Pain
Pain Management Unit, Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Bedford Park, SA 5042 Australia.
Published: December 1985
This study examines the cephalad migration of morphine in CSF following lumbar epidural administration in cancer patients with pain. Fourteen cancer patients were administered 10 mg of morphine in 10 ml of normal saline via an epidural catheter inserted in the lumbar region (usually L2.3) and attached to a subcutaneously implanted portal for drug administration. There was a rapid vascular uptake of morphine from the epidural space with a mean (+/- S.D.) peak blood concentration of 110 +/- 32 ng/ml (range 76-182 ng/ml and the mean time associated with this peak blood concentration was 5.1 +/- 2.3 min (range 2-10 min). A cervical CSF sample was obtained from the C7-T1 interspace in each patient at one of the following times from the completion of the epidural morphine dose: 10, 30, 60, 120, 180, 240 or 360 min. There was a delay of at least 60 min before morphine was detected in significant concentrations (approximately 300 ng/ml) in the cervical CSF samples and peak CSF concentrations occurred after approximately 3 h. The results of this study are compatable with the hypothesis that the delayed onset of respiratory depression sometimes observed following epidural morphine in opioid naive patients results from significant amounts of morphine reaching the respiratory centre in the brain-stem as a consequence of passive CSF flow in a rostral direction from the lumbar region.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/0304-3959(85)90001-6 | DOI Listing |
Breast J
January 2025
Department of Radiology, Cork University Hospital, Cork, Ireland.
Chest ports are typically inserted via the right internal jugular vein with the left side being utilized in certain patient populations. The purpose of this study was to evaluate the dynamic position of the chest port and catheter tip, comparing a demographically matched cohort of female breast cancer patients with right- or left-sided chest ports. 142 female patients with breast cancer requiring chest port insertion for chemotherapy and imaging confirming catheter tip position initially with supine fluoroscopy and follow-up with erect chest radiography over a 5-year period were identified.
View Article and Find Full Text PDFNeuromodulation
November 2024
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Introduction: Standard anterograde placement of a surgical paddle lead (SPL) for spinal cord stimulation (SCS) can be challenging in patients with scarring from prior spine surgery, instrumentation obstructing the targeted level, or severe stenosis below the targeted level. One potential alternative is retrograde (caudal) insertion by performing laminotomies cephalad to the targeted levels. The literature is limited to only a small number of individual cases describing this technique.
View Article and Find Full Text PDFMinerva Anestesiol
October 2024
Department of Anesthesiology, All India Institute of Medical Sciences, Bhopal, India.
World J Surg
November 2024
Department of Surgery, Centre for Gastro-esophageal Reflux Disease, Limmattal Hospital, Schlieren, Switzerland.
Background: The surgical technique in large hiatal hernia (HH) repair is controversially discussed and the outcome measures and follow-up schemes are highly heterogeneous. The aim of this study is to assess the true recurrence rate using computed tomography (CT) in patients with standardized large HH repair.
Methods: Prospective single-center study investigating the outcome after dorsal, mesh-enforced large HH repair with anterior fundoplication.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!
© LitMetric 2025. All rights reserved.