0% (SD, 37.0%) and 'continuous infusion' patients 40.0% (SD, 37.5%) of the time below 94% saturation. Although newer therapies (e.g. epidural analgesia and patient-controlled analgesia) are currently receiving greater attention, the sequelae of these more traditional analgesic techniques warrant further study.
Kluger
M T
MT
Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Bedford Park, South Australia.
Owen
H
H
Watson
D
D
Ilsley
A H
AH
Baldwin
A M
AM
Fronsko
R R
RR
Plummer
J L
JL
Brose
W G
WG
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009020:Morphine / Q000627:therapeutic use*; D010092:Oximetry; D010108:Oxyhemoglobins / Q000032:analysis*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000097:blood / Q000188:drug therapy*; D013997:Time Factors
D010108:Oxyhemoglobins; D009020:Morphine