Advertisement

Rückenmarknahe Blockaden: Opiate

  • H. J. McQuay
  • R. A. Moore
  • K. A. Lehmann

Zusammenfassung

Die Anwendung rückenmarknaher („spinal“) Opiate hat die akute und chronische Schmerztherapie in den beiden letzten Jahrzehnten erheblich bereichert [35, 36,150, 152]. Ihr Wirkungsmechanismus beruht auf einer Hemmung der Übertragung afferenter nozizeptiver Impulse im Hinterhorn, wo reichlich Opiatrezeptoren vorkommen. Als wichtigster Vorteil wird angesehen, daß rückenmarknahe Opioide weder die motorische noch die vegetative Reaktionsfähigkeit des Organismus beeinträchtigen [8, 146].

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 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 - 143PubMedCrossRefGoogle Scholar
  2. 2.
    Abouleish E (1988) Apnoea associated with the intrathecal administration of morphine in obstetrics. A case report. Br J Anaesth 60: 592 - 494PubMedCrossRefGoogle Scholar
  3. 3.
    Abouleish E, Rawal N, Fallon K, Hernandez D (1988) Combined intrathecal morphine and bupivacaine for cesarean section. Anesth Analg 67: 370 - 374PubMedCrossRefGoogle Scholar
  4. 4.
    Acalovschi I, Ene V, Lörinczi E, Nicolaus F (1986) Saddle block with pethidine for perineal operations. Br J Anaesth 58: 1012 - 1016PubMedCrossRefGoogle Scholar
  5. 5.
    Ahigren FIH, Ahlgren MBE (1987) Epidural administration of opiates by a new device. Pain 31: 353 - 357CrossRefGoogle Scholar
  6. 6.
    Amer S, Amer B (1985) Differential effects of epidural morphine in the treatment of cancer-related pain. Acta Anaesthesiol Scand 29: 32 - 36Google Scholar
  7. 7.
    Amer S, Rawal N, Gustafsson LL (1988) Clinical experience of long-term treatment with epidural and intrathecal opioids - a nationwide survey. Acta Anaesthesiol Scand 32: 253 - 259CrossRefGoogle Scholar
  8. 8.
    van der Auwera D, Verborgh C, Camu F (1987) Analgesic and cardiorespiratory effects of epidural sufentanil and morphine in humans. Anesth Analg 66: 999 - 1003PubMedGoogle Scholar
  9. 9.
    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: 11161119Google Scholar
  10. 10.
    Bailey PW, Smith BE (1980) Continuous epidural infusion of fentanyl for postoperative analgesia. Anaesthesia 35: 1002 - 1006PubMedCrossRefGoogle Scholar
  11. 11.
    Baraka A, Noueihed R, Hajj S (1981) Intrathecal injection of morphine for obstetric analgesia. Anesthesiology 54: 136 - 140PubMedCrossRefGoogle Scholar
  12. 12.
    Barron DW, Strong JE (1984) The safety and efficacy of intrathecal diamorphine. Pain 18: 279 - 285PubMedCrossRefGoogle Scholar
  13. 13.
    Beeby D, Macintosh KC, Bailey M, Welch DB (1984) Postoperative analgesia for caesarean section using epidural methadone. Anaesthesia 39: 61 - 63PubMedCrossRefGoogle Scholar
  14. 14.
    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 - 402PubMedCrossRefGoogle Scholar
  15. 15.
    Bilsback P, Rolly G, Tampbulon 0 (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: 943-948Google Scholar
  16. 16.
    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 - 399Google Scholar
  17. 17.
    Blond S, Meynadier J, Chrubasik J, Dupard T, Dubar M, Combelles-Pruvot M, Christiaens JL, Demaille A (1985) Intrathekale and intraventrikuläre MorphinAnalgesie bei Karzinompatienten. Langzeit-Erfahrungen. Schmerz-Pain-Douleur 6: 129-135Google Scholar
  18. 18.
    Boersma FP, Buist AB, Thie J (1987) Epidural pain treatment in the northern Netherlands. Organizational and treatment aspects. Acta Anaesthesiol Belg 38: 213-216Google Scholar
  19. 19.
    Bohannon TW, Estes MD (1987) Evaluation of subarachnoid fentanyl for postoperative analgesia. Anesthesiology 67: A237CrossRefGoogle Scholar
  20. 20.
    Brodsky JB, Kretzschmar KM, Mark JBD (1988) Caudal epidural morphine for postthoracotomy pain. Anesth Analg 67: 409 - 410PubMedCrossRefGoogle Scholar
  21. 21.
    Bromage PR, Camporesi E, Chestnut D (1980) Epidural narcotics for postoperative analgesia. Anesth Analg 59: 473 - 480PubMedCrossRefGoogle Scholar
  22. 22.
    Brownridge P, Wrobel J, Watt-Smith J (1983) Respiratory depression following accidental subarachnoid pethidine. Anaesth Intensive Care 11: 237 - 240PubMedGoogle Scholar
  23. 23.
    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 - 130PubMedGoogle Scholar
  24. 24.
    Buatti M, Pasternak GW (1981) Multiple opiate receptors: phylogenetic differences. Brain Res 218: 400 - 405PubMedCrossRefGoogle Scholar
  25. 25.
    Busch EH, Stedman PM (1987) Epidural morphine for postoperative pain on medical-surgical wards - a clinical review. Anesthesiology 67: 101 - 104PubMedCrossRefGoogle Scholar
  26. 26.
    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 - 38PubMedCrossRefGoogle Scholar
  27. 27.
    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 - 267PubMedCrossRefGoogle Scholar
  28. 28.
    Clemensen SE, Thayssen P, Hole P (1987) Epidural morphine for outpatients with severe anginal pain. Br Med J 294: 475 - 476CrossRefGoogle Scholar
  29. 29.
    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 - 685PubMedCrossRefGoogle Scholar
  30. 30.
    Cohen SE, Tan S, Albright GA, Halpern J (1987) Epidural fentanyl/bupivacaine mixtures for obstetric analgesia. Anesthesiology 67: 403 - 407PubMedCrossRefGoogle Scholar
  31. 31.
    Colpaert FC, Niemegeers CJE, Janssen PAJ, Maroli AN (1980) The effects of prior fentanyl administration and of pain on fentanyl analgesia: tolerance to and enhacement of narcotic analgesia. J Pharmacol Exp Therap 213: 418 - 426Google Scholar
  32. 32.
    Coombs DW, Fratkin JD, Meier FA, Nierenberg DW, Saunders RL (1985) Neuropathological lesions and CSF concentrations during continuous intraspinal morphine infusion. A clinical and post-mortem study. Pain 22: 337-351Google Scholar
  33. 33.
    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: 358-363Google Scholar
  34. 34.
    Coombs DW (1986) Management of chronic pain by epidural and intrathecal opioids. Newer drugs and delivery systems. Int Anesthesiol Clin 24: 59 - 74PubMedCrossRefGoogle Scholar
  35. 35.
    Cousins MJ, Mather LE (1984) Intrathecal and epidural administration of opioids. Anesthesiology 61: 276 - 310PubMedCrossRefGoogle Scholar
  36. 36.
    Cousins MJ (1988) The spinal route of analgesia. Acta Anaesthesiol Belg 39 (Suppl 2): 71 - 82PubMedGoogle Scholar
  37. 37.
    Crawford JS (1980) Site of action of intrathecal morphine. Br Med J 281: 680PubMedCrossRefGoogle Scholar
  38. 38.
    Crawford JS (1980) Site of action of intrathecal morphine. Br Med J 281: 1144PubMedCrossRefGoogle Scholar
  39. 39.
    Crawford ME, Anderson HB, Augestenberg G, Bay J, Beck O, Benveniste D, Larsen LB, Carl P, Djernes M, Eriksen J (1983) Pain treatment on outpatient basis utilizing extradural opiates: a Danish multicentre study comprising 105 patients. Pain 16: 41 - 47PubMedCrossRefGoogle Scholar
  40. 40.
    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 - 323PubMedCrossRefGoogle Scholar
  41. 41.
    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 - 726PubMedGoogle Scholar
  42. 42.
    Cuocolo R, Amantea B, Savoia G (1984) Subarachnoid morphine for labor and delivery. Pain Suppl 2: S334CrossRefGoogle Scholar
  43. 43.
    Dailey PA, Brookshire L, Abboud TK, Kotelko DM, Noueihed 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 - 666PubMedCrossRefGoogle Scholar
  44. 44.
    Davis I (1987) Intrathecal morphine in aortic aneurysm surgery. Anaesthesia 42: 491497Google Scholar
  45. 45.
    Di Chiro G (1966) Observations on the circulation of the cerebrospinal fluid. Acta Radiolog 5: 988 - 1002Google Scholar
  46. 46.
    Donadoni R, Capiau P (1987) Cardiac arrest after spinal sufentanil: a case report. Acta Anaesthesiol Belg 38: 175 - 177PubMedGoogle Scholar
  47. 47.
    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: 737740Google Scholar
  48. 48.
    Downing JW, Williams V, Porte D, Woods S, Fogel K, Horn JH (1984) Rostral spread of epidural morphine. Anesth Analg 63: 371 - 376CrossRefGoogle Scholar
  49. 49.
    Duckett JE, McDonnell T, Zebrowski M, Witte M (1987) Lumbar versus thoracic continuous epidural sufentanil for postoperative analgesia after upper abdominal surgery. Anesth Analg 66: S45CrossRefGoogle Scholar
  50. 50.
    Duffy BL, Read MD (1984) Epidural pethidine for relief of episiotomy pain. Anaesth Intensive Care 12: 137 - 139PubMedGoogle Scholar
  51. 51.
    DuPen SL, Ramsey D, Chin S (1987) Chronic epidural morphine and preservative-induced injury. Anesthesiology 67: 987 - 988CrossRefGoogle Scholar
  52. 52.
    Editorial (1980) Epidural opiates. Lancet 1: 962 - 963Google Scholar
  53. 53.
    Erickson DL, Lo J, Michaelson M (1984) Intrathecal morphine for treatment of pain due tomalignancy. Pain Suppl 2: S19CrossRefGoogle Scholar
  54. 54.
    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: 109-112Google Scholar
  55. 55.
    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 - 144PubMedCrossRefGoogle Scholar
  56. 56.
    Famewo CE, Naguib M (1985) Spinal anaesthesia with meperidine as the sole agent. Can Anaesth Soc J 32: 533 - 537PubMedCrossRefGoogle Scholar
  57. 57.
    Feldstein GS, Waldmann SD, Allen ML (1987) Reversal of apparent tolerance to epidural morphine by epidural methylprednisolone. Anesth Analg 66: 264 - 266PubMedCrossRefGoogle Scholar
  58. 58.
    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 - 563PubMedCrossRefGoogle Scholar
  59. 59.
    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: 639-644Google Scholar
  60. 60.
    Glass PSA (1984) Respiratory depression following only 0.4 mg of intrathecal morphine. Anesthesiology 60: 256 - 257PubMedCrossRefGoogle Scholar
  61. 61.
    Glynn CJ, McQuay HJ, Lloyd JW, Moore RA, Teddy CJ (1984) Intrathecal buprenorphine for the treatment of painful muscle spasms in paraplegic patients. Pain Suppl 2: S341CrossRefGoogle Scholar
  62. 62.
    Gourlay GK, Cherry DA, Cousins MH (1985) Cephalad migration of morphine in CSF following lumbar epidural administration in patients with cancer pain. Pain 23: 317 - 326PubMedCrossRefGoogle Scholar
  63. 63.
    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 - 305PubMedCrossRefGoogle Scholar
  64. 64.
    Gray JR, Fromme GA, Nauss LA, Wang JK, Ilstrup DM (1986) Intrathecal morphine for post-thoracotomy pain. Anesth Analg 65: 873 - 876PubMedCrossRefGoogle Scholar
  65. 65.
    Gundersen RY, Andersen R, Narverud G (1986) Postoperative pain relief with high-dose epidural buprenorphine: a double-blind study. Acta Anaesthesiol Scand 30: 664 - 667PubMedCrossRefGoogle Scholar
  66. 66.
    Gustafsson LL, Frieberg-Nielson 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: 1167-1174Google Scholar
  67. 67.
    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 - 486PubMedCrossRefGoogle Scholar
  68. 68.
    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 - 830PubMedCrossRefGoogle Scholar
  69. 69.
    Hendrick P, Abou Hatem R, Nicaise C (1984) Implantable injection port for epidural opiates self-administration. Acta Anaesthesiol Belg 35 (Suppl): 279 - 284Google Scholar
  70. 70.
    Hill RG (1981) The status of naloxone in the identification of pain control mechanisms operated by endogenous opioids. Neuroscience Letters 21: 217 - 222PubMedCrossRefGoogle Scholar
  71. 71.
    Houlton PG, Reynolds F (1981) Epidural diamorphine and fentanyl for postoperative pain. Anaesthesia 36: 1144 - 1147PubMedCrossRefGoogle Scholar
  72. 72.
    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 - 324PubMedCrossRefGoogle Scholar
  73. 73.
    Hyde NH, Harrison DM (1986) Intrathecal morphine in a parturient with cystic fibrosis. Anesth Analg 65: 1357 - 1358PubMedCrossRefGoogle Scholar
  74. 74.
    Inturrisi CE, Max MB, Foley KM, Schultz M, Shin SU, Houde RW (1984) The pharmacokinetics of heroin in patients with chronic pain. N Engl J Med 31: 1213 - 1217CrossRefGoogle Scholar
  75. 75.
    Jamous MA, Hand CW, Moore RA, Teddy PJ, McQuay HJ (1986) Epinephrine reduces systemic absorption of extradural diacetylmorphine. Anesth Analg 65: 1290 - 1294PubMedCrossRefGoogle Scholar
  76. 76.
    Jyu C, Lamb JD (1985) Respiratory depression following epidural morphine. Can Anaesth Soc J 32: 99 - 100PubMedCrossRefGoogle Scholar
  77. 77.
    Kaiser KG, Bainton CR (1987) Treatment of intrathecal morphine overdose by aspiration of cerebrospinal fluid. Anesth Analg 66: 475 - 477PubMedCrossRefGoogle Scholar
  78. 78.
    Kalia PK, Madan R, Saksena R, Batra RK, Gode GR (1983) Epidural pentazocine for postoperative pain relief. Anesth Analg 62: 949 - 950PubMedCrossRefGoogle Scholar
  79. 79.
    Kalso E (1983) Effect of intrathecal morphine injected with bupivacaine on pain after orthopaedic surgery. Br J Anaesth 55: 415 - 422PubMedCrossRefGoogle Scholar
  80. 80.
    Knape JTA (1986) Early respiratory depression resistant to naloxone following epidural buprenorphine. Anesthesiology 64: 382 - 384PubMedCrossRefGoogle Scholar
  81. 81.
    Knill RL, Clement JL, Thompson WR (1981) Epidural morphine causes delayed and prolonged ventilatory depression. Can Anaesth Soc J 28: 537 - 543PubMedCrossRefGoogle Scholar
  82. 82.
    Kotob HIM, Hand CW, Moore RA, Evans PJD, Wells J, Rubin AP, McQuay HJ (1986) Intrathecal morphine and heroin in man: six hour drug analysis in spinal fluid and plasma. Anesth Analg 65: 718 - 722PubMedCrossRefGoogle Scholar
  83. 83.
    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 - 653PubMedCrossRefGoogle Scholar
  84. 84.
    Krane EJ (1988) Delayed respiratory depression in a child after caudal epidural morphine. Anesth Analg 67: 79 - 82PubMedCrossRefGoogle Scholar
  85. 85.
    Krantz T, Christensen CB (1987) Respiratory depression after intrathecal opioids. Report of a patient receiving long-term epidural opioid therapy. Anaesthesia 42: 168170Google Scholar
  86. 86.
    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 - 598PubMedCrossRefGoogle Scholar
  87. 87.
    Lipp M, Daubländer M, Lanz E (1987) Buprenorphin 0,15 mg intrathecal zur postoperativen Analgesia. Eine klinische Doppelblindstudie. Anaesthesist 36: 233-238Google Scholar
  88. 88.
    Lobato RD, Madrid JL, Fatela LV, Rivas JJ, Gozalo J, Barcena A (1984) Analgesia elicited by low-dose intraventricular morphine in terminal cancer patients. Pain Suppl 2: 5342Google Scholar
  89. 89.
    Lobato RD, Madrid JL, Fatela LV, Sarabia R, Rivas JJ, Gozalo A (1987) Intraventricular morphine for intractable cancer pain: rationale, methods, clinical results. Acta Anaesthesiol Scand 31 (Suppl 85): 68 - 74CrossRefGoogle Scholar
  90. 90.
    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 - 791PubMedCrossRefGoogle Scholar
  91. 91.
    Lutze M, Kaden B, Weigel K, Brock M (1987) Intraventrikuläre Opiatapplikation mit implantierten Medikamentenpumpen. Dtsch Ärzteblatt 84: 1762 - 1768Google Scholar
  92. 92.
    Macrae DJ, Munishankrappa S, Burrow LM, Milne MK, Grant IS (1987) Double-blind comparison of the efficacy of extradural diamorphine, extradural phenoperidine and i.m. diamorphine following cesarean section. Br J Anaesth 59: 354 - 359PubMedCrossRefGoogle Scholar
  93. 93.
    Malins AF, Goodman NW, Cooper GM, Prys-Roberts C, Baird RN (1984) Ventilatory effects of pre-and postoperative diamorphine. A comparison of extradural with intramuscular administration. Anaesthesia 39: 118-125Google Scholar
  94. 94.
    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: 72CrossRefGoogle Scholar
  95. 95.
    Mathews ET, Abrams LD (1980) Intrathecal morphine in open heart surgery. Lancet 1: 543CrossRefGoogle Scholar
  96. 96.
    McQuay HJ, Bullingham RES, Evans PJD, Lloyd JW, Moore RA (1980) Demand analgesia to assess pain relief from epidural opiates. Lancet 1: 768 - 769PubMedCrossRefGoogle Scholar
  97. 97.
    McQuay HJ, Bullingham RES, Moore RA (1981) Acute opiate tolerance in man. Life Sci 28: 2513 - 2517PubMedCrossRefGoogle Scholar
  98. 98.
    Meier FA, Coombs DW, Saunders RL, Pageau MG (1982) Pathologic anatomy of constant morphine infusion by intraspinal silastic catheter. Anesthesiology 57: A206CrossRefGoogle Scholar
  99. 99.
    Molke Jensen F, Jensen NH, Holk IK, Ravnborg M (1987) Prolonged and biphasic respiratory depression following epidural buprenorphine. Anaesthesia 42: 470 - 475PubMedCrossRefGoogle Scholar
  100. 100.
    Moore RA, Bullingham RES, McQuay HJ, Hand CW, Aspel JB, Allen MC, Thomas D (1982) Dural permeability to narcotics: in vitro determination and application to extradural administration. Br J Anaesth 54: 1117 - 1128PubMedCrossRefGoogle Scholar
  101. 101.
    Moore RA, Bullingham RES, McQuay HJ, Allen MC, Cole A (1984) Spinal fluid kinetics of morphine and heroin. Clin Pharmacol Therap 35: 40 - 45CrossRefGoogle Scholar
  102. 102.
    Moulin D, Max M, Kaiko R, Inturrisi C, Maggard J, Foley K (1984) The analgesic efficacy of intrathecal D-Ala2-D-Leu5 Enkephalin ( DADL) in cancer patients with chronic pain. Pain Suppl 2: 5343Google Scholar
  103. 103.
    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 - 383Google Scholar
  104. 104.
    Müller H, Gips H, Krumholz W, Zierski J, Lüben U, Hempelmann G (1986) Pharmakokinetik der kontinuierlichen periduralen Morphininfusion. Anaesthesist 35: 672 - 678PubMedGoogle Scholar
  105. 105.
    Niv D, Rudick V, Golan A, Chayen MS (1986) Augmentation of bupivacaine analgesia in labor by epidural morphine. Obstet Gynecol 67: 206 - 209PubMedCrossRefGoogle Scholar
  106. 106.
    Nordberg G (1984) Pharmacokinetic aspects of spinal morphine analgesia. Acta Anaesthesiol Scand 28 (Suppl 79): 1 - 39CrossRefGoogle Scholar
  107. 107.
    Nordberg G, Hedner T, Mellstrand T, Dahlstrom B (1984) Pharmacokinetic aspects of intrathecal morphine analgesia. Anesthesiology 60: 448 - 454PubMedCrossRefGoogle Scholar
  108. 108.
    Nordberg G, Mellstand T, Borg L, Hedner T (1986) Extradural morphine: influence of adrenaline admixture. Br J Anaesth 58: 598 - 604PubMedCrossRefGoogle Scholar
  109. 109.
    Nurchi G (1984) Use of intraventricular and intrathecal morphine in intractable pain associated with cancer. Neurosurgery 15: 801 - 803PubMedCrossRefGoogle Scholar
  110. 110.
    Obbens EAMT, Hill CS, Leavens ME, Ruthenbeck SS, Otis F (1987) Intraventricular morphine administration for control of chronic cancer pain. Pain 28: 61 - 68PubMedCrossRefGoogle Scholar
  111. 111.
    Oyama T, Murakawa T, Baba S, Nagao h (1987) Continuous vs. bolus epidural morphine. Acta Anaesthesiol Scand 31 (Suppl 85): 77 - 79CrossRefGoogle Scholar
  112. 112.
    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 - 286PubMedCrossRefGoogle Scholar
  113. 113.
    Paterson GMC, McQuay HJ, Bullingham RES, Moore RA (1984) Intradural morphine and diamorphine dose-response studies. Anaesthesia 39: 113 - 117PubMedCrossRefGoogle Scholar
  114. 114.
    Paulus DA, Paul WL, Munson ES (1981) Neurologic depression after intrathecal morphine. Anesthesiology 54: 517 - 518PubMedCrossRefGoogle Scholar
  115. 115.
    Payne R (1987) CSF distribution of opioids in animals and man. Acta Anaesthesiol Scand 31 (Suppl 85): 38 - 46CrossRefGoogle Scholar
  116. 116.
    Perrot G, Muller A, Laugner B (1983) Surdosage accidentel en morphine intrarachidienne. Traitement par naloxone intravéneuse seule. Ann Fr Anesth Reanim 2: 412-414Google Scholar
  117. 117.
    Pert CB, Snyder SH (1973) Opiate receptor: demonstration in nervous tissue. Science 179: 1011 - 1014PubMedCrossRefGoogle Scholar
  118. 118.
    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 - 426PubMedCrossRefGoogle Scholar
  119. 119.
    Phillips DM, Moore RA, Bullingham RES, Allen MC, Baldwin D, Fisher A, Lloyd JW, McQuay HJ (1984) Plasma morphine concentrations and clinical effects after thoracic morphine and diamorphine. Br J Anaesth 56: 829 - 836PubMedCrossRefGoogle Scholar
  120. 120.
    Pybus A, Torda T, McQuay HJ, Moore RA (1984) Opiates and sexual function. Nature 310: 636PubMedCrossRefGoogle Scholar
  121. 121.
    Rawal N, Mollefors K, Axelsson K, Lingardh G, Widman B (1983) An experimental study of urodynamic effects of epidural morphine and naloxone reversal. Anesth Analg 42: 641 - 647Google Scholar
  122. 122.
    Rawal N, Sjostrand UH (1986) Clinical application of epidural and intrathecal opioids for pain management. Int Anesthesiol Clin 24:43-57 •Google Scholar
  123. 123.
    Rawal N, Amer 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: 791-799Google Scholar
  124. 124.
    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 - 198PubMedCrossRefGoogle Scholar
  125. 125.
    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: 915-920Google Scholar
  126. 126.
    Samuelsson H, Nordberg G, Hedner T, Lindqvist J (1987) CSF and plasma morphine concentrations in cancer patients during chronic morphine therapy and its relation to pain relief. Pain 30: 303 - 310PubMedCrossRefGoogle Scholar
  127. 127.
    Scott PV, Bowen FE, Cartwright P, Rao BCM, Deeley D, Wotherspoon HG, Sumrein IMA (1980). Intrathecal morphine as sole analgesic during labour. Br Med J 281: 35 1355Google Scholar
  128. 128.
    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 - 638PubMedCrossRefGoogle Scholar
  129. 129.
    Shulman MS, Wakerlin G, Yamaguchi L, Brodsky JB (1987) Experience with epidural hydromorphone for post-thoracotomy pain relief. Anesth Analg 66: 1331 - 1333PubMedCrossRefGoogle Scholar
  130. 130.
    Siegismund K, Beutner M, Fiedler C (1982) Postoperative Analgesie durch peridurale Piritramidapplikation. Zentralbl Gynaecol 104: 615 - 622Google Scholar
  131. 131.
    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 - 631PubMedCrossRefGoogle Scholar
  132. 132.
    Sjöström S, Hartvig P, Persson P, Tamsen A (1987) Pharmacokinetics of epidural morphine and meperidine in humans. Anesthesiology 67: 877 - 888PubMedCrossRefGoogle Scholar
  133. 133.
    Sjöström S, Tamsen A, Persson P, Hartvig P (1987) Pharmacokinetics of intrathecal morphine and meperidine in humans. Anesthesiology 67: 889 - 895PubMedCrossRefGoogle Scholar
  134. 134.
    Stein C, Brechner T (1987) Epidural morphine tolerance: use of norepinephrine. Clin J Pain 2: 267 - 269CrossRefGoogle Scholar
  135. 135.
    Sullivan SP, Cherry DA (1987) Pain from an invasive facial tumor relieved by lumbar epidural morphine. Anesth Analg 66: 777 - 779PubMedCrossRefGoogle Scholar
  136. 136.
    Tamsen A, Sjöström S, Hartvig P (1986) The Uppsala experience of patient-controlled analgesia. Adv Pain Res Ther 8: 325 - 332Google Scholar
  137. 137.
    Torda TA, Pybus DA (1982) Comparison of four narcotic analgesics for extradural analgesia. Br J Anaesth 54: 291 - 295PubMedCrossRefGoogle Scholar
  138. 138.
    Twycross RG, Lack SA (1983) Symptom Control in Far Advanced Cancer: Pain Relief. Pitman, LondonGoogle Scholar
  139. 139.
    Verborgh C, van der Auwera D, van Droogenbroek E, Camu F (1986) Epidural sufentanil for postsurgical pain relief. Eur J Anaesth 3: 313 - 320Google Scholar
  140. 140.
    Waldman SD, Feldstein GS, Allen ML, Turnage G (1986) Selection of patients for implantable intraspinal narcotic delivery systems. Anesth Analg 65: 883 - 885PubMedCrossRefGoogle Scholar
  141. 141.
    Wang JK, Nauss LE, Thomas JE (1979) Pain relief by intrathecally applied morphine in man. Anesthesiology 50: 149 - 151PubMedCrossRefGoogle Scholar
  142. 142.
    Wang JK (1985) Intrathecal morphine for intractable pain secondary to cancer of pelvic organs. Pain 21: 99 - 102PubMedCrossRefGoogle Scholar
  143. 143.
    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 - 634PubMedCrossRefGoogle Scholar
  144. 144.
    Welchew EA, Thornton JA (1982) Continuous thoracic epidural fentanyl. Anaesthesia 37: 309 - 316PubMedCrossRefGoogle Scholar
  145. 145.
    Wells DG, Davies G (1987) Profound central nervous system depression from epidural fentanyl for extracorporeal shock wave lithotrypsy. Anesthesiology 67: 991 - 992PubMedCrossRefGoogle Scholar
  146. 146.
    Willer JC, Bergeret S, Gaudy JH (1985) Epidural morphine strongly depresses nociceptive flexion reflexes in patients with postoperative pain. Anesthesiology 63: 675680Google Scholar
  147. 147.
    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 - 338PubMedCrossRefGoogle Scholar
  148. 148.
    Wüst HJ, Bromage PR (1987) Delayed respiratory arrest after epidural hydromorphone. Anaesthesia 42: 404 - 406PubMedCrossRefGoogle Scholar
  149. 149.
    Yaksh TL, Rudy TA (1976) Analgesia mediated by direct spinal action of narcotics. Science 192: 1357 - 1358PubMedCrossRefGoogle Scholar
  150. 150.
    Yaksh TL (1981) Spinal opiate analgesia: characteristics and principles of action. Pain 11: 293 - 346PubMedCrossRefGoogle Scholar
  151. 151.
    Yaksh TL (1983) Spinal narcotics. In: Bullingham R (ed) Opiate Analgesia. Clinics in Anesthesiology Vol 1. Saunders, LondonGoogle Scholar
  152. 152.
    Yaksh TL, Noueihed R (1985) The physiology and pharmacology of spinal opiates. Annu Rev Pharmacol Toxicol 25: 433 - 462PubMedCrossRefGoogle Scholar
  153. 153.
    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 - 223PubMedCrossRefGoogle Scholar
  154. 154.
    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 Therap 215: 626 - 632Google Scholar
  155. 155.
    Zenz M, Schappler-Scheele B, Neuhans R, Piepenbrock S, Hilfrich J (1981) Long term peridural morphine analgesia in cancer pain. Lancet 1: 91PubMedCrossRefGoogle Scholar
  156. 156.
    Zenz M (1984) Epidural opiates for the treatment of cancer pain. In: Zimmermann M, Drings P, Wagner G (eds) Pain in the Cancer Patient: Pathogenesis, Diagnosis and Therapy, Vol 89. Springer, Berlin Wien, S 107 - 115CrossRefGoogle Scholar
  157. 157.
    Zinck B, Fritz KW (1982) Atemdepression nach epiduraler Opiat-Analgesie mit Buprenorphin-Hydrochlorid? Anaesth Intensivther Notfallmed 17: 345 - 347CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • H. J. McQuay
  • R. A. Moore
  • K. A. Lehmann

There are no affiliations available

Personalised recommendations