Skip to main content
SpringerLink
Log in

Rückenmarknahe Blockaden: Opioide

  • Chapter
Der postoperative Schmerz

Zusammenfassung

Die Anwendung rückenmarknaher Opioide hat die akute und chronische Schmerztherapie in den letzten Jahrzehnten erheblich bereichert [44, 52, 69, 172, 177, 253]. Ihr Wirkungsmechanismus beruht auf einer Hemmung der Übertragung afferenter nozizeptiver Impulse im Hinterhorn, wo reichlich Opioidrezeptoren vorkommen. Durch Aktivierung dieser Rezeptoren werden entweder weniger erregende Neurotransmitter aus den primären Afferenzen freigesetzt (präsynaptischer Angriffsort), oder es wird die Aktivität der nachgeschalteten Hinterhornzelle postsynaptisch gedämpft. Als wichtigster Vorteil gilt, daß rückenmarknahe Opioide weder die motorische noch die vegetative Reaktionsfähigkeit des Organismus beeinträchtigen. Nach der anfänglichen Begeisterung für diese neue Analgesiemethode sieht es derzeit eher danach aus, als verspräche die Kombination von rückenmarknahen Opioiden mit Lokalanästhetika den größten Erfolg.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

Literatur

  1. Abboud TK, Dror A, Mosaad P, Zhu J, Mantilla M, Swart F, Gangolly J, Silao P, Makar A, Mocre J, Davis H, Lee J (1988) Mini-dose intrathecal morphine for the relief of post-cesarean section pain: safety, efficacy, and ventilatory response to carbon dioxide. Anesth Analg 67:137–143

    Article  PubMed  CAS  Google Scholar 

  2. Abouleish E (1988) Apnoea associated with the intrathecal administration of morphine in obstetrics. A case report. Br J Anaesth 60:592–594

    Article  PubMed  CAS  Google Scholar 

  3. Abouleish E, Rawal N, Tobon-Randall B, Rivera-Weiss M, Meyer B, Wu A, Rashad MN (1993) A clinical and laboratory study to compare the addition of 0.2 mg morphine, 0.2 mg epinephrine, or their combination to hyperbaric bupivacaine for spinal anesthesia in cesarean section. Anesth Analg 77:457–462

    Article  PubMed  CAS  Google Scholar 

  4. Acalovschi I, Ene V, Lörinczi E, Nicolaus F (1986) Saddle block with pethidine for perineal operations. Br J Anaesth 58:1012–1016

    Article  PubMed  CAS  Google Scholar 

  5. Ackerman WE, Juneja MM, Kaczorowiski DM, Colclough GW (1989) A comparison of the incidence of pruritus following epidural opioid administration in the parturient. Can J Anaesth 36:388–391

    Article  PubMed  CAS  Google Scholar 

  6. Ahlgren FIH, Ahlgren MBE (1987) Epidural administration of opiates by a new device. Pain 31:353–357

    Article  PubMed  CAS  Google Scholar 

  7. Alahuhta S, Rasanen J, Jouppila P, Jouppila R, Hollmen AL (1993) Epidural sufentanil and bupivacaine for labor analgesia and Doppler velocimetry of the umbilical and uterine arteries. Anesthesiology 78:231–236

    Article  PubMed  CAS  Google Scholar 

  8. Arner S, Arner B (1985) Differential effects of epidural morphine in the treatment of cancer-related pain. Acta Anaesthesiol Scand 29:32–36

    Article  PubMed  CAS  Google Scholar 

  9. Asantila R, Eklund P, Rosenberg PH (1993) Epidural analgesia with 4mg of morphine following caesarean section: effect of injected volume. Acta Anaesthesiol Scand 37:764–767

    Article  PubMed  CAS  Google Scholar 

  10. Bach V, Carl P, Ravlo O, Crawford ME, Werner M (1986) Potentiation of epidural opioids with epidural droperidol. A one year retrospective study. Anaesthesia 41:1116–1119

    Article  PubMed  CAS  Google Scholar 

  11. Bailey PW, Smith BE (1980) Continuous epidural infusion of fentanyl for postoperative analgesia. Anaesthesia 35:1002–1006

    Article  PubMed  CAS  Google Scholar 

  12. Ballantyne JC, Loach AB, Carr DB (1992) Itching after epidural and spinal opiates. Pain 33:149–160

    Article  Google Scholar 

  13. Baraka A, Noueihid R, Hajj S (1981) Intrathecal injection of morphine for obstetric analgesia. Anesthesiology 54:136–140

    Article  PubMed  CAS  Google Scholar 

  14. Baraka A, Jabbour S, Ghabash M, Nader A, Khoury GG., Sibai A (1993) A comparison of epidural tramadol and epidural morphine for postoperative analgesia. Can J Anaesth 49:308–313

    Google Scholar 

  15. Barron DW, Strong JE (1984) The safety and efficacy of intrathecal diamorphine. Pain 18:279–285

    Article  PubMed  CAS  Google Scholar 

  16. Beattie WS, Buckley DN, Forrest JB (1993) Epidural morphine reduces the risk of postoperative myocardial ischaemia in patients with cardiac risk factors. Can J Anaesth 40:532–541

    Article  PubMed  CAS  Google Scholar 

  17. Beeby D, Macintosh KC, Bailey M, Welch DB (1984) Postoperative analgesia for caesarean section using epidural methadone. Anaesthesia 39:61–63

    Article  PubMed  CAS  Google Scholar 

  18. Benzon HT, Wong HY, Belavic AM, Goodman I, Mitchell D, Lefheit T, Locipero J (1993) A randomized double-blind comparison of epidural fentanyl infusion versus patient-controlled analgesia with morphine for postthoracotomy pain. Anesth Analg 76:316–322

    PubMed  CAS  Google Scholar 

  19. Berger JM, Ontell R (1987) Intrathecal morphine in conjunction with a combined spinal and general anesthetic in a patient with multiple sclerosis. Anesthesiology 66:400–402

    Article  PubMed  CAS  Google Scholar 

  20. Bernard JM, Hommeril JL, Legendre MP, Passuti N, Pinaud M (1993) Spinal or systemic analgesia after extensive spinal surgery: comparison between intrathecal morphine and intravenous fentanyl plus clonidine. J Clin Anesth 5:231–236

    Article  PubMed  CAS  Google Scholar 

  21. Bigler D, Dirkes W, Hansen R, Rosenberg J, Kehlet H (1989) Effects of thoracic paravertebral block with bupivacaine versus combined thoracic epidural block with bupivacaine and morphine on pain and pulmonary function after cholecystectomy. Acta Anaesthesiol Scand 33:561–564

    Article  PubMed  CAS  Google Scholar 

  22. Bilsback P, Roily GG., Tampbulon O (1985) Efficacy of the extradural administration of lofentanil, buprenorphine or saline in the management of postoperative pain. A double-blind study. Br J Anaesth 57:943–948

    Article  PubMed  CAS  Google Scholar 

  23. Blanco J, Blanco E, Carceller JM, Sarabia A, Solares G (1987) Epidural analgesia for post-cesarean pain relief: a comparison between morphine and fentanyl. Eur J Anaesth 4:395–399

    CAS  Google Scholar 

  24. Boidin MP, Sulimma H, Hamers SEES (1991) Fentanyl in 2% mepivacaine compared with fentanyl in 0.5% bupivacaine: two parallel controlled double blind studies. Acta Anaesthesiol Belg 42:93–99

    PubMed  CAS  Google Scholar 

  25. Bonnet F, Diallo A, Saada M, Belon M, Guilbaud M, Boico O (1989) Prevention of tourniquet pain by spinal isobaric bupivacaine with clonidine. Br J Anaesth 63:93–96

    Article  PubMed  CAS  Google Scholar 

  26. Borgeat A, Wilder-Smith OHG, Saiah M, Rifat K (1992) Subhypnotic doses of propofol relieve pruritus induced by epidural and intrathecal morphine. Anesthesiology 76:510–512

    Article  PubMed  CAS  Google Scholar 

  27. Breen TW, Shapiro T, Glass B, Foster-Payne D, Oriol NE (1993) Epidural anesthesia for labor in an ambulatory patient. Anesth Analg 77:919–924

    Article  PubMed  CAS  Google Scholar 

  28. Brodsky JB, Kretzschmar KM, Mark JBD (1988) Caudal epidural morphine for postthoracotomy pain. Anesth Analg 67:409–410

    Article  PubMed  CAS  Google Scholar 

  29. Bromage PR, Joyal AC, Binney JC (1963) Local anaesthetic drugs: penetration from the spinal extradural space into the neuraxis. Science 140:392–394

    Article  PubMed  CAS  Google Scholar 

  30. Bromage PR, Camporesi E, Chestnut D (1980) Epidural narcotics for postoperative analgesia. Anesth Analg 59:473–480

    Article  PubMed  CAS  Google Scholar 

  31. Bromage PR, Camporesi EM, Durant PAC, Nielsen CH (1982) Rostral spread of epidural morphine. Anesthesiology 56:431–436

    Article  PubMed  CAS  Google Scholar 

  32. Bromage PR, Camporesi EM, Durant PAC, Nielsen CH (1982) Nonrespiratory side effects of epidural morphine. Anesth Analg 61:490–495

    PubMed  CAS  Google Scholar 

  33. Brose WG, Tanelian DL, Mark JBD, Cousins MJ (1991) CSF and blood pharmacokinetics of hydromorphone and morphine following lumbar epidural administration. Pain 45:11–15

    Article  PubMed  CAS  Google Scholar 

  34. Brownridge P, Wrobel J, Watt-Smith J (1983) Respiratory depression following accidental subarachnoid pethidine. Anaesth Intensive Care 11:237–240

    PubMed  CAS  Google Scholar 

  35. Brownridge P, Frewin DB (1985) A comparative study of techniques of postoperative analgesia following Cesarean section and lower abdominal surgery. Anaesth Intensive Care 13:123–130

    PubMed  CAS  Google Scholar 

  36. Brownridge P, Plummer L, Mitchell J, Marshall P (1992) An evaluation of epidural bupivacaine with and without meperidine in labor. Regional Anesthesia 17:15–21

    PubMed  CAS  Google Scholar 

  37. Buatti M, Pasternak GW (1981) Multiple opiate receptors: phylogenetic differences. Brain Res 218:400–405

    Article  PubMed  CAS  Google Scholar 

  38. Busch EH, Stedman PM (1987) Epidural morphine for postoperative pain on medical-surgical wards — a clinical review. Anesthesiology 67:101–104

    Article  PubMed  CAS  Google Scholar 

  39. Camann WR, Denney RA, Holby ED, Datta S (1992) A comparison of intrathecal, epidural, and intravenous sufentanil for labor analgesia. Anesthesiology 77:884–887

    Article  PubMed  CAS  Google Scholar 

  40. Camann WR, Mintzer BH, Denney RA, Datta S (1993) Intrathecal sufentanil for labor analgesia. Effects of added epinephrine. Anesthesiology 78:870–874

    Article  PubMed  CAS  Google Scholar 

  41. Carabine UA, Milligan KR, Moore J (1992) Extradural clonidine and bupivacaine for postoperative analgesia. Br J Anaesth 68:132–135

    Article  PubMed  CAS  Google Scholar 

  42. Carl P, Crawford ME, Ravlo O, Bach V (1986) Longterm treatment with epidural opioids. A retrospective study comprising 150 patients treated with morphine chloride and buprenorphine. Anaesthesia 41:32–38

    Article  PubMed  CAS  Google Scholar 

  43. Camu F, Debucquoy F (1991) Alfentanil infusion for postoperative pain: a comparison of epidural and intravenous routes. Anesthesiology 75:171–178

    Article  PubMed  CAS  Google Scholar 

  44. De Castro J, Meynadier J, Zenz M (eds) (1991) Regional opioid analgesia. Physiophar-macological basis, drugs, equipment and clinical application. Kluwer Academic, Dordrecht

    Google Scholar 

  45. Celleno D, Capogna GG., Sebastiani M, Constantino P, Muratori F, Cipriani GG., Emanuelli M (1991) Epidural analgesia during and after cesarean delivery. Comparison of five opioids. Regional Anesthesia 16:79–83

    PubMed  CAS  Google Scholar 

  46. Chaplan SR, Duncan SR, Brodsky JB, Brose WG (1992) Morphine and hydromorphone epidural analgesia. A prospective, randomized comparison. Anesthesiology 77:1090–1094

    Article  PubMed  CAS  Google Scholar 

  47. Chauvin M, Samii K, Schermann JM, Sandouk P, Bourdon R, Viars P (1982) Plasma pharmacokinetics of morphine after i. m., extradural and intrathecal administration. Br J Anaesth 54:843–847

    Article  PubMed  CAS  Google Scholar 

  48. Chauvin M, Hongnat JM, Mourgeon E, Lebrault C, Bellenfant F, Alfonsi P (1993) Equivalence of postoperative analgesia with patient-controlled intravenous or epidural alfentanil. Anesth Analg 76:1251–1258

    PubMed  CAS  Google Scholar 

  49. Di Chiro G (1966) Observations on the circulation of the cerebrospinal fluid. Acta Radiol 5:988–1002

    Google Scholar 

  50. Chrubasik J, Wiemers K (1985) Continuous-plus-on-demand epidural infusion of morphine for postoperative pain relief by means of a small, externally worn infusion device. Anesthesiology 62:263–267

    Article  PubMed  CAS  Google Scholar 

  51. Chrubasik J, Warth L, Wüst H, Bretschneider H, Schulte-Mönting J, Röher HD, Zindler M (1988) Untersuchungen zur analgetischen Wirksamkeit peridural applizierten Tramadols bei der Behandlung von Schmerzen nach abdominalchirurgischen Eingriffen. Schmerz-Pain-Douleur 9:12–18

    Google Scholar 

  52. Chrubasik J, Chrubasik S, Mather L (1993) Postoperative epidural opioids. Springer, Berlin Heidelberg New York Tokyo

    Book  Google Scholar 

  53. Clavier N, Lombard MC, Besson JM (1992) Benzodiazepines and pain: effects of midazolam on the activities of nociceptive non-specific dorsal horn neurons in the rat spinal cord. Pain 48:61–71

    Article  PubMed  CAS  Google Scholar 

  54. Clemensen SE, Thayssen P, Hole P (1987) Epidural morphine for outpatients with severe anginal pain. Br Med J 294:475–476

    Article  CAS  Google Scholar 

  55. Clergue F, Montembault C, Despierres O, Ghesquiere F, Harari A, Viars P (1984) Respiratory effects of intrathecal morphine after upper abdominal surgery. Anesthesiology 61:677–685

    Article  PubMed  CAS  Google Scholar 

  56. Cohen SE, Tan S, Albright GA, Halpern J (1987) Epidural fentanyl/bupivacaine mixtures for obstetric analgesia. Anesthesiology 67:403–407

    Article  PubMed  CAS  Google Scholar 

  57. Cohen S, Amar D, Pantuck CB, Pantuck EJ, Weissman AM, Landa S, Singer N (1992) Epidural patient-controlled analgesia after cesarean section: buprenorphine-0.015% bupivacaine versus fentanyl-0.015% with and without epinephrine. Anesth Analg 74:226–230

    Article  PubMed  CAS  Google Scholar 

  58. Cohen SE, Ratner EF, Kreitzman TR, Archer JH, Mignano LR (1992) Nalbuphine is better than naloxone for treatment of side effects after epidural morphine. Anesth Analg 75:747–752

    PubMed  CAS  Google Scholar 

  59. Cohen S, Amar D, Pantuck CB, Pantuck EJ, Goodman EJ, Widroff JS, Kanas RJ, Brady JA (1993) Postcesarean delivery epidural patient-controlled analgesia. Fentanyl or sufentanil? Anesthesiology 78:486–491

    Article  PubMed  CAS  Google Scholar 

  60. Cohen E, Neustein SM (1993) Intrathecal morphine during thoracotomy, part I: effect on intraoperative enflurane requirements. J Cardiothorac Vasc Anesth 7:154–156

    Article  PubMed  CAS  Google Scholar 

  61. Coombs DW, Fratkin JD, Meier FA, Nierenberg DW, Saunders RL (1985) Neuropatho-logical lesions and CSF concentrations during continuous intraspinal morphine infusion. A clinical and post-mortem study. Pain 22:337–351

    Article  PubMed  CAS  Google Scholar 

  62. Coombs DW, Saunders RL, Lachange D, Savage S, Ragnarsson TS, Jensen LE (1985) Intrathecal morphine tolerance: use of intrathecal clonidine, DADLE, and intraventricular morphine. Anesthesiology 62:358–363

    Article  PubMed  CAS  Google Scholar 

  63. Coombs DW (1986) Management of chronic pain by epidural and intrathecal opioids. Newer drugs and delivery systems. Int Anesthesiol Clin 24:59–74

    Article  PubMed  CAS  Google Scholar 

  64. Cooper RA, Devlin E, Boyd TH, Bali IM (1993) Epidural analgesia for labour using a continuous infusion of bupivacaine and alfentanil. Eur J Anaesth 10:183–187

    CAS  Google Scholar 

  65. Cooper DW, Turner G (1993) Patient-controlled extradural analgesia to compare bupivacaine, fentanyl, and bupivacaine with fentanyl in the treatment of postoperative pain. Br J Anaesth 70:503–507

    Article  PubMed  CAS  Google Scholar 

  66. Coppe E, Willaert J (1992) Postoperative analgesia for major abdominal surgery with continuous thoracic epidural infusion of bupivacaine with sufentanil, versus bupivacaine with morphine. A randomized double blind study. Acta Anaesthesiol Belg 43:131–137

    PubMed  CAS  Google Scholar 

  67. Courtney MA, Bader AM, Hartwell B, Hauch M, Grennan MJ, Datta S (1992) Perioperative analgesia with subarachnoid sufentanil administration. Regional Anesthesia 17:274–278

    PubMed  CAS  Google Scholar 

  68. Cousins MJ, Mather LE (1984) Intrathecal and epidural administration of opioids. Anesthesiology 61:276–310

    Article  PubMed  CAS  Google Scholar 

  69. Cousins MJ, Bridenbaugh PO (1986) Spinal opioids and pain relief in acute care. In: Cousins MJ, Phillips GD (eds) Acute pain management, Churchill Livingstone, New York, pp 151–185

    Google Scholar 

  70. Crone LAL, Conly JM, Clark KM, Crichlow AC, Wardell GC, Zbitnew A, Rea LM, Cronk SL, Anderson CM, Tan LK, Albritton WL (1988) Recurrent herpes simplex virus labialis and the use of epidural morphine in obstetric patients. Anesth Analg 67:318–323

    Article  PubMed  CAS  Google Scholar 

  71. Crone LAL, Conly JM, Storgard C, Zbitnew A, Cronk SL, Rea LM, Greeg K, Berenbaum E, Tan LK, To T (1990) Herpes labialis in parturients receiving epidural morphine following cesarean section. Anesthesiology 73:208–213

    Article  PubMed  CAS  Google Scholar 

  72. Cross DA, Hunt JB (1991) Feasibility of epidural morphine for postoperative analgesia in a small community hospital. Anesth Analg 72:765–768

    Article  PubMed  CAS  Google Scholar 

  73. Cullen ML, Staren ED, El-Ganzouri A, Logas WG, Ivkanovich AD, Economou SG (1985) Continuous epidural infusion for analgesia after major abdominal operations: a randomised prospective double-blind study. Surgery 98:718–726

    PubMed  CAS  Google Scholar 

  74. Dailey PA, Brookshire L, Abboud TK, Kotelko DM, Noueihid R, Thipgen JW, Khoo SS, Raya JA, Foutz SE, Vrizgys RV, Goebelsmann U, Lo MW (1985) The effects of naloxone associated with the intrathecal use of morphine in labor. Anesth Analg 64:658–666

    Article  PubMed  CAS  Google Scholar 

  75. Davis I (1987) Intrathecal morphine in aortic aneurysm surgery. Anaesthesia 42:491–497

    Article  PubMed  CAS  Google Scholar 

  76. Delilkan AE, Vijayan R (1993) Epidural tramadol for postoperative pain relief. Anaesthesia 48:328–331

    Article  PubMed  CAS  Google Scholar 

  77. Dickenson AH, Sullivan AF, McQuay HJ (1990) Intrathecal etorphine, fentanyl and buprenorphine on spinal nociceptive neurones in the rat. Pain 42:227–234

    Article  PubMed  CAS  Google Scholar 

  78. Domsky M, Kwartowitz J (1992) Efficacy of subarachnoid morphine in a community hospital. Regional Anesthesia 17:279–282

    PubMed  CAS  Google Scholar 

  79. Donadoni R, Capiau P (1987) Cardiac arrest after spinal sufentanil: a case report. Acta Anaesthesiol Belg 38:175–177

    PubMed  CAS  Google Scholar 

  80. Dottrens M, Rifat K, Morel DR (1992) Comparison of extradural administration of sufentanil, morphine and sufentanil-morphine combination after caesarean section. Br J Anaesth 69:9–12

    Article  PubMed  CAS  Google Scholar 

  81. Dougherty TB, Baysinger CL, Henenberger JC, Gooding DJ (1989) Epidural hydrom-orphine with and without epinephrine for post-operative analgesia after cesarean delivery. Anesth Analg 68:318–322

    Article  PubMed  CAS  Google Scholar 

  82. Douglas MJ, Kim JHK, Ross PLE, McMorland GH (1986) The effect of epinephrine in local anaesthetic on epidural morphine-induced pruritus. Can Anaesth Soc J 33:737–740

    Article  PubMed  CAS  Google Scholar 

  83. Downing JW, Williams V, Porte D, Woods S, Fogel K, Horn JH (1984) Rostral spread of epidural morphine. Anesth Analg 63:371–376

    Article  Google Scholar 

  84. Duffy BL, Read MD (1984) Epidural pethidine for relief of episiotomy pain. Anaesth Intensive Care 12:137–139

    PubMed  CAS  Google Scholar 

  85. DuPen SL, Ramsey D, Chin S (1987) Chronic epidural morphine and preservative-induced injury. Anesthesiology 67:987–988

    Article  CAS  Google Scholar 

  86. Egan KJ, Ready LB (1994) Patient satisfaction with intravenous PCA or epidural morphine. Can J Anaesth 41:6–11

    Article  PubMed  CAS  Google Scholar 

  87. Ellis DJ, Millar WL, Reisner LS (1990) A randomised double-blind comparison of epidural versus intravenous fentanyl infusion for analgesia after cesarian section. Anesthesiology 72:981–986

    Article  PubMed  CAS  Google Scholar 

  88. Etches RC, Sandier AN, Daley MD (1989) Respiratory depression and spinal opioids. Can J Anaesth 36:165–185

    Article  PubMed  CAS  Google Scholar 

  89. van Essen EJ, Bovill JG, Ploeger EJ, Beerman H (1988) Intrathecal morphine and clonidine for control of intractable cancer pain. A case report. Acta Anaesthesiol Belg 39:109–112

    PubMed  Google Scholar 

  90. Evron S, Samueloff A, Simon A, Drengler B, Magora F (1985) Urinary function during epidural analgesia with methadone and morphine in post-cesarean section patients. Pain 23:135–144

    Article  PubMed  CAS  Google Scholar 

  91. Famewo CE, Naguib M (1985) Spinal anaesthesia with meperidine as the sole agent. Can Anaesth Soc J 32:533–537

    Article  PubMed  CAS  Google Scholar 

  92. Feldstein GS, Waldmann SD, Allen ML (1987) Reversal of apparent tolerance to epidural morphine by epidural methylprednisolone. Anesth Analg 66:264–266

    Article  PubMed  CAS  Google Scholar 

  93. Fischer RL, Lubenow TR, Liceaga A, McCarthy RJ, Ivankovich AD (1988) Comparison of continuous epidural infusion of fentanyl-bupivacaine and morphine-bupivacaine in management of postoperative pain. Anesth Analg 67:559–563

    Article  PubMed  CAS  Google Scholar 

  94. Fitzpatrick GJ, Moriarty DC (1988) Intrathecal morphine in the management of pain following cardiac surgery. A comparison with morphine i. v. Br J Anaesth 60:639–644

    Article  PubMed  CAS  Google Scholar 

  95. Fogarty DJ, Carabine UA, Milligan KR (1993) Comparison of the analgesic effects of intrathecal clonidine and intrathecal morphine after spinal anaesthesia in patients undergoing total hip replacement. Br J Anaesth 71:661–664

    Article  PubMed  CAS  Google Scholar 

  96. Fraser HM, Chapman V, Dickenson AH (1992) Spinal local anaesthetic actions on afferent evoked responses and wind-up of nociceptive neurones in the rat spinal cord: combination with morphine produces marked potentiation of antinociception. Pain 49:33–41

    Article  PubMed  CAS  Google Scholar 

  97. Gambling DR, Huber CJ, Howell P, Swenerton JE, Ross PLE, Crochetière CT, Pavy TJG (1993) Patient-controlled epidural analgesia in labour: varying bolus dose and lockout interval. Can J Anaesth 40:211–217

    Article  PubMed  CAS  Google Scholar 

  98. Geller E, Chrubasik J, Graf R, Chrubasik S, Schulte-Mönting J (1993) A randomized double-blind comparison of epidural sufentanil versus intravenous sufentanil or epidural fentanyl analgesia after major abdominal surgery. Anesth Analg 76:1243–1250

    PubMed  CAS  Google Scholar 

  99. George KA, Chisakuta AM, Gamble JAS, Browne GA (1992) Thoracic epidural infusion for postoperative pain relief following abdominal aortic surgery: bupivacaine, fentanyl or a mixture of both? Anaesthesia 47:338–394

    Article  Google Scholar 

  100. Girotra S, Kumar S, Rajendran KM (1993) Caudal buprenorphine for postoperative analgesia in children: a comparison with intramuscular buprenorphine. Acta Anaesthesiol Scand 37:361–364

    Article  PubMed  CAS  Google Scholar 

  101. Glass PSA (1984) Respiratory depression following only 0.4mg of intrathecal morphine. Anesthesiology 60:256–257

    Article  PubMed  CAS  Google Scholar 

  102. Goodchild CS, Serrao JM (1987) Intrathecal midazolam in the rat: evidence for spinally-mediated analgesia. Br J Anaesth 59:1563–1570

    Article  PubMed  CAS  Google Scholar 

  103. Gordh T (1988) Epidural clonidine for treatment of postoperative pain after thoracotomy. A double-blind placebo-controlled study. Acta Anaesthesiol Scand 32:702–709

    Article  PubMed  Google Scholar 

  104. Gourlay GK, Cherry DA, Cousins MJ (1985) Cephalad migration of morphine in CSF following lumbar epidural administration in patients with cancer pain. Pain 23:317–326

    Article  PubMed  CAS  Google Scholar 

  105. Gourlay GK, Cherry DA, Plummer JL, Armstrong PJ, Cousins MJ (1987) The influence of drug polarity on the absorption of opioid drugs into CSF and subsequent cephalad migration following lumbar epidural administration: application to morphine and pethidine. Pain 31:297–305

    Article  PubMed  CAS  Google Scholar 

  106. Grant RP, Dolman JF, Harper JA, White SA, Parsons DG, Evans KG, Merrick CP (1992) Patient-controlled lumbar epidural fentanyl compared with patient-controlled intravenous fentanyl for post-thoracotomy pain. Can J Anaesth 39:214–219

    Article  PubMed  CAS  Google Scholar 

  107. Grass JA (1992) Sufentanil: clinical use as postoperative analgesic — epidural/intrathecal route. J Pain Symptom Manage 7:271–286

    Article  PubMed  CAS  Google Scholar 

  108. Grass JA (1992) Fentanyl: clinical use as postoperative analgesic — epidural/intrathecal route. J Pain Symptom Manage 7:419–430

    Article  PubMed  CAS  Google Scholar 

  109. Gray JR, Fromme GA, Nauss LA, Wang JK, Ilstrup DM (1986) Intrathecal morphine for post-thoracotomy pain. Anesth Analg 65:873–876

    Article  PubMed  CAS  Google Scholar 

  110. Grieco WM, Norris MC, Leighton BL, Arkoosh VA, Huffnagle HJ, Hornet JE, Costello D (1993) Intrathecal sufentanil labor analgesia: the effect of adding morphine or epinephrine. Anesth Analg 77:1149–1154

    Article  PubMed  CAS  Google Scholar 

  111. Guinard JP, Chiolera R, Mavrocordatos P, Carpenter RL (1993) Prolonged intrathecal fentanyl analgesia via 32-Gauge catheters after thoracotomy. Anesth Analg 77:936–941

    Article  PubMed  CAS  Google Scholar 

  112. Gundersen RY, Andersen R, Narverud G (1986) Postoperative pain relief with high-dose epidural buprenorphine: a double-blind study. Acta Anaesthesiol Scand 30:664–667

    Article  PubMed  CAS  Google Scholar 

  113. Gustafsson LL, Friberg-Nielsen S, Garle M, Mohall A, Rane A, Schildt B, Symreng T (1982) Extradural and parenteral morphine: kinetics and effects in postoperative pain. A controlled clinical study. Br J Anaesth 54:1167–1174

    Article  PubMed  CAS  Google Scholar 

  114. Gustafsson LL, Schildt B, Jacobsen K (1982) Adverse effects of extradural and intrathecal opiates: report of a nationwide survey in Sweden. Br J Anaesth 54:479–486

    Article  PubMed  CAS  Google Scholar 

  115. Halonen PM, Paatero H, Hovorka J, Haasio J, Korttila K (1993) Comparison of two fentanyl doeses to improve epidural anaesthesia with 0.5% bupivacaine for caesarean section. Acta Anaesthesiol Scand 37:774–779

    Article  PubMed  CAS  Google Scholar 

  116. Haynes SR, Davidson I, Allsop JR, Dutton DA (1993) Comparison of epidural methadone with epidural diamorphine for analgesia following caesarean section. Acta Anaesthesiol Scand 37:375–380

    Article  PubMed  CAS  Google Scholar 

  117. Henderson SK, Cohen H (1986) Nalbuphine augmentation of analgesia and reversal of side effects following epidural hydromorphone. Anesthesiology 65:216–218

    Article  PubMed  CAS  Google Scholar 

  118. Henderson SK, Matthew EB, Cohen H, Avram MJ (1987) Epidural hydromorphone: a double-blind comparison with intramuscular hydromorphone for postcesarean section analgesia. Anesthesiology 66:825–830

    Article  PubMed  CAS  Google Scholar 

  119. Henneberg SW, Hole P, Madsen de Haas I, Jensen PJ (1993) Epidural morphine for postoperative pain relief in childrebn. Acta Anaesthesiol Scand 37:664–667

    Article  PubMed  CAS  Google Scholar 

  120. Herz A, Teschemacher HJ (1971) Activities and sites of antinociceptive action of morphine-like analgesics. Adv Drug Res 6:79–119

    CAS  Google Scholar 

  121. Hjortso NC, Neumann P, Frosig F, Andersen T, Lindhard A, Rogon E, Kehlet H (1985) A controlled study on the effect of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery. Acta Anaesthesiol Scand 29:790–796

    Article  PubMed  CAS  Google Scholar 

  122. Hogan Q, Haddox JD, Abram S, Weissman D, Taylor ML, Janjan N (1991) Epidural opiates and local anaesthetics for the management of cancer pain. Pain 46:271–279

    Article  PubMed  CAS  Google Scholar 

  123. Honet JE, Arkoosh VA, Norris MC, Huffnagle HJ, Silverman NS, Leighton BL (1992) Comparison among intrathecal fentanyl, meperidine, and sufentanil for labor analgesia. Anesth Analg 75:734–739

    Article  PubMed  CAS  Google Scholar 

  124. Houweling PL, Ionescu TI, Leguit P, van der Tweel I, Smalhout B (1993) Comparison of the cardiovascular effects of intravenous, epidural and intrathecal sufentanil analgesia as a supplement to general anaesthesia for abdominal aortic aneurysm surgery. Eur J Anaesth 10:403–411

    CAS  Google Scholar 

  125. Horta ML, Horta BL (1993) Inhibition of epidural morphine-induced pruritus by intravenous droperidol. Regional Anesthesia 18:118–120

    PubMed  CAS  Google Scholar 

  126. Howell CJ, Chalmers I (1992) A review of prospectively controlled comparisons of epidural forms of pain relief during labour. Int J Obstet Anesth 2:1–17

    Google Scholar 

  127. Hughes SC, Rosen MA, Shnider SM, Abboud TK, Stefani SJ, Norton M (1984) Maternal and neonatal effects of epidural morphine for labor and delivery. Anesth Analg 63:319–324

    Article  PubMed  CAS  Google Scholar 

  128. Huntoon M, Eisenach JC, Boese P (1992) Epidural clonidine after cesarian section. Anesthesiology 76:187–193

    Article  PubMed  CAS  Google Scholar 

  129. Husemeyer RP, O’Connor MC, Davenport HT (1980) Failure of epidural morphine to relieve pain in labour. Anaesthesia 35:161–163

    Article  PubMed  CAS  Google Scholar 

  130. Hyde NH, Harrison DM (1986) Intrathecal morphine in a parturient with cystic fibrosis. Anesth Analg 65:1357–1358

    Article  PubMed  CAS  Google Scholar 

  131. Jacobson L, Chabal C, Brody MC, Ward RJ, Ireton RC (1989) Intrathecal methadone and morphine for postoperative analgesia: a comparison of the efficacy, duration, and side effects. Anesthesiology 70:742–746

    Article  PubMed  CAS  Google Scholar 

  132. Jacobson L, Chabal C, Brody MC, Ward RJ, Wasse L (1990) Intrathecal methadone: a dose-response study and comparison with intrathecal morphine 0.5mg. Pain 43:141–148

    Article  PubMed  CAS  Google Scholar 

  133. Jamous MA, Hand CW, Moore RA, Teddy PJ, McQuay HJ (1986) Epinephrine reduces systemic absorption of extradural diacetylmorphine. Anesth Analg 65:1290–1294

    Article  PubMed  CAS  Google Scholar 

  134. Johansson A, Hao J, Sjölund B (1990) Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand 34:335–338

    Article  PubMed  CAS  Google Scholar 

  135. Johnsson A, Bengtsson M, Söderlind K, Löfström JB (1992) Influence of intrathecal morphine and naloxone intervention on postoperative ventilatory regulation in elderly patients. Acta Anaesthesiol Scand 36:436–444

    Article  Google Scholar 

  136. Jyu C, Lamb JD (1985) Respiratory depression following epidural morphine. Can Anaesth Soc J 32:99–100

    Article  PubMed  CAS  Google Scholar 

  137. Kafle SK (1993) Intrathecal meperidine for elective caesarean section: a comparison with lidocaine. Can J Anaesth 40:718–721

    Article  PubMed  CAS  Google Scholar 

  138. Kaiser KG, Bainton CR (1987) Treatment of intrathecal morphine overdose by aspiration of cerebrospinal fluid. Anesth Analg 66:475–477

    Article  PubMed  CAS  Google Scholar 

  139. Kalia PK, Madan R, Saksena R, Batra R, Gode GR (1983) Epidural pentazocine for postoperative pain relief. Anesth Analg 62:949–950

    Article  PubMed  CAS  Google Scholar 

  140. Kalso E (1983) Effect of intrathecal morphine injected with bupivacaine on pain after orthopaedic surgery. Br J Anaesth 55:415–422

    Article  PubMed  CAS  Google Scholar 

  141. Kehlet H, Dahl JB (1993) The value of „multimodal“ or „balanced analgesia“ in postoperative pain treatment. Anesth Analg 77:1048–1056

    Article  PubMed  CAS  Google Scholar 

  142. Kestin IG, Madden AP, Mulvein JT, Goodman NW (1992) Analgesia for labour and delivery using incremental diamorphine and bupivacaine via a 32-Gauge intrathecal catheter. Br J Anaesth 68:244–247

    Article  PubMed  CAS  Google Scholar 

  143. Knape JTA (1986) Early respiratory depression resistant to naloxone following epidural buprenorphine. Anesthesiology 64:382–384

    Article  PubMed  CAS  Google Scholar 

  144. Knill RL, Clement JL, Thompson WR (1981) Epidural morphine causes delayed and prolonged ventilatory depression. Can Anaesth Soc J 28:537–543

    Article  PubMed  CAS  Google Scholar 

  145. Kotob HIM, Hand CW, Moore RA, Evans PJD, Wells J, Rubin AP, McQuay HJ (1986) Intrathecal morphine and heroin in man: six hour drug levels in spinal fluid and plasma. Anesth Analg 65:718–722

    Article  PubMed  CAS  Google Scholar 

  146. Krane EJ, Jacobson LE, Lynn AM, Parrot C, Tyler DC (1987) Caudal morphine for postoperative analgesia in children: a comparison with caudal bupivacaine and intravenous morphine. Anesth Analg 66:647–653

    PubMed  CAS  Google Scholar 

  147. Krane EJ (1988) Delayed respiratory depression in a child after caudal epidural morphine. Anesth Analg 67:79–82

    Article  PubMed  CAS  Google Scholar 

  148. Lanz E, Simon G, Theiss D, Glocke MH (1984) Epidural buprenorphine — a double blind study of postoperative analgesia and side effects. Anesth Analg 63:593–598

    Article  PubMed  CAS  Google Scholar 

  149. Laveaux MMD, Hasenbos MAWM, Harbers JBM, Liem T (1993) Thoracic epidural bupivacaine plus sufentanil: high concentration/low volume versus low concentration/ high volume. Regional Anesthesia 18:39–43

    PubMed  CAS  Google Scholar 

  150. Lee A, Simpson D, Whitfield A, Scott DB (1988) Postoperative analgesia by continuous extradural infusion of bupivacaine and diamorphine. Br J Anaesth 60:845–850

    Article  PubMed  CAS  Google Scholar 

  151. Leighton BL, DeSimone CA, Norris MC, Ben-David B (1989) Intrathecal narcotics for labor revisited: the combination of fentanyl and morphine intrathecally provides rapid onset of profound, prolonged analgesia. Anesth Analg 69:122–125

    Article  PubMed  CAS  Google Scholar 

  152. Lehmann KA, Stern S, Breuker KH (1992) Geburtshilfliche Periduralanästhesie mit Bupivacain und Buprenorphin. Eine randomisierte Doppelblindstudie im Vergleich zur unbehandelten Kontrolle. Anaesthesist 41:414–422

    PubMed  CAS  Google Scholar 

  153. Lewis RP, Spiers SPW, McLaren IM, Hunt PCW, Smith HS (1992) Pethidine as a spinal anaesthetic agent — a comparison with plain bupivacaine in patients undergoing transurethral resection of the prostate. Eur J Anaesth 9:105–109

    CAS  Google Scholar 

  154. Lipp M, Daubländer M, Lanz E (1987) Buprenorphin 0,15 mg intrathecal zur postoperativen Analgesie. Eine klinische Doppelblindstudie. Anaesthesist 36:233–238

    PubMed  CAS  Google Scholar 

  155. Logas WG, El-Baz N, El-Ganzouri A, Cullen M, Staren E, Faber LP, Ivankovich AD (1987) Continuous thoracic epidural analgesia for postoperative pain relief following thoracotomy. Anesthesiology 67:787–791

    Article  PubMed  CAS  Google Scholar 

  156. Loper KA, Ready LB, Downey M, Sandier AN, Nessly M, Rapp S, Badner N (1990) Epidural and intravenous fentanyl infusions are clinically equivalent after knee surgery. Anesth Analg 70:72–75

    Article  PubMed  CAS  Google Scholar 

  157. Madsen KE, Stowe DF, McDonald DJ, Ebert TJ, Kampine JP (1990) A comparison of epidural narcotics, with and without a test dose, to epidural lignocaine for extracorporeal shock wave lithotripsy. Regional Anesthesia 15:288–294

    PubMed  CAS  Google Scholar 

  158. Maier C, Wawersik J, Wulf H (1991) Ergebnis einer Fragebogenerhebung zur Praxis und Organisation der postoperativen Periduralanalgesie an 461 Fachabteilungen für An-ästhesiologie. Reg Anaesth 14:61–69

    PubMed  CAS  Google Scholar 

  159. Malinow AM, Moriski BLK, Nomura MK, Kaufman MA, Snell JA, Sharp GD, Howard RA (1990) Effect of epinephrine on intrathecal fentanyl analgesia in patients undergoing postpartum tubal ligation. Anesthesiology 73:381–385

    Article  PubMed  CAS  Google Scholar 

  160. Marlowe S, Engstrom R, White PF (1989) Epidural patient-controlled analgesia (PCA): an alternative to continuous epidural infusions. Pain 37:97–101

    Article  PubMed  CAS  Google Scholar 

  161. Martin CS, McGrady EM, Colquhoun A, Thorburn J (1990) Extradural methadone and bupivacaine in labour. Br J Anaesth 65:330–332

    Article  PubMed  CAS  Google Scholar 

  162. Martin R, Tetrault JP, Tetrault L, Lamarche Y, Veilleux LJ (1983) Epidural morphine in obstetrical analgesia: effect of epinephrine addition. Can Anaesth Soc J 30:72

    Article  Google Scholar 

  163. Mathews ET, Abrams LD (1980) Intrathecal morphine in open heart surgery. Lancet 2:543

    Article  PubMed  CAS  Google Scholar 

  164. Maves TJ, Gebhart GF (1992) Antinociceptive synergy between intrathecal morphine and lidocaine during visceral and somatic nociception in the rat. Anesthesiology 76:91–99

    Article  PubMed  CAS  Google Scholar 

  165. McEllistrem RF, Bennington RG, Roth SH (1993) In vitro determination of human dura mater permeability to opioids and local anaesthetics. Can J Anaesth 40:165–169

    Article  PubMed  CAS  Google Scholar 

  166. McQuay HJ, Bullingham RES, Moore RA (1981) Acute opiate tolerance in man. Life Sci 28:2513–2517

    Article  PubMed  CAS  Google Scholar 

  167. McQuay HJ, Sullivan AF, Smallman K, Dickenson AH (1989) Intrathecal opioids, potency and lipophilicity. Pain 36:111–115

    Article  PubMed  CAS  Google Scholar 

  168. Molke Jensen F, Jensen NH, Holk IK, Ravnborg M (1987) Prolonged and biphasic respiratory depression following epidural buprenorphine. Anaesthesia 42:470–475

    Article  PubMed  CAS  Google Scholar 

  169. Moore RA, Bullingham RES, McQuay HJ, Hand CW, Aspel JB, Allen MC, Thomas D (1982) Durai permeability to narcotics: in vitro determination and application to extradural administration. Br J Anaesth 54:1117–1128

    Article  PubMed  CAS  Google Scholar 

  170. Moore R, Bullingham R, McQuay HJ, Allen M, Baldwin D, Cole A (1984) Spinal fluid kinetics of morphine and heroin. Clin Pharmacol Ther 35:40–45

    Article  PubMed  CAS  Google Scholar 

  171. Moreau JL, Pieri L (1988) Effects of an intrathecally administered benzodiazepine receptor agonist, antagonist and inverse agonist on morphine-induced inhibition of a spinal nociceptive reflex. Br J Pharmacol 93:964–968

    Article  PubMed  CAS  Google Scholar 

  172. Morgan M (1989) The rational use of intrathecal and extradural opioids. Br J Anaesth 63:165–188

    Article  PubMed  CAS  Google Scholar 

  173. Motsch J, Gräber E, Ludwig K (1990) Addition of clonidine enhances postoperative analgesia from epidural morphine: a double-blind study. Anesthesiology 73:1067–1073

    Article  PubMed  CAS  Google Scholar 

  174. Moulin DE, Inturrisi CE, Foley KM (1986) Epidural and intrathecal opioids: cerebrospinal fluid and plasma pharmacokinetics in cancer pain patient. Adv Pain Res Ther 8:369–383

    Google Scholar 

  175. Müller H, Gips H, Krumholz W, Zierski J, Lüben V, Hempelmann G (1986) Pharmakokinetik der kontinuierlichen periduralen Morphininfusion. Anaesthesist 35:672–678

    PubMed  Google Scholar 

  176. Naji P, Farschtschian M, Wilder-Smith O, Wilder-Smith CH (1990) Epidural droperidol and morphine for postoperative pain. Anesth Analg 70:583–588

    Article  PubMed  CAS  Google Scholar 

  177. Naulty JS (1989) The role of intrathecal opiates in the management of acute pain. Clin J Pain [Suppl 1]:S16-S27

    Google Scholar 

  178. Nguyen Thi TV, Orliaguet GG., Liu N, Delaunay L, Bonnet F (1992) A dose-range study of intrathecal meperidine combined with bupivacaine. Acta Anaesthesiol Scand 36:516–518

    Article  Google Scholar 

  179. Niemi L, Pitkänen MT, Tuominen MK, Rosenberg PH (1993) Comparison of intrathecal fentanyl infusion with intrathecal morphine infusion or bolus for postoperative pain relief after hip arthroplasty. Anesth Analg 77:126–130

    Article  PubMed  CAS  Google Scholar 

  180. Niv D, Whitwam JG, Loh L (1983) Depression of nociceptive sympathetic reflexes by the intrathecal administration of midazolam. Br J Anaesth 55:541–547

    Article  PubMed  CAS  Google Scholar 

  181. Niv D, Rudick V, Golan A, Chayen MS (1986) Augmentation of bupivacaine analgesia in labor by epidural morphine. Obstet Gynecol 67:206–209

    Article  PubMed  CAS  Google Scholar 

  182. Nolan JP, Dow AAC, Parr MJA, Dauphinee K, Kalish M (1992) Patient-controlled epidural analgesia following post-traumatic pelvic reconstruction. A comparison with continuous epidural analgesia. Anaesthesia 47:1037–1041

    Article  PubMed  CAS  Google Scholar 

  183. Nordberg GG., Hedner T, Meilstrand T, Dahlström B (1983) Pharmacokinetic aspects of epidural morphine analgesia. Anesthesiology 58:545–551

    Article  PubMed  CAS  Google Scholar 

  184. Nordberg G (1984) Pharmacokinetic aspects of spinal morphine analgesia. Acta Anaesthesiol Scand 28 [Suppl 79]:1–39

    Article  Google Scholar 

  185. Nordberg G, Hedner T, Meilstrand T, Dahlström B (1984) Pharmacokinetic aspects of intrathecal morphine analgesia. Anesthesiology 60:448–454

    Article  PubMed  CAS  Google Scholar 

  186. Nordberg G, Mellstrand T, Borg L, Hedner T (1986) Extradural morphine: influence of adrenaline admixture. Br J Anaesth 58:598–604

    Article  PubMed  CAS  Google Scholar 

  187. Ogawa K, Iranami H, Yoshiyama T, Maeda H, Hatano Y (1993) Severe respiratory depression after epidural morphine in a patient with myotonic dystrophy. Can J Anaesth 40:968–970

    Article  PubMed  CAS  Google Scholar 

  188. Ossipov MH, Suarez LJ, Spaulding TC (1989) Antinociceptive interactions between alpha2-adrenergic and opiate agonists at the spinal level in rodents. Anesth Analg 68:194–200

    Article  PubMed  CAS  Google Scholar 

  189. Oyama T, Murakawa T, Baba S, Nagao H (1987) Continuous vs. bolus epidural morphine. Acta Anaesthesiol Scand 31 [Suppl 85]:77–79

    Article  Google Scholar 

  190. Palmer CM (1991) Early respiratory depression following intrathecal fentanyll-morphine combination. Anesthesiology 74:1153–1155

    Article  PubMed  CAS  Google Scholar 

  191. Parker RK, White PF (1992) Epidural patient-controlled analgesia: an alternative to intravenous patient-controlled analgesia for pain relief after cesarean delivery. Anesth Analg 75:245–251

    PubMed  CAS  Google Scholar 

  192. Pasqualucci V, Tantucci C, Paoletti F, Dottorini ML, Bifarini G, Belfiori R, Berioli MB, Sorbini CA (1987) Buprenorphine vs. morphine via the epidural route: a controlled comparative clinical study of respiratory effects and analgesic activity. Pain 29:273–286

    Article  PubMed  CAS  Google Scholar 

  193. Paterson GMC, McQuay HJ, Bullingham RES, Moore RA (1984) Intradural morphine and diamorphine dose-response studies. Anaesthesia 39:113–117

    Article  PubMed  CAS  Google Scholar 

  194. Paulus DA, Paul WL, Munson ES (1981) Neurologic depression after intrathecal morphine. Anesthesiology 54:517–518

    Article  PubMed  CAS  Google Scholar 

  195. Payne R (1987) CSF distribution of opioids in animals and man. Acta Anaesthesiol Scand 31 [Suppl 85]:38–46

    Article  Google Scholar 

  196. Pelton JJ, Fish DJ, Keller SM (1993) Epidural narcotic analgesia after thoracotomy. South Med J 86:1106–1109

    Article  PubMed  CAS  Google Scholar 

  197. Perrot GG., Muller A, Laugner B (1983) Surdosage accidentel en morphine intrarachidienne. Traitement par naloxone intravéneuse seule. Ann Fr Anesth Reanim 2:412–414

    Article  PubMed  CAS  Google Scholar 

  198. Petry T, Cloez O, Pertek JP, Heck M, Auque J (1985) Dépression respiratoire après injection intrathécale de morphine: intert de la naloxone in situe. Ann Fr Anesth Reanim 4:424–426

    Article  PubMed  CAS  Google Scholar 

  199. Philippe AC, Durant MD (1988) Intraspinal analgesia and urinary bladder dysfunction. Acta Anaesthesiol Belg 39:163–167

    PubMed  CAS  Google Scholar 

  200. Racle JP, Poy JY, Benkhadra A, Lourdren L, Fockenier F (1988) Prolongation de la rachianesthésie la bupivacaine hyperbare par l’adrenaline et la clonidine chez le viellard. Ann Fr Anesth Réanim 7:139–144

    Article  PubMed  CAS  Google Scholar 

  201. Rawal N, Mollefors K, Axelsson K, Lingardh GG., Widman B (1983) An experimental study of urodynamic effects of epidural morphine and naloxone reversal. Anesth Analg 62:641–647

    Article  PubMed  CAS  Google Scholar 

  202. Rawal N, Sjöstrand UH (1986) Clinical application of epidural and intrathecal opioids for pain management. Int Anesthesiol Clin 24:43–57

    Article  PubMed  CAS  Google Scholar 

  203. Rawal N, Arner S, Gustafsson LL, Allvin R (1987) Present state of extradural and intrathecal opioid analgesia in Sweden. A nationwide follow-up survey. Br J Anaesth 59:791–799

    Article  PubMed  CAS  Google Scholar 

  204. Ready LB, Oden R, Chadwick HS, Benedetti C, Rooke GA, Caplan R, Wild LM (1988) Development of an anesthesiology-based postoperative pain management service. Anesthesiology 68:100–106

    Article  PubMed  CAS  Google Scholar 

  205. Ready LB, Loper KA, Nessly M, Wild L (1991) Postoperative epidural morphine is safe on surgical wards. Anesthesiology 75:452–456

    Article  PubMed  CAS  Google Scholar 

  206. Ready LB, Edwards WT (eds) (1992) Managemement of acute pain: a practical guide. Task Force on Acute Pain, International Association for the Study of Pain, IASP Publications, Seattle

    Google Scholar 

  207. Rosaeg OP, Suderman V, Yarnell RW (1992) Early respiratory depression during caesarean section following epidural meperidine. Can J Anaesth 39:71–74

    Article  PubMed  CAS  Google Scholar 

  208. Rosseel PMJ, van den Broek WGM, Boer EC, Prakash O (1988) Epidural sufentanil for intra-and postoperative analgesia in thoracic surgery: a comparative study with intravenous sufentanil. Acta Anaesthesiol Scand 32:193–198

    Article  PubMed  CAS  Google Scholar 

  209. Rostaing S, Bonnet F, Levron JC, Vodinh J, Pluskwa F, Saada M (1991) Effect of epidural clonidine on analgesia and pharmacokinetics of epidural fentanyl in postoperative patients. Anesthesiology 75:420–425

    Article  PubMed  CAS  Google Scholar 

  210. Rutter DV, Skewes DG, Morgan M (1981) Extradural opioids for postoperative analgesia. A double-blind comparison of pethidine, fentanyl and morphine. Br J Anaesth 55:915–920

    Article  Google Scholar 

  211. Salomäki TE, Laitinen JO, Nuutinen LS (1991) A randomized double-blind comparison of epidural versus intravenous fentanyl infusion for analgesia after thoracotomy. Anesthesiology 75:790–795

    Article  PubMed  Google Scholar 

  212. Salomäki TE, Leppäluoto J, Laitinen JO, Vuolteenaho O Nuutinen LS (1993) Epidural versus intravenous fentanyl for reducing hormonal, metabolic, and physiologic responses after toracotomy. Anesthesiology 79:672–679

    Article  PubMed  Google Scholar 

  213. Scherer R, Schmutzler H, Giebler R, Erhard J, Stöcker L, Kox WJ (1993) Complications related to thoracic epidural analgesia: a prospective study in 1071 surgical patients. Acta Anaesthesiol Scand 37:370–374

    Article  PubMed  CAS  Google Scholar 

  214. Scott NB, Mogensen T, Bigler D, Lund C, Kehlet H (1989) Continuous thoracic extradural 0.5% bupivacaine with or without morphine: effect on quality of blockade, lung function and the surgical stress response. Br J Anaesth 62:253–257

    Article  PubMed  CAS  Google Scholar 

  215. Schulze S, Roikjaer O, Hasselstrom L, Jensen NH, Kehlet H (1988) Epidural bupivacaine and morphine plus systemic indomethacin eliminates pain but not systemic response and convalescence after cholecystectomy. Surgery 103:321–327

    PubMed  CAS  Google Scholar 

  216. Seeling W, Bruckmooser KP, Hüfner C, Kneitinger E, Rigg C, Rockemann M (1990) Keine Verminderung postoperativer Komplikationen durch Katheterepiduralanalgesie nach großen abdominellen Eingriffen. Anaesthesist 39:33–40

    PubMed  CAS  Google Scholar 

  217. Seeling W, Bothner U, Eifert B, Rockemann M, Schreiber M, Schürmann W, Steffen P, Zeininger A (1991) Patientenkontrollierte Analgesie versus Epiduralanalgesie mit Bupivacain oder Morphin nach großen abdominellen Eingriffen. Kein Unterschied in der postoperativen Morbidität. Anaesthesist 40:614–623

    PubMed  CAS  Google Scholar 

  218. Semple AJ, Macrae DJ, Munishankarappa S, Burrow LM, Milne MK, Grant IS (1988) Effects of the addition of adrenaline to extradural diamorphine analgesia after caesarean section. Br J Anaesth 60:632–638

    Article  PubMed  CAS  Google Scholar 

  219. Serrao JM, Marks RL, Morley SJ, Goodchild CS (1992) Intrathecal midazolam for the treatment of chronic mechanical low back pain: a controlled comparison with epidural steroid in a pilot study. Pain 48:5–12

    Article  PubMed  CAS  Google Scholar 

  220. Shir Y, Eimerl D, Magora F, Damm D, Schulte-Mönting J, Chrubasik J (1990) Plasma concentrations of methadone during postoperative patient-controlled extradural analgesia. Br J Anaesth 65:204–209

    Article  PubMed  CAS  Google Scholar 

  221. Shulman MS, Wakerlin GG., Yamaguchi L, Brodsky JB (1987) Experience with epidural hydromorphone for post-thoracotomy pain relief. Anesth Analg 66:1331–1333

    Article  PubMed  CAS  Google Scholar 

  222. Siegismund K, Beutner M, Fiedler C (1982) Postoperative Analgesie durch peridurale Piritramidapplikation. Zentralbl Gynaecol 104:615–622

    CAS  Google Scholar 

  223. Simpson KH, Madej TH, McDowell HM, Macdonald R, Lyons G (1988) Comparison of extradural buprenorphine and extradural morphine after caesarean section. Br J Anaesth 60:627–631

    Article  PubMed  CAS  Google Scholar 

  224. Simpson T, Wahl GG., DeTraglia M, Speck E, Taylor D (1992) The effect of epidural versus parenteral opioid analgesia on postoperative pain and pulmonary function in adults who have undergoine thoracic and abdominal surgery: a critique of research. Heart Lung 21:121–140

    Google Scholar 

  225. Sinatra RS, Sevarino FB, Chung JH, Graf GG., Paige D, Takla V, Silkverman DG (1991) Comparison of epidurally administered sufentanil, morphine, and sufentanil-morphine combination for postoperative analgesia. Anesth Analg 72:522–527

    Article  PubMed  CAS  Google Scholar 

  226. Sjöström S, Hartvig P, Persson P, Tamsen A (1987) Pharmacokinetics of epidural morphine and meperidine in humans. Anesthesiology 67:877–888

    Article  PubMed  Google Scholar 

  227. Sjöström S, Tamsen A, Persson P, Hartvig P (1987) Pharmacokinetics of intrathecal morphine and meperidine in humans. Anesthesiology 67:889–895

    Article  PubMed  Google Scholar 

  228. Smedstad KG, Beattie WS, Blair ES, Buckley DN (1992) Postoperative pain relief and hospital stay after total esophagectomy. Clin J Pain 8:149–153

    Article  PubMed  CAS  Google Scholar 

  229. Stein C, Brechner T (1987) Epidural morphine tolerance: use of norepinephrine. Clin J Pain 2:267–269

    Article  Google Scholar 

  230. Sullivan SP, Cherry DA (1987) Pain from an invasive facial tumor relieved by lumbar epidural morphine. Anesth Analg 66:777–779

    Article  PubMed  CAS  Google Scholar 

  231. Sullivan AF, Kalso E, McQuay HJ, Dickenson AH (1992) The antinociceptive actions of dexmedetomidine on dorsal horn neuronal responses in the anaesthetized rat. Eur J Pharmacol 215:127–133

    Article  PubMed  CAS  Google Scholar 

  232. Tamsen A, Sjöström S, Hartvig P (1986) The Uppsala experience of patient-controlled analgesia. Adv Pain Res Ther 8:325–332

    Google Scholar 

  233. Tanaka M, Watanabe S, Endo T, Okane M, Hamaya Y (1991) Combination of epidural morphine and fentanyl for postoperative analgesia. Regional Anesthesia 16:214–217

    PubMed  CAS  Google Scholar 

  234. Tanaka M, Watanabe S, Ashimura H, Akiyoshi Y, Nishijima Y, Sato S, Naito H (1993) Minimum effective combination dose of epidural morphine and fentanyl for posthyster-ectomy analgesia: a randomized, prospective, double-blind study. Anesth Analg 77:942–946

    Article  PubMed  CAS  Google Scholar 

  235. Tauzin-Fin P, Maurette P, Vincon GG., Hecquet D, Houdeck MC, Bonnet F (1992) Clinical and pharmacokinetic aspects of the combination of meperidine and prilocaine for spinal anaesthesia. Can J Anaesth 39:655–660

    Article  PubMed  CAS  Google Scholar 

  236. Thomas DA, Williams GM, Iwata K, Kenshalo DR, Dubner R (1993) Multiple effects of morphine on facial scratching in monkeys. Anesth Analg 77:933–935

    Article  PubMed  CAS  Google Scholar 

  237. Torda TA, Pybus DA, Liberman H, Clark M, Crawford M (1980) Experimental comparison of extradural and i. m. morphine. Br J Anaesth 52:939–943

    Article  PubMed  CAS  Google Scholar 

  238. Torda TA, Pybus DA (1982) Comparison of four narcotic analgesics for extradural analgesia. Br J Anaesth 54:291–295

    Article  PubMed  CAS  Google Scholar 

  239. Valley MA, Bourke DL, McKenzie AM (1992) Recurrence of thoracic and labial herpes simplex virus infection in a patient receiving epidural fentanyl. Anesthesiology 76:1056–1057

    Article  PubMed  CAS  Google Scholar 

  240. Vanstrum GS, Bjornson KM, Ilko R (1988) Postoperative effects of intrathecal morphine in coronary artery bypass surgery. Anesth Analg 67:261–267

    Article  PubMed  CAS  Google Scholar 

  241. Verborgh C, van der Auwera D, van Droogenbroek E, Camu F (1986) Epidural sufentanil for postsurgical pain relief. Eur J Anaesth 3:313–320

    CAS  Google Scholar 

  242. Vercauteren M, Lauwers E, Meert T, De Hert S, Adriaensen H (1990) Comparison of epidural sufentanil plus clonidine with sufentanil alone for postoperative pain relief. Anaesthesia 45:531–534

    Article  PubMed  CAS  Google Scholar 

  243. Vercauteren MP (1992) PCA by epidural route (PCEA) Acta Anaesthesiol Belg 43:33–39

    PubMed  CAS  Google Scholar 

  244. Vincent RD, Chestnut DH, Choi WW, Ostman PLG, Bates JN (1992) Does epidural fentanyl decrease the efficacy of epidural morphine after cesarean delivery? Anesth Analg 74:658–663

    PubMed  Google Scholar 

  245. Wang JK (1985) Intrathecal morphine for intractable pain secondary to cancer of pelvic organs. Pain 21:99–102

    Article  PubMed  CAS  Google Scholar 

  246. Wang JM, Knarr DC, Prithvi P, Denson D (1992) Continuous epidural methadone for the management of postoperative pain after lower abdominal surgery. Regional Anesthesia 17:26–28

    PubMed  CAS  Google Scholar 

  247. Watson J, Moore A, McQuay H, Teddy P, Baldwin D, Allen M, Bullingham R (1984) Plasma morphine concentrations and analgesic effects of lumbar extradural morphine and heroin. Anesth Analg 63:629–634

    Article  PubMed  CAS  Google Scholar 

  248. Welchew EA, Thornton JA (1982) Continuous thoracic epidural fentanyl. Anaesthesia 37:309–316

    Article  PubMed  CAS  Google Scholar 

  249. Wells DG, Davies G (1987) Profound central nervous system depression from epidural fentanyl for extracorporeal shock wave lithotrypsy. Anesthesiology 67:991–992

    Article  PubMed  CAS  Google Scholar 

  250. Wittels B, Glosten B, Faure EAM, Moawad AHJ, Ismail M, Hibbard J, Amundsen L, Binstock W, Senal JA, Cox SM, Blackman SC, Karl L, Thisted RA (1993) Opioid antagonist adjuncts to epidural morphine for postcesarean analgesia: maternal outcomes. Anesth Analg 77:925–932

    Article  PubMed  CAS  Google Scholar 

  251. Writer WDR, Hurtig JB, Evans D, Needs RE, Hope CE, Forrest JB (1985) Epidural morphine prophylaxis of postoperative pain: report of a double-blind multicentre study. Can Anaesth Soc J 32:330–338

    Article  PubMed  CAS  Google Scholar 

  252. Wüst HJ, Bromage PR (1987) Delayed respiratory arrest after epidural hydromorphone. Anaesthesia 42:404–406

    Article  PubMed  Google Scholar 

  253. Yaksh TL, Noueihed R (1985) The physiology and pharmacology of spinal opiates. Annu Rev Pharmacol Toxicol 25:433–462

    Article  PubMed  CAS  Google Scholar 

  254. Yaksh TL, Onofrio BM (1987) Retrospective consideration of the doses of morphine given intrathecally by chronic infusion in 163 patients by 19 physicians. Pain 31:211–223

    Article  PubMed  CAS  Google Scholar 

  255. Yamaguchi H, Watanabe S, Fukuda T, Takahashi H, Motokawa K, Ishizwawa Y (1989) Minimum effective dose of intrathecal morphine for pain relief following transabdominal hysterectomy. Anesth Analg 68:537–540

    Article  PubMed  CAS  Google Scholar 

  256. Yarnell RW, Polis T, Reid GN, Murphy IL, Penning JP (1992) Patient-controlled analgesia with epidural meperidine after elective cesarean section. Regional Anesthesia 17:329–333

    PubMed  CAS  Google Scholar 

  257. Yee I, Carstoniu J, Halpern S, Pittini R (1993) A comparison of two doses of epidural fentanyl during caesarean section. Can J Anaesth 40:722–725

    Article  PubMed  CAS  Google Scholar 

  258. Yeung JC, Rudy TA (1980) Sites of antinociceptive action of systemically injected morphine: involvement of supraspinal loci as revealed by intracerebroventricular injection of naloxone. J Pharmacol Exp Ther 215:626–632

    PubMed  CAS  Google Scholar 

  259. Yu PYH, Gambling DR (1993) A comparative study of patient-controlled epidural fentanyl and single dose epidural morphine for post-caesarean analgesia. Can J Anaesth 40:416–420

    Article  PubMed  CAS  Google Scholar 

  260. Zeiler D, Müller H, Hempelmann G (1991) Kontinuierliche peridurale Sufentanil-Applikation zur postoperativen Analgesie. Anaesthesist 40:543–548

    PubMed  CAS  Google Scholar 

  261. Zimmermann DL, Stewart J (1993) Postoperative pain management and Acute Pain Service activity in Canada. Can J Anaesth 40:568–575

    Article  PubMed  CAS  Google Scholar 

  262. Zinck B, Fritz KW (1982) Atemdepression nach epiduraler Opiat-Analgesie mit Buprenorphin-Hydrochlorid? Anaesth Intensivther Notfallmed 17:345–347

    Article  CAS  Google Scholar 

Download references

Authors
  1. K. A. Lehmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. J. McQuay
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie und operative Intensivmedizin, Universität Köln, Joseph-Stelzmann-Straße 9, 50924, Köln, Deutschland

    Klaus A. Lehmann

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lehmann, K.A., McQuay, H.J. (1994). Rückenmarknahe Blockaden: Opioide. In: Lehmann, K.A. (eds) Der postoperative Schmerz. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-21762-7_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-21762-7_23

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-21763-4

  • Online ISBN: 978-3-662-21762-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation