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British Journal of Anaesthesia, 1985, Vol. 57, No. 4 407-411
© 1985 The Board of Management and Trustees of the British Journal of Anaesthesia


research-article

EFFECT OF POSTOPERATIVE EXTRADURAL MORPHINE ON ADH SECRETION

A. M. KORINEK, M.D., M. LANGUILLE, M.D., F. BONNET, M.D., M. THIBONNIER, M.D., P. SASANO, M.D., A. LIENHART, M.D. and P. VIARS, M.D.

Département d'Anesthesie-Réanimation, Groupe Hospitalíer Pitié-Salpétrière, 83, boulevard de 1'Hôpital 75651 Paris Cedex, France
I.N.S.E.R.M. Unité 34 17, rue du Fer à Moulin, 75005 Paris, France

The effect of extradural morphine on antidiuretic hormone (ADH) secretion was assessed for the first 6 h after surgery in three groups of patients. Surgery was conducted under extradural bupivacaine: thereafter patients in group I (n = 6) received further injections of bupivacaine, patients in group II (n = 6) received an extradural injection of morphine and in patients in group III (n = 5) both bupivacaine and morphine, were administered extradurally. In group I, plasma ADH values remained unchanged throughout the study. In contrast, in the two groups of patients receiving extradural morphine a delayed and stepwise increase in plasma ADH concentration was documented. These results indicate that extradural morphine induces ADH secretion and suggest that this effect is the consequence of the migration of morphine to the brainstem.


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