Document Detail


Present state of extradural and intrathecal opioid analgesia in Sweden. A nationwide follow-up survey.
MedLine Citation:
PMID:  2886144     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A nationwide follow-up survey was undertaken to study the use of extradural and intrathecal opioids in the management of pain, to estimate the incidence of delayed ventilatory depression and to study post-injection surveillance routines. A questionnaire was sent to all 93 anaesthetic departments in Sweden; 96% responded. The major indication for using extradural opioids was the treatment of postoperative, traumatic and cancer pain. During 1984 over 14,000 patients received extradural, and over 1100 patients intrathecal, opioids. Morphine was the predominant opioid for extradural administration and was used in 96% of patients. Extradural opioid analgesia constitutes about 25% of all extradural blocks performed in Sweden. Pruritus and urinary retention were considered as minor problems; however, the risk was considerably higher after intrathecal morphine. The incidence of delayed ventilatory depression was about 1:1100 (0.09%) following extradural morphine and 1:275 (0.36%) following intrathecal morphine. Risk factors for delayed ventilatory depression are discussed. Administration of extradural morphine for postoperative pain relief in patients undergoing major surgery is considered a high benefit-low risk technique by most Swedish anaesthetists. The results of the present nationwide survey suggests that, following extradural morphine, surveillance of patients for more than 12 h appears unnecessary.
Authors:
N Rawal; S Arnér; L L Gustafsson; R Allvin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  59     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  1987 Jun 
Date Detail:
Created Date:  1987-09-24     Completed Date:  1987-09-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  791-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analgesics, Opioid / administration & dosage,  adverse effects,  therapeutic use*
Anesthesia Department, Hospital
Drug Utilization
Follow-Up Studies
Health Surveys
Humans
Injections, Epidural
Injections, Spinal
Middle Aged
Pain / drug therapy*
Postoperative Care
Pruritus / chemically induced
Respiratory Insufficiency / chemically induced
Sweden
Urination Disorders / chemically induced
Chemical
Reg. No./Substance:
0/Analgesics, Opioid

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


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