Key result
Large-dose intrathecal opioids produce sympatholytic effects similar to epidural bupivacaine.
Why the study?
Decreases in blood pressure after spinal injection of opioids suggest intrathecal opioids may have a sympatholytic effect similar to local anesthetics.
Do large-dose intrathecal opioids produce a sympatholytic effect similar to epidural bupivacaine in patients aged 10-16 years?
Comparison
Intrathecal opioids vs 0.5% bupivacaine epidurally
Design
Comparative cohort study
Follow-up
40 minutes
Authors
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May support sympatholysis with intrathecal opioids in adolescents; hypothesis-generating and leaves open randomized confirmation before practice change.
Do large-dose intrathecal opioids produce a sympatholytic effect similar to epidural bupivacaine in patients aged 10-16 years?
Large-dose intrathecal opioids demonstrate a sympatholytic effect comparable to epidural bupivacaine, evidenced by similar changes in temperature gradients and pulse wave amplitude.
Goodarzi et al. (2001) studied this question. Intrathecal opioids vs. 0.5% bupivacaine epidurally was evaluated on Changes in calf to toe temperature gradients and pulse wave plethysmography amplitude. Large-dose intrathecal opioids produced a sympatholytic effect similar to epidural bupivacaine, with all patients demonstrating changes in calf to toe gradients (-3.2 ± 1.6).
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