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Pain Research and Management
Volume 1, Issue 2, Pages 86-92
Original Article

Analgesic and Nonanalgesic Effects of Intravenous Hydromorphone - Relation to Plasma Concentrations in Healthy Volunteers

D Westerling, H Bjork, P Svedman, and P Hoglund

Department of Anesthesiology, Clinical Pharmacology and Plastic and Reconstructive Surgery, University of Lund, Lund, Sweden

Received 27 December 1995; Accepted 14 February 1996

Copyright © 1996 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


OBJECTIVE: To investigate the analgesic and nonanalgesic effects and the pharmacokinetics of an intravenous infusion of 2 mg hydromorphone over 20 mins.

DESIGN: Open study.

SUBJECTS: Twelve healthy volunteers.

MEASUREMENTS: The analgesic effect of hydromorphone was evaluated serially using pressure pain thresholds (PPTs) measured on the third fingers and toes. The nonanalgesic effects of hydromorphone were measured as miosis, decrease of saliva production and central nervous effects such as euphoria/dysphoria, nausea, headache, fatigue and feeling of heaviness. Plasma concentration of hydromorphone was measured using high performance liquid chromatography.

RESULTS: PPTs were significantly increased compared with baseline levels for up to 2 h after the infusion of hydromorphone. Significant miosis and reduction of saliva production were registered up to 6 h after drug administration. Fatigue and heaviness were reported by all subjects. In the studied opioid-naive subjects, the hydromorphone-induced analgesic effect was of shorter duration than the studied nonanalgesic effects. The terminal elimination half-life of hydromorphone was 1.87±0.4 h (± SD) (95% CI 1.61 to 2.13), systemic clearance was 1.81±0.25 L/min (95% CI 1.65 to 1.97) and volume of distribution was 4.15±0.86 L/kg (95% CI 3.6 to 4.71).

CONCLUSION: Analgesia and nonanalgesic effects appear to be well correlated with the plasma concentrations of the hydromorphone.