נגישות
menu      
Advanced Search
Syntax
Search...
Volcani treasures
About
Terms of use
Manage
Community:
אסיף מאגר המחקר החקלאי
Powered by ClearMash Solutions Ltd -
The pharmacokinetics of morphine and lidocaine in nine severe trauma patients
Year:
1999
Source of publication :
Journal of Clinical Anesthesia
Authors :
Ezra, David
;
.
Volume :
11
Co-Authors:
Berkenstadt, H., Depts. of Anesth. and Intensive Care, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Mayan, H., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Segal, E., Depts. of Anesth. and Intensive Care, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Rotenberg, M., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Almog, S., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Perel, A., Depts. of Anesth. and Intensive Care, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Ezra, D., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Facilitators :
From page:
630
To page:
634
(
Total pages:
5
)
Abstract:
Study Objective: To study the pharmacokinetic parameters of morphine and lidocaine after a single intravenous (IV) bolus in severe trauma patients. Design: Clinical case study. Setting: Department of Anesthesiology and Intensive Care of a university hospital.Patients: Nine patients, ages 24 to 91 years (mean 54.4 yrs), admitted to the hospital with severe trauma (Injury Severity Score >20) were included in the study.Interventions: After initial evaluation and stabilization, a single IV dose of morphine 0.025 mg/kg and lidocaine 1.5 mg/kg was given separately, and blood samples were drawn for each drug serum concentration. Measurements and Main Results: Morphine pharmacokinetics was studied in eight patients, lidocaine pharmacokinetics in seven patients, and both drugs were studied in six patients. Morphine clearance 2.5 to 10 ml/kg/min (6 ± 2.6, mean ± SD) and volume of distribution 0.28 to 3.30 L/kg (1.4 ± 1.0) were found to be lower than values described previously for healthy volunteers (33.5 ± 9 ml/kg/min and 5.16 ± 1.40 L/kg, respectively), and are similar to those described in trauma patients (5 ± 2.9 ml/kg/min and 0.9 ± 0.2 L/kg, respectively). In contrast, lidocaine clearance 4.5 to 9.4 ml/kg/min (6.7 ± 1.7) and volume of distribution 0.39 to 1.20 L/kg (0.72 ± 0.28) were similar to the value described in healthy volunteers (10 ml/kg/min and 1.32 L/kg, respectively). Conclusion: Changes in pharmacokinetics of drugs eliminated by the liver may occur in patients with severe trauma. The preserved lidocaine clearance indicates an almost normal hepatic blood flow and suggests that other mechanisms may be involved in the lower morphine clearance. The findings may have applications for the treatment of severe trauma patients and suggest that drug monitoring might be needed in some instances so as to avoid toxicity. Copyright (C) 1999 Elsevier Science Inc.
Note:
Related Files :
adult
aged
Analgesics, Opioid
clinical article
clinical trial
controlled clinical trial
Female
liver blood flow
Male
Show More
Related Content
More details
DOI :
10.1016/S0952-8180(99)00115-4
Article number:
Affiliations:
Database:
Scopus
Publication Type:
article
;
.
Language:
English
Editors' remarks:
ID:
25271
Last updated date:
02/03/2022 17:27
Creation date:
17/04/2018 00:13
Scientific Publication
The pharmacokinetics of morphine and lidocaine in nine severe trauma patients
11
Berkenstadt, H., Depts. of Anesth. and Intensive Care, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Mayan, H., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Segal, E., Depts. of Anesth. and Intensive Care, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Rotenberg, M., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Almog, S., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Perel, A., Depts. of Anesth. and Intensive Care, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
Ezra, D., Clinical Pharmacology, Sheba Med. Ctr., Tel Hashomer, S., Tel Aviv, Israel
The pharmacokinetics of morphine and lidocaine in nine severe trauma patients
Study Objective: To study the pharmacokinetic parameters of morphine and lidocaine after a single intravenous (IV) bolus in severe trauma patients. Design: Clinical case study. Setting: Department of Anesthesiology and Intensive Care of a university hospital.Patients: Nine patients, ages 24 to 91 years (mean 54.4 yrs), admitted to the hospital with severe trauma (Injury Severity Score >20) were included in the study.Interventions: After initial evaluation and stabilization, a single IV dose of morphine 0.025 mg/kg and lidocaine 1.5 mg/kg was given separately, and blood samples were drawn for each drug serum concentration. Measurements and Main Results: Morphine pharmacokinetics was studied in eight patients, lidocaine pharmacokinetics in seven patients, and both drugs were studied in six patients. Morphine clearance 2.5 to 10 ml/kg/min (6 ± 2.6, mean ± SD) and volume of distribution 0.28 to 3.30 L/kg (1.4 ± 1.0) were found to be lower than values described previously for healthy volunteers (33.5 ± 9 ml/kg/min and 5.16 ± 1.40 L/kg, respectively), and are similar to those described in trauma patients (5 ± 2.9 ml/kg/min and 0.9 ± 0.2 L/kg, respectively). In contrast, lidocaine clearance 4.5 to 9.4 ml/kg/min (6.7 ± 1.7) and volume of distribution 0.39 to 1.20 L/kg (0.72 ± 0.28) were similar to the value described in healthy volunteers (10 ml/kg/min and 1.32 L/kg, respectively). Conclusion: Changes in pharmacokinetics of drugs eliminated by the liver may occur in patients with severe trauma. The preserved lidocaine clearance indicates an almost normal hepatic blood flow and suggests that other mechanisms may be involved in the lower morphine clearance. The findings may have applications for the treatment of severe trauma patients and suggest that drug monitoring might be needed in some instances so as to avoid toxicity. Copyright (C) 1999 Elsevier Science Inc.
Scientific Publication
You may also be interested in