Effect of subarachnoid morphine administration on extubation time after coronary artery bypass graft surgery

Jamal A. Alhashemi, Michael D. Sharpe, Chris L. Harris, Vadim Sherman, Walter D Boyd

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objective: To determine the effects of 2 low doses of intrathecal morphine on extubation time and on postoperative analgesic requirements after coronary artery bypass graft (CABG) surgery. Design: A prospective, randomized, double-blind, placebo-controlled study. Setting: Tertiary-care university hospital. Participants: Fifty adult patients scheduled for elective primary CABG surgery. Interventions: Patients were randomized to receive placebo, 250 μg, or 500 μg intrathecal morphine, preoperatively. Intraoperative fentanyl and midazolam were limited to 15/μg/kg and 20/μg/kg intravenously. Patients were extubated in the intensive care unit by a blinded observer using predefined extubation criteria. Measurements and Main Results: Time to extubation and postoperative requirements for morphine, midazolam, nitroglycerin, and sodium nitroprusside were recorded by a blinded observer. Extubation times were 441 ± 207 minutes versus 325 ± 188 minutes versus 409 ± 245 minutes for the placebo, 250-μg, and 500-μg groups (p = 0.27). Postoperative morphine requirements, in the 250-μg and 500-μg groups were 13.6 ± 7.8 mg and 11.7 ± 7.4 mg, compared with 21.3 ± 6.2 mg in the placebo group (p = 0.001). There were no differences among the study groups with regard to postoperative midazolam, nitroglycerin, and sodium nitro-prusside requirements. Conclusions: Despite decreased postoperative morphine requirements, intrathecal morphine administration did not have a clinically relevant effect on extubation time after CABG surgery. This study suggests that 250/μg is the optimal dose of intrathecal morphine to provide significant post-operative analgesia without delaying tracheal extubation. Copyright (C) 2000 by W.B. Saunders Company.

Original languageEnglish (US)
Pages (from-to)639-644
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume14
Issue number6
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Coronary Artery Bypass
Morphine
Transplants
Midazolam
Placebos
Nitroglycerin
Airway Extubation
Nitroprusside
Fentanyl
Tertiary Healthcare
Analgesia
Intensive Care Units
Analgesics
Sodium

Keywords

  • Antihypertensives
  • Coronary artery bypass graft surgery
  • Neuraxial opioid
  • Tracheal extubation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of subarachnoid morphine administration on extubation time after coronary artery bypass graft surgery. / Alhashemi, Jamal A.; Sharpe, Michael D.; Harris, Chris L.; Sherman, Vadim; Boyd, Walter D.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 14, No. 6, 2000, p. 639-644.

Research output: Contribution to journalArticle

Alhashemi, Jamal A. ; Sharpe, Michael D. ; Harris, Chris L. ; Sherman, Vadim ; Boyd, Walter D. / Effect of subarachnoid morphine administration on extubation time after coronary artery bypass graft surgery. In: Journal of Cardiothoracic and Vascular Anesthesia. 2000 ; Vol. 14, No. 6. pp. 639-644.
@article{b8dc3303b196450793c19e06a9a55453,
title = "Effect of subarachnoid morphine administration on extubation time after coronary artery bypass graft surgery",
abstract = "Objective: To determine the effects of 2 low doses of intrathecal morphine on extubation time and on postoperative analgesic requirements after coronary artery bypass graft (CABG) surgery. Design: A prospective, randomized, double-blind, placebo-controlled study. Setting: Tertiary-care university hospital. Participants: Fifty adult patients scheduled for elective primary CABG surgery. Interventions: Patients were randomized to receive placebo, 250 μg, or 500 μg intrathecal morphine, preoperatively. Intraoperative fentanyl and midazolam were limited to 15/μg/kg and 20/μg/kg intravenously. Patients were extubated in the intensive care unit by a blinded observer using predefined extubation criteria. Measurements and Main Results: Time to extubation and postoperative requirements for morphine, midazolam, nitroglycerin, and sodium nitroprusside were recorded by a blinded observer. Extubation times were 441 ± 207 minutes versus 325 ± 188 minutes versus 409 ± 245 minutes for the placebo, 250-μg, and 500-μg groups (p = 0.27). Postoperative morphine requirements, in the 250-μg and 500-μg groups were 13.6 ± 7.8 mg and 11.7 ± 7.4 mg, compared with 21.3 ± 6.2 mg in the placebo group (p = 0.001). There were no differences among the study groups with regard to postoperative midazolam, nitroglycerin, and sodium nitro-prusside requirements. Conclusions: Despite decreased postoperative morphine requirements, intrathecal morphine administration did not have a clinically relevant effect on extubation time after CABG surgery. This study suggests that 250/μg is the optimal dose of intrathecal morphine to provide significant post-operative analgesia without delaying tracheal extubation. Copyright (C) 2000 by W.B. Saunders Company.",
keywords = "Antihypertensives, Coronary artery bypass graft surgery, Neuraxial opioid, Tracheal extubation",
author = "Alhashemi, {Jamal A.} and Sharpe, {Michael D.} and Harris, {Chris L.} and Vadim Sherman and Boyd, {Walter D}",
year = "2000",
doi = "10.1053/jcan.2000.18300",
language = "English (US)",
volume = "14",
pages = "639--644",
journal = "Journal of Cardiothoracic and Vascular Anesthesia",
issn = "1053-0770",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Effect of subarachnoid morphine administration on extubation time after coronary artery bypass graft surgery

AU - Alhashemi, Jamal A.

AU - Sharpe, Michael D.

AU - Harris, Chris L.

AU - Sherman, Vadim

AU - Boyd, Walter D

PY - 2000

Y1 - 2000

N2 - Objective: To determine the effects of 2 low doses of intrathecal morphine on extubation time and on postoperative analgesic requirements after coronary artery bypass graft (CABG) surgery. Design: A prospective, randomized, double-blind, placebo-controlled study. Setting: Tertiary-care university hospital. Participants: Fifty adult patients scheduled for elective primary CABG surgery. Interventions: Patients were randomized to receive placebo, 250 μg, or 500 μg intrathecal morphine, preoperatively. Intraoperative fentanyl and midazolam were limited to 15/μg/kg and 20/μg/kg intravenously. Patients were extubated in the intensive care unit by a blinded observer using predefined extubation criteria. Measurements and Main Results: Time to extubation and postoperative requirements for morphine, midazolam, nitroglycerin, and sodium nitroprusside were recorded by a blinded observer. Extubation times were 441 ± 207 minutes versus 325 ± 188 minutes versus 409 ± 245 minutes for the placebo, 250-μg, and 500-μg groups (p = 0.27). Postoperative morphine requirements, in the 250-μg and 500-μg groups were 13.6 ± 7.8 mg and 11.7 ± 7.4 mg, compared with 21.3 ± 6.2 mg in the placebo group (p = 0.001). There were no differences among the study groups with regard to postoperative midazolam, nitroglycerin, and sodium nitro-prusside requirements. Conclusions: Despite decreased postoperative morphine requirements, intrathecal morphine administration did not have a clinically relevant effect on extubation time after CABG surgery. This study suggests that 250/μg is the optimal dose of intrathecal morphine to provide significant post-operative analgesia without delaying tracheal extubation. Copyright (C) 2000 by W.B. Saunders Company.

AB - Objective: To determine the effects of 2 low doses of intrathecal morphine on extubation time and on postoperative analgesic requirements after coronary artery bypass graft (CABG) surgery. Design: A prospective, randomized, double-blind, placebo-controlled study. Setting: Tertiary-care university hospital. Participants: Fifty adult patients scheduled for elective primary CABG surgery. Interventions: Patients were randomized to receive placebo, 250 μg, or 500 μg intrathecal morphine, preoperatively. Intraoperative fentanyl and midazolam were limited to 15/μg/kg and 20/μg/kg intravenously. Patients were extubated in the intensive care unit by a blinded observer using predefined extubation criteria. Measurements and Main Results: Time to extubation and postoperative requirements for morphine, midazolam, nitroglycerin, and sodium nitroprusside were recorded by a blinded observer. Extubation times were 441 ± 207 minutes versus 325 ± 188 minutes versus 409 ± 245 minutes for the placebo, 250-μg, and 500-μg groups (p = 0.27). Postoperative morphine requirements, in the 250-μg and 500-μg groups were 13.6 ± 7.8 mg and 11.7 ± 7.4 mg, compared with 21.3 ± 6.2 mg in the placebo group (p = 0.001). There were no differences among the study groups with regard to postoperative midazolam, nitroglycerin, and sodium nitro-prusside requirements. Conclusions: Despite decreased postoperative morphine requirements, intrathecal morphine administration did not have a clinically relevant effect on extubation time after CABG surgery. This study suggests that 250/μg is the optimal dose of intrathecal morphine to provide significant post-operative analgesia without delaying tracheal extubation. Copyright (C) 2000 by W.B. Saunders Company.

KW - Antihypertensives

KW - Coronary artery bypass graft surgery

KW - Neuraxial opioid

KW - Tracheal extubation

UR - http://www.scopus.com/inward/record.url?scp=0033664005&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033664005&partnerID=8YFLogxK

U2 - 10.1053/jcan.2000.18300

DO - 10.1053/jcan.2000.18300

M3 - Article

C2 - 11139101

AN - SCOPUS:0033664005

VL - 14

SP - 639

EP - 644

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 6

ER -