Enhancement of the epidural morphine-induced analgesia by systemic nifedipine.
We evaluated postoperative pain relief and incidence of side effects of the combination of epidural morphine (0.5 mg) and sublingual nifedipine (10 mg). Thirty-six patients were submitted to elective operations and divided into 4 groups receiving placebo (groups A and B) or morphine (groups C and D) by the epidural route, followed by sublingual placebo (groups A and C) or nifedipine (groups B and D) administered in a double-blind fashion. The mean (+/- S.E.M.) periods of analgesia were 16.6 +/- 1.6 (A), 15 (B) 105 +/- 77.0 (C), and 428.8 +/- 72.0 (D) min. No patient had pruritus, excessive sedation or respiratory depression. Episodes of nausea and/or vomiting requiring no specific therapy were observed in groups A, B and D. Nifedipine-treated groups also had a significant fall in blood pressure which was controlled by rehydration. These results indicate that epidural morphine-induced postoperative pain relief may be enhanced by systemic administration of nifedipine, with easily controlled side effects.
Pereira
Ivan T
IT
Department of Surgery, Orthopedics and Traumatology, Discipline of Anesthesiology, RibeirãoBrazil Department of Pharmacology, Faculty of Medicine of Ribeirão Preto, RibeirãoBrazil.
Prado
Wiliam A
WA
Dos Reis
Marlene P
MP
D000286:Administration, Sublingual; D000328:Adult; D000367:Age Factors; D000368:Aged; D015360:Analgesia, Epidural; D001794:Blood Pressure / Q000502:physiology; D001835:Body Weight; D004311:Double-Blind Method; D004357:Drug Synergism; D005260:Female; D005836:Genitalia, Female / Q000601:surgery; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use*; D009543:Nifedipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*
D009020:Morphine; D009543:Nifedipine