Premedication with slow release morphine (MST) and adjuvants.
Sixty-one women undergoing major gynaecological surgery received slow release morphine (MST) 60 mg, with placebo, hyoscine 0.6 mg or diazepam 10 mg, by mouth 2 h before surgery. Plasma morphine concentrations reached a steady level usually within 3 h after administration of MST, and did not increase after surgery unless supplementary opioid was given. Hyoscine delayed morphine absorption. Before operation no fewer than 50% of patients were sedated after MST alone, but this increased to 85% after MST and diazepam. Similarly, only the combination MST and diazepam produced anxiolysis. Postoperative mood was unhappier after MST and hyoscine. Emesis occurred in 40-57% of patients, and was not reduced by hyoscine. Therefore premedication with MST alone did not produce reliable sedation or anxiolysis. A combination of hyoscine and MST premedication cannot be recommended, as it did not produce sedation, anxiolysis or antiemesis and hyoscine may have delayed morphine absorption.
Simpson
K H
KH
University Department of Anaesthesia, St James's University Hospital, Leeds.
Dearden
M J
MJ
Ellis
F R
FR
Jack
T M
TM
D000042:Absorption; D000328:Adult; D003692:Delayed-Action Preparations; D003975:Diazepam / Q000494:pharmacology; D004341:Drug Evaluation; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000097:blood / Q000493:pharmacokinetics / Q000494:pharmacology; D009638:Norepinephrine / Q000097:blood; D010149:Postoperative Pain / Q000517:prevention & control; D011229:Preanesthetic Medication; D012601:Scopolamine / Q000494:pharmacology
D003692:Delayed-Action Preparations; D009020:Morphine; D012601:Scopolamine; D003975:Diazepam; D009638:Norepinephrine; D004837:Epinephrine