Morphine and postoperative rewarming in critically ill patients

Morphine sulfate (MSO4) has been demonstrated to attenuate the stress response. MSO4 might be useful in minimizing the stress associated with the perioperative period, particularly that due to awakening from anesthesia and rewarming. Two groups of critically ill patients who developed hypothermia (3...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1983-12, Vol.68 (6), p.1238-1246
Main Authors: RODRIGUEZ, J. L, WEISSMAN, C, DAMASK, M. C, ASKANAZI, J, HYMAN, A. I, KINNEY, J. M
Format: Article
Language:English
Subjects:
Aged
Anesthesia
Anesthesia, General
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Body Temperature
Energy Metabolism - drug effects
Female
General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation
Hemodynamics
Humans
Hypothermia - drug therapy
Intensive Care Units
Male
Medical sciences
Middle Aged
Morphine - therapeutic use
Postoperative Period
Stress, Physiological - drug therapy
Surgical Procedures, Operative
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Summary:Morphine sulfate (MSO4) has been demonstrated to attenuate the stress response. MSO4 might be useful in minimizing the stress associated with the perioperative period, particularly that due to awakening from anesthesia and rewarming. Two groups of critically ill patients who developed hypothermia (35.8 degrees C) during a surgical procedure were studied. The control group was observed during routine medical management. Group II received 1 or 4 mg/kg MSO4 followed by an infusion of 0.2 or 0.5 mg/kg/hr. During the postoperative rewarming period the control group patients demonstrated a major increase in metabolic demand and myocardial work. In group II patients the infusion of MSO4 resulted in a lower metabolic rate. This was associated with a significantly longer rewarming time and a significant reduction in shivering, heat loss, heart rate, mean arterial pressure, and rate-pressure product. Infusion of MSO4 in critically ill patients during the perioperative period suppressed metabolic demands and myocardial work while preserving cardiovascular function.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.68.6.1238