Background: In contemporary medicine, morphine remains the drug of choice in the treatment of severe postoperative pain. Nevertheless, morphine has several side effects, which can seriously compromise its analgesic effectiveness and the patient safety/compliance. The search for opioid analgesics with a better side-effect profile than morphine has led to a morphine metabolites, morphine-6-glucuronide (M6G).
Objective: The objectives of the current paper are to give an overview of the analgesic properties of M6G, assess the dose range at which it produces equianalgesia to morphine and explore its side-effect profile.
Methods: A review of published clinical studies (Phase II - III) on M6G in the treatment of experimental and clinical pain is given.
Results/conclusions: M6G > 0.2 mg/kg is an effective analgesic with a slower onset but longer duration of action (> 12 h) compared with morphine. Side effects, most importantly postoperative nausea and vomiting, occur less frequent after M6G treatment. M6G is an attractive alternative to morphine in the treatment of severe postoperative pain.
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http://dx.doi.org/10.1517/14656566.9.11.1955 | DOI Listing |
A A Pract
January 2025
Division of Anaesthesiology and Perioperative Medicine, Department of Pain Medicine, Singapore General Hospital, Singapore.
Brugada syndrome is a rare condition that increases the risk of life-threatening arrhythmias. Although there are existing anesthesia recommendations for patients with Brugada syndrome, guidance on pain management is limited. We present a novel approach to pain management in these patients, illustrated by the case of a young woman with Brugada syndrome who underwent ropivacaine peripheral nerve infusion and intravenous ketamine infusion for acute-on-chronic left upper limb pain.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
April 2024
Anesthesia and Intensive Care, Faculty of Medicine, Aswan University, Aswan, Egypt.
Background And Aims: Even though patient tolerance is critical to the success of noninvasive ventilation (NIV), research on using sedation to improve tolerance to NIV after traumatic chest injuries is limited. We hypothesized that dexmedetomidine would be superior to ketamine in terms of patient tolerance and lengthening the NIV sessions after blunt chest trauma.
Material And Methods: This randomized, double-blinded, placebo-controlled trial included 45 patients of both genders aged 18-60 who needed NIV after blunt chest trauma.
J Anaesthesiol Clin Pharmacol
November 2024
Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Background And Aims: Nasotracheal intubation evokes greater hemodynamic responses than oral intubation. We compared the heart rate (HR) and mean arterial pressure (MAP) responses following nasal intubation during opioid-free anesthesia (OFA) using intravenous lignocaine versus standard regimen using morphine in cancer patients undergoing tumor resection.
Material And Methods: This randomized, double-blinded study was conducted in 84 adults.
J Anaesthesiol Clin Pharmacol
May 2024
Department of Anaesthesiology and Critical Care, Lady Hardinge Medical College, New Delhi, India.
Background And Aims: Bispectral index (BIS) and minimum alveolar concentration (MAC) are commonly used to monitor the depth of anesthesia. The objective was to study the correlation between BIS and age-adjusted minimum alveolar concentration (aaMAC) during the maintenance phase of anesthesia. The influence of variables affecting BIS and or aaMAC was studied to determine an equation between BIS and aaMAC.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
July 2024
Department of Anesthesia, Surgical Intensive Care, and Pain Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
Background And Aims: Emergence agitation (EA) is frequently encountered following nasal surgeries, and postoperative pain is a significant contributing element. We aimed to assess the role of suprazygomatic maxillary nerve (MN) block (SMB) guided by ultrasound (US) in lowering EA incidence and enhancing analgesia quality in septorhinoplasty cases.
Material And Methods: Sixty cases aged 18-60 years, of both genders, categorized by the American Society of Anesthesiologists (ASA) I-II and listed for septorhinoplasty, were randomized to receive general anesthesia (GA) with either no block (the control group) or combined with bilateral US-guided SMB (the SMB group).
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