Related Experiment Videos
Reduction in postoperative pain after spinal fusion with instrumentation using intrathecal morphine
Michael K Urban1, Kethy Jules-Elysee, Barbara Urquhart
1Departments of Anesthesiology and Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA. mkpu@aol.com
Study Design:
The efficacy of intrathecal (spinal) morphine in the treatment of pain after posterior spinal fusions was assessed.
Objective:
To investigate improved posterior pain control with fewer side effects in patients with posterior spinal fusions.
Summary Of Background Data:
After multilevel spinal fusion with instrumentation, patients experience considerable pain that is difficult to treat.
Methods:
For this study, 65 patients undergoing elective multilevel posterior spinal instrumentation were randomized to receive spinal morphine as follows: 10 microgram/kg, 20 microgram/kg, or none. These patients were assessed after surgery for pain control and narcotic-associated complications.
Results:
The patients who received 20 microgram/kg of spinal morphine were more comfortable immediately after surgery, remained pain free for a longer period, and required significantly less additional narcotic. These patients also had fewer respiratory complications.
Conclusions:
Relatively high-dose spinal morphine administration provides simple, reliable postoperative pain control after posterior spinal fusions. This may contribute to reduced postoperative respiratory morbidity and an improved outcome.