Comparison of the respiratory effects of i.v. infusions of morphine and regional analgesia by extradural block.
The incidence of postoperative respiratory apnoea was compared between five patients receiving a continuous i.v. infusion of morphine (mean 73.6 mg) and five patients receiving a continuous extradural infusion of 0.25% bupivacaine (mean 192 mg) in the 24-h period following upper abdominal surgery. Monitoring consisted of airflow detection by a carbon dioxide analyser, chest wall movement detected by pneumatic capsules, and continuous electrocardiograph recorded with a Holter ambulatory monitor. Both obstructive (P less than 0.05) and central apnoea (P less than 0.05) occurred more frequently in patients who had a morphine infusion. There was also a higher incidence of tachyarrhythmias (P less than 0.05) and ventricular ectopic beats (P less than 0.05) in the morphine infusion group.
Clyburn
P A
PA
Department of Anaesthetics, University of Wales College of Medicine, Heath Park, Cardiff.
Rosen
M
M
Vickers
M D
MD
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002045:Bupivacaine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000592:standards; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000209:etiology*; D011897:Random Allocation; D012891:Sleep Apnea Syndromes / Q000139:chemically induced*
D009020:Morphine; D002045:Bupivacaine