| Studies on morphine disposition: plasma concentrations of morphine and its metabolites in anesthetized middle-aged and elderly surgical patients. | |
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MedLine Citation:
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PMID: 2627383 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effects of aging on the disposition of morphine and its metabolites have been investigated in 10 middle-aged patients (36 to 55 years of age) undergoing lower abdominal or body surface surgery, and compared with 10 elderly patients (65 to 83 years of age) undergoing similar surgery. All patients received 10 mg morphine sulphate pentahydrate IV over 30 seconds as part of a balanced anesthetic technique. Peripheral venous blood samples were collected to 180 min, and plasma concentrations of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) were assayed by differential radioimmunoassay. There were no differences between the two groups for morphine elimination half-life (middle-aged patients, 129 min; elderly patients, 162 min), mean residence time (154 and 207 min), and apparent volume of distribution at steady state (116 and 107 l). However, clearance was significantly greater in the younger patients (853 vs. 559 ml/min; p less than 0.02). The area under the curve (AUC0-180) for M3G and M6G were similar in the two patient groups, as were the peak metabolite concentrations and times to peak concentrations. M6G has been shown in both animals and humans to exert analgesic properties. Despite the reduced clearance of the parent drug, there was an unaltered AUC for M6G, presumed due to the greater decrease in glomerular filtration rate seen during anesthesia in the elderly patient. This phenomenon may result in enhanced analgesic efficacy from a given dose of morphine in the elderly patient. |
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Authors:
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J W Sear; C W Hand; R A Moore |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of clinical anesthesia Volume: 1 ISSN: 0952-8180 ISO Abbreviation: J Clin Anesth Publication Date: 1989 |
Date Detail:
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Created Date: 1990-04-26 Completed Date: 1990-04-26 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8812166 Medline TA: J Clin Anesth Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 164-9 Citation Subset: IM |
Affiliation:
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Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Headington, England. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aging / metabolism* Anesthesia, Intravenous / adverse effects* Dose-Response Relationship, Drug Female Humans Liver Circulation Male Middle Aged Morphine / administration & dosage, blood, pharmacokinetics* Morphine Derivatives / pharmacokinetics Renal Circulation Surgical Procedures, Operative* |
| Chemical | |
Reg. No./Substance:
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0/Morphine Derivatives; 20290-09-9/morphine-3-glucuronide; 20290-10-2/morphine-6-glucuronide; 57-27-2/Morphine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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