Document Detail


Emetic effects of morphine and piritramide.
MedLine Citation:
PMID:  12878621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Successful management of postoperative pain requires that adequate analgesia is achieved without excessive adverse effects. Opioid-induced nausea and vomiting is known to impair patients' satisfaction, but there are no studies providing sufficient power to test the hypothesis that the incidence of opioid-induced nausea and vomiting differs between micro -opioid receptor agonists. Thus, we tested the hypothesis that the incidence of vomiting and nausea differs between morphine and piritramide. METHODS: In a prospective, randomized, double-blind fashion, we administered either morphine (n=250) or piritramide (n=250) by patient-controlled analgesia (PCA) for postoperative pain relief. We used a bolus dose of 1.5 mg with a lockout time of 10 min. Incidence and intensity (numerical rating scale) of postoperative nausea, vomiting, pain, patient satisfaction (score 0-10), side-effects (score 0-3) and drug consumption were measured. RESULTS: Mean drug consumption did not differ between the piritramide and morphine groups (30.8 (SD 22.4) mg day(-1) vs 28.4 (21.8) mg day(-1)) during the first postoperative day and there were no significant differences in the overall incidence of nausea (30% vs 27%) and vomiting (19% vs 15%). Intensity of nausea correlated inversely (P=0.01) with morphine consumption but not with piritramide consumption. Pain scores both at rest (2.2 (1.9) vs 2.6 (2)) and during movement (4.4 (2.2) vs 4.9 (2.3)) were slightly but significantly less with morphine. CONCLUSIONS: Opioid-induced emesis was observed in about one-third of the patients using morphine and piritramide for PCA and the incidence of vomiting was one-half of that. Potential differences in the incidence of vomiting during PCA therapy between these micro-opioid receptor agonists can be excluded.
Authors:
C Breitfeld; J Peters; T Vockel; C Lorenz; M Eikermann
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  91     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-24     Completed Date:  2003-09-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  218-23     Citation Subset:  IM    
Affiliation:
Klinik für Anästhesiologie und Intensivmedizin and Apotheke, Universitätsklinikum Essen, Hufelandstr. 55, D-45122 Essen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analgesia, Patient-Controlled / adverse effects,  methods
Analgesics, Opioid / adverse effects*
Double-Blind Method
Drug Administration Schedule
Female
Humans
Male
Middle Aged
Morphine / adverse effects*
Pain Measurement
Pain, Postoperative / drug therapy
Pirinitramide / adverse effects*
Postoperative Care / adverse effects,  methods
Postoperative Nausea and Vomiting / chemically induced*
Prospective Studies
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 302-41-0/Pirinitramide; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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