X. Paqueron, A. Lumbroso, P. Mergoni, F. Aubrun, O. Langeron, P

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Presentation transcript:

Is morphine-induced sedation synonymous with analgesia during intravenous morphine titration? X. Paqueron, A. Lumbroso, P. Mergoni, F. Aubrun, O. Langeron, P. Coriat, B. Riou British Journal of Anaesthesia Volume 89, Issue 5, Pages 697-701 (November 2002) DOI: 10.1093/bja/aef262 Copyright © 2002 British Journal of Anaesthesia Terms and Conditions

Fig 1 Evolution of the BIS and of VAS in the Sleep and Awake groups. Values are mean (sd). In the Sleep group, BIS and VAS were assessed just before the onset of titration (STonset), when patients started to sleep (STsleep), then 5 (ST1), 10 (ST2), 20 (ST3), and 30 min (ST4) after the onset of sleep. In the Awake group, BIS and VAS were recorded just before the onset of titration (ATonset), then at 5 (AT0), 10 (AT1), 20 (AT2), 30 min (AT3), and at the end of titration (AT4). (a) BIS and VAS evolution in the Awake group: BIS value remained stable over the entire study period and VAS decreased regularly over time. (b) BIS and VAS evolution in the Sleep group: BIS decreased from 95 (5) at STonset to 90 (10) at STsleep then remained on a plateau until ST4 (P<0.05 vs Sleep group). The time-course of VAS was comparable with the evolution of VAS observed in the Awake group. British Journal of Anaesthesia 2002 89, 697-701DOI: (10.1093/bja/aef262) Copyright © 2002 British Journal of Anaesthesia Terms and Conditions

Fig 2 Division into subgroups, according to VAS. Values are percentages. Patients in the Sleep group were separated into three subgroups according to their VAS, 10 (ST2), 20 (ST3) and 30 (ST4) min after onset of sleep. Similarly, the same analysis by subgroup was performed among the patients of the Awake group 20 (AT2) and 30 (AT3) min after the onset of morphine titration as well as at the end of titration (AT4). In the Sleep group (a), analgesia progressively improved over time in 25% of patients. Then, at ST4, VAS was below 30 mm in 48% of patients. Conversely, 25% of patients in Sleep group had a persistent high level of VAS, not decreasing over time. In the Awake group (b), a constant decrease in the percentage of patients with a VAS above 30 mm was observed over time. In the Awake group at AT4, VAS was below 30 mm in 95% of the patients. British Journal of Anaesthesia 2002 89, 697-701DOI: (10.1093/bja/aef262) Copyright © 2002 British Journal of Anaesthesia Terms and Conditions