title: The influence of adrenaline on postoperative analgesia after subarachnoid morphine.
abstract: A randomised, double-blind study was conducted to investigate the postoperative effects of subarachnoid morphine, with or without adrenaline, after major gynaecological surgery. Seventy-five women having spinal anaesthesia combined with either sedation or general anaesthesia were randomised to receive subarachnoid morphine 0.25 mg with (group MA) or without (group M) adrenaline 200 micrograms; or normal saline (group C). Groups M (n = 22) and MA (n = 25) differed significantly from control (n = 23) with respect to the quality and duration of postoperative analgesia (P < 0.0002) and to a higher incidence of pruritus (P < 0.02). Groups were similar with respect to the incidence of other postoperative side-effects and respiratory data, although the latter showed a trend to less hypoxaemia in the control group. There was no significant difference in any outcome between groups MA and M. It was concluded that, under the study conditions in a post-gynaecological surgery population, the addition of adrenaline to subarachnoid morphine was of no benefit.
authors.affiliation: Department of Anaesthesia, King Edward Memorial Hospital for Women, Perth, Western Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Paech
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural; D000771:Anesthesia, Intravenous; D000775:Anesthesia, Spinal; D002045:Bupivacaine / Q000008:administration & dosage; D016292:Procedural Sedation; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009325:Nausea / Q000139:chemically induced; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D012119:Respiration / Q000187:drug effects; D013346:Subarachnoid Space; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced
chemical_list: D009020:Morphine; D002045:Bupivacaine; D004837:Epinephrine