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Postoperative analgesia by nicomorphine intramuscularly versus high thoracic epidural administration: Effects on ventilatory and airway occlusion pressure responses to CO 2
Author(s) -
Hasenbos M.,
Simon M.,
Egmond J. Van,
Folgering H.,
Hoorn P. Van
Publication year - 1986
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1986.tb02446.x
Subject(s) - medicine , anesthesia , airway , occlusion , surgery
In this study the effects of nicomorphine, administered either intramuscularly or by high thoracic epidural route, on the ventilatory and airway occlusion pressure response to CO 2 were investigated and compared. Twenty‐four patients scheduled for thoracic surgery were allocated randomly to postoperative pain relief by i.m. nicomorphine or by high thoracic epidural nicomorphine. The ventilatory response to 5% carbon dioxide was measured in all patients: first 1 day before operation, secondly on the first day after surgery immediately before nicomorphine administration and finally after the administration, at the moment when no further rise in end‐tidal Pco 2 (P et co 2 ) was measured. Respiratory response was assessed in two ways, by measuring minute ventilation (Ve) and mouth occlusion pressure (p 0.1 ). There was a significant depression in ventilatory response to CO 2 in the intramuscular group ( P = 0.03) due to nicomorphine as assessed by the slope of V e vs P et CO 2 No significant depression was found in the epidural group, irrespective of measurement of V E , or P 0.1 . No significant shift of apnoeie threshold‐P ET co 2 was observed in either group.