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Biomedical subjects

K Möllefors

Publications and source records attributed to K Möllefors.

4 recordsLinked to original sources
PubMed1985

Bladder function in spinal anaesthesia.

Spinal anaesthesia with bupivacaine (22.5 mg) or with a glucose-containing solution of bupivacaine (20 mg) or tetracaine (15 mg) was given to 21 patients allocated randomly to these three groups. A urodynamic study was performed by CO2 cystometry. It consisted of recording of first sensation of bladder filling, sensation of full bladder, strength of maximal detrusor contraction, bladder capacity and urethral pressure. At the same time, using a quantitative method for measuring muscle strength, the motor block was evaluated for three separate movements--hip flexion, knee extension and plantar flexion of the big toe. After the spinal injection, the micturition reflex was rapidly blocked. One minute after the injection, eight patients experienced no strong desire to void when the bladder was overfilled, and 5 min after the injection bladder paralysis was present in most patients. The length of time from spinal injection to complete recovery of detrusor strength was 7-8 h and did not differ significantly between the three groups. The level of analgesia lay at or caudal to L5 when the detrusor strength returned. On the average, sensibility (pin-prick) in the sacral segments returned simultaneously with or somewhat earlier than complete recovery of detrusor strength. The muscle strength in the lower limbs was fully restored 40-140 min, on average, before the detrusor strength had completely recovered. There was good correlation between the time of full restoration of hip flexion and detrusor strength in the bupivacaine groups. Urethral pressure was reduced by a mean of 48% and returned to normal either at the same time as or slightly before complete recovery of detrusor strength.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

An experimental study of urodynamic effects of epidural morphine and of naloxone reversal.

Urinary retention after epidural morphine is a distressing and troublesome complication. This study was undertaken to determine the effects of morphine (epidural, intramuscular, and intravenous) on urinary bladder function and possible reversal by naloxone. Thirty male volunteers (aged 20-28 years) were studied; the doses studied were 2, 4, and 10 mg of epidural morphine, 10 mg intramuscular morphine, and 10 mg intravenous morphine. The urodynamic study consisted of measurements of urine flow rate, strength of detrusor contraction, bladder capacity, and urethral pressure. Irrespective of dose, all subjects receiving epidural morphine showed marked relaxation of the detrusor shortly after injection. There was a corresponding increase in the maximal bladder capacity leading to urinary retention. These effects lasted an average of 14-16 h. Urethral pressures remained unchanged. Urodynamic changes after intramuscular and intravenous morphine were minimal. Treatment using a single intravenous injection of 0.8 mg naloxone promptly reversed the effects of epidural morphine on the bladder. Prevention of urinary retention was achieved with an intravenous infusion of naloxone started before administration of epidural morphine. The possible mechanisms of urinary retention following epidural opiates are discussed.

Adult↗