Sedation in intensive care: morphine and renal function

Intensive Care Medicine
J F BionI M Ledingham

Abstract

Intravenous morphine infusions have been administered to 12 critically-ill patients during controlled ventilation. Acute oliguric renal failure was present in 4 patients, who were treated with a combination of haemofiltration and haemodialysis. Severity of physiological disturbance was assessed using a modified APACHE Score, level of sedation by a linear-analogue scale, and blood morphine levels by high-pressure liquid chromatography. Morphine clearance was impaired in renal failure, and was dependent on haemofiltration volumes; accumulation of morphine did not occur during this form of treatment. Conscious level was clearly more closely related to the degree of physiological disturbance than blood morphine levels; and for a given blood morphine level, depression of consciousness was more pronounced the greater the degree of physiological disturbance. Use of a physiological sickness score may help to clarify some of the factors influencing cerebral function during critical illness. Careful clinical monitoring of level of sedation is important in patients with oliguric renal failure receiving morphine, and haemofiltration appears to reduce the risk of morphine accumulation in these patients.

References

Aug 1, 1979·Journal of Pharmaceutical Sciences·L ShargelA B Yu
Aug 1, 1975·British Journal of Clinical Pharmacology·J L MaddocksM J Harber
May 11, 1985·Lancet·S P JoelM L Slevin
Feb 1, 1985·Critical Care Medicine·G J OssenkoppeleL G Thijs
Aug 17, 1985·British Medical Journal·J F BionI M Ledingham
Feb 1, 1985·Anaesthesia·M Morgan, J G Whitwam
Apr 1, 1985·British Journal of Clinical Pharmacology·J SäweA Rane
Sep 1, 1971·The Tohoku Journal of Experimental Medicine·K ShimomuraH Tsukamoto
Oct 1, 1983·The Journal of Infectious Diseases·E TubaroC Santiangeli
Oct 8, 1983·British Medical Journal·N J DoddM J Weston

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Citations

Mar 8, 2006·Intensive Care Medicine·Karin SamuelsonBengt Fridlund
Feb 21, 2004·The Journal of Pain : Official Journal of the American Pain Society·Sebastiano Mercadante, Edoardo Arcuri
May 1, 1995·Disease-a-month : DM·R C BoneM Guerrero
Nov 1, 2000·Critical Care : the Official Journal of the Critical Care Forum·S R FinferM M Fisher
Aug 21, 2001·Clinical Pharmacokinetics·J Lötsch, G Geisslinger
Jan 1, 1991·Intensive Care Medicine·R Ritz
Nov 1, 1993·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·G R Park
Dec 24, 1997·Critical Care Medicine·G McLeodJ Colvin
May 1, 1997·Seminars in Veterinary Medicine and Surgery (small Animal)·A M Faggella
Jan 1, 1988·Resuscitation·I M LedinghamP G Wallace
Sep 1, 1987·Anaesthesia·L H NewmanI M Ledingham
Feb 1, 1988·Journal of Clinical Pharmacy and Therapeutics·J W Freeman, R B Hopkinson
Oct 7, 2006·Current Opinion in Anaesthesiology·Jörn Lötsch
May 27, 2004·São Paulo Medical Journal = Revista Paulista De Medicina·Geraldo Rolim Rodrigues Júnior, José Luiz Gomes do Amaral
Mar 7, 2002·British Journal of Anaesthesia·M P Shelly
Mar 21, 2007·Hypertension Research : Official Journal of the Japanese Society of Hypertension·UNKNOWN Japanese Society of Hypertension
Jan 1, 1995·Acta Anaesthesiologica Scandinavica. Supplementum·J M Elliot, J F Bion
Nov 30, 1999·Anesthesia and Analgesia·K TakahashiY Hirasaki
May 1, 2001·Current Opinion in Critical Care·Erkan Hassan
Oct 21, 1999·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·C J Diskin, S Thomas

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