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Medline ® Abstract for Reference 94

of 'Prevention and management of side effects in patients receiving opioids for chronic pain'

Narcotic-induced histamine release: a comparison of morphine, oxymorphone, and fentanyl infusions.
Warner MA, Hosking MP, Gray JR, Squillace DL, Yunginger JW, Orszulak TA
J Cardiothorac Vasc Anesth. 1991;5(5):481.
This study, using an improved histamine assay, repeated previous studies that demonstrated large doses of morphine for induction of anesthesia in patients undergoing coronary artery bypass grafting were associated with histamine release. Thirty randomized patients received infusions of either morphine, 1 mg/kg, oxymorphone, 0.2 mg/kg, or fentanyl, 50 micrograms/kg, over a 10-minute period for induction of anesthesia prior to surgery. There were no significant changes in plasma histamine levels in individual patients or among drug groups. The discrepancy between the present histamine results and those previously reported using similar protocols is due, in part, to variations in plasma histamine measurements that can occur using the less reproducible, older assays for histamine. During routine inductions, large doses of morphine, oxymorphone, or fentanyl administered by infusion do not appear to stimulate release of clinically significant plasma levels of histamine.
Department of Anesthesiology, Mayo Medical School, Rochester, MN 55905.