Intrathecal morphine for post-operative analgesia in patients with fractured hips

This prospective, randomised, double blind study examined the efficacy of intrathecal morphine for post-operative analgesia in Chinese patients undergoing surgery to repair fractured hips. There were a total of 40 American Society of Anesthesiologists physical status grade I to IV patients scheduled for surgery following a fractured neck of the femur. Patients were randomised to a control group in which they received subarachnoid plain 0.5% bupivacaine, 2.2 mL, and normal saline, 0.4 mL, giving a total volume of 2.6 mL, or to a study group in which they received plain 0.5% bupivacaine, 2.2 mL, and preservative-free morphine, 0.2 mg, diluted with normal saline to a total volume of 2.6 mL. Patients were monitored for up to 24 hours by staff blinded to group allocation. The level of pain was assessed by a visual analogue pain score and the time of first request for analgesia was noted. The results show the median pain-free period in the control group was nine hours (range, 2-24 hours), while it was 24 hours (range, 16-24 hours) in the morphine group, a significant difference (P<0.05). No major complications were reported. Intrathecal morphine is a useful technique for giving post-operative pain relief, especially in the elderly, in whom many other techniques cannot be safely used.