Respiratory depression after epidural and intrathecal narcotics

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Intrathecal and epidural narcotics.

This paper presents an overall review of epidural and intrathecal narcotics. The early laboratory studies and initial clinical applications are presented. This is followed by a description of the mechanism of action of narcotics acting both intrathecally and epidurally, and some of the similarities and differences between narcotics and local anesthetic drugs. Technique, dosages, indications, an...

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BACKGROUND Perispinal anaesthesia for Caesarean section allows injection of epidural (ED) or intrathecal (i.t.) morphine to provide long-lasting postoperative analgesia. To compare these two routes, a prospective, randomized, double-blinded study of 53 patients undergoing elective Caesarean section was performed. METHODS Combined spinal-epidural anaesthesia with 6 mg of i.t. hyperbaric bupiva...

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A 48-year-old man who had undergone thoracotomy for carcinoma of the middle third of his oesophagus developed severe postoperative respiratory depression following intramuscular ketorolac 30 mg 2 h after 150 micrograms epidural buprenorphine. Summation of analgesia by drugs used in combination can have deleterious respiratory effects.

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Epidural, intrathecal pharmacokinetics, and intrathecal bioavailability of ropivacaine.

BACKGROUND Ropivacaine is used by the epidural route for postoperative pain management with various neuraxial techniques. Given the widespread use of these techniques and the relative paucity of data on spinal disposition of local anesthetics, we evaluated through an experimental animal model, the spinal disposition of ropivacaine, allowing further studies of factors influencing their intrathec...

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ژورنال

عنوان ژورنال: Anaesthesia

سال: 1982

ISSN: 0003-2409,1365-2044

DOI: 10.1111/j.1365-2044.1982.tb01245.x