{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T06:02:21Z","timestamp":1760853741832},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,2,27]],"date-time":"2014-02-27T00:00:00Z","timestamp":1393459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Methylnaltrexone is a peripheral opioid receptor antagonist that does not cross the blood\u2013brain barrier; so without interference with pain relief, it could reverse the peripheral opioid side effects such as constipation, pruritus, postoperative ileus, and urinary retention. This study has been designed to evaluate the effect of methylnaltrexone on postoperative side effects of intrathecal morphine. In seventy\u2010two 18\u2010 to 55\u2010year\u2010old patients scheduled for elective orthopedic operations under spinal anesthesia, neuraxial blockade was achieved using 10\u00a0mg 0.5% hyperbaric bupivacaine and 0.1\u00a0mg preservative\u2010free morphine sulfate. The first group (M) received 12\u00a0mg methylnaltrexone, while the second group (P) received normal saline, subcutaneously, immediately after spinal block in a randomized, double\u2010blind fashion. There was a significant decrease in the rate of nausea and vomiting in group M, but there was no significant difference in the rate of pruritus or urinary retention between the two groups. Pain score was significantly lower in group M. Respiratory depression or decreased level of consciousness was not reported in any patient. Subcutaneous administration of methylnaltrexone was not effective in decreasing postoperative urinary retention and pruritus, but lowered the rate of nausea and vomiting and pain score after intrathecal bupivacaine and morphine.<\/jats:p>","DOI":"10.1111\/papr.12185","type":"journal-article","created":{"date-parts":[[2014,2,27]],"date-time":"2014-02-27T07:24:45Z","timestamp":1393485885000},"page":"348-354","source":"Crossref","is-referenced-by-count":13,"title":["The Effect of Methylnaltrexone on the Side Effects of Intrathecal Morphine after Orthopedic Surgery under Spinal Anesthesia"],"prefix":"10.1111","volume":"15","author":[{"given":"Farid","family":"Zand","sequence":"first","affiliation":[{"name":"Shiraz Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afshin","family":"Amini","sequence":"additional","affiliation":[{"name":"Shiraz Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saman","family":"Asadi","sequence":"additional","affiliation":[{"name":"Shiraz Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arash","family":"Farbood","sequence":"additional","affiliation":[{"name":"Shiraz Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,2,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03021032"},{"key":"e_1_2_6_3_1","first-page":"1143","article-title":"Comparison of intrathecal morphine plus PCA and PCA alone for post\u2010operative analgesia after kidney surgery","volume":"90","author":"Boonmak S","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen368"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.2012.01101.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2012.09.006"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000090147.97636.77"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm908"},{"key":"e_1_2_6_9_1","volume-title":"A Clinical Guide to Opioid Analgesia","author":"Fine PG","year":"2004"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.300.1.118"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200363070-00003"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1586\/egh.09.42"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.4065\/83.10.1116"},{"key":"e_1_2_6_14_1","first-page":"90","article-title":"Methylnaltrexone, a new peripheral mu\u2010receptor antagonist for the prevention and treatment of opioid\u2010induced extracerebral side effects","volume":"9","author":"Reichle FM","year":"2008","journal-title":"Curr Opin Investig Drugs"},{"key":"e_1_2_6_15_1","unstructured":"Protecting and Promoting Your Health. 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