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British Journal of Anaesthesia, Vol 75, Issue 4 394-398, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Interaction of extradural morphine and lignocaine on ventilatory response

Y. Saito, S. Sakura, M. Kaneko and Y. Kosaka
Department of Anesthesiology, Shimane Medical University, 89-1 Enya-cho, Izumo, Shimane 693, Japan

We have evaluated the effects of lumbar extradural morphine and lignocaine on the ventilatory response to carbon dioxide. Twenty-four female patients were allocated randomly to receive extradural morphine 2 mg (group M), 2% lignocaine 10 ml (group L) or a combination of morphine 2 mg and 2% lignocaine 10 ml (group ML). On the day before surgery, resting ventilatory values including minute volume (VE) and tidal volume (VT), and ventilatory response to progressive hyperoxic hypercapnia (VE/PE'CO2) were measured. On the day of surgery, the same measurements were repeated 30 min after extradural injection. Ventilatory values at rest were not altered after extradural injection. Mean VE/PE'CO2 decreased significantly after extradural morphine (P = 0.002) and increased (P = 0.011) after extradural lignocaine. Mean VE 7.3 (VE at PE'CO2 7.3 kPa) decreased significantly after extradural morphine (P < 0.001) and increased after extradural lignocaine (P = 0.047). Extradural morphine and lignocaine did not significantly alter mean VE/PE'CO2 and mean VE 7.3: 14.6 (95% confidence intervals 12.1- 17.1) to 15.3 (13.1-17.6) litre min-1 kPa-1 and 22.8 (18.1-27.5) to 22.8 (17.3-28.3) litre min-1, respectively. We conclude that extradural co-administration of morphine and lignocaine did not increase the risk of respiratory depression associated with morphine.
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