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Published on: November 24, 2014
Intrathecal morphine for off-pump coronary artery bypass grafting
Samuel Metz1, Nanette Schwann, Wael Hassanein
1Department of Anesthesiology, Drexel University College of Medicine, Philadelphia, PA, USA. Samuel.Metz@Drexel.edu
Objective:
To determine if preinduction intrathecal morphine is associated with successful intraoperative extubation in patients undergoing off-pump coronary artery bypass grafting.
Design:
A retrospective noncontrolled chart review of all patients undergoing off-pump coronary artery bypass grafting.
Setting:
Single university hospital.
Participants:
One hundred twelve patients.
Interventions:
One hundred twelve of 150 patients received preinduction intrathecal morphine as part of routine anesthetic care for off-pump coronary artery bypass grafting. Patients received a mean of 1.0 mg of intrathecal morphine (range 0.3-1.6 mg); average weight-corrected dose was 13.2 microg/kg (range 5-24 microg/kg).
Measurements And Main Results:
This study included intraoperative extubation rate, delayed respiratory depression, and other complications potentially attributable to intrathecal morphine. An intraoperative extubation rate of 77% was found. Five patients received naloxone postoperatively, 4 of them for delayed respiratory depression.
Conclusions:
It is concluded that intrathecal morphine is associated with a high intraoperative extubation rate in patients undergoing off-pump coronary artery bypass grafting. The authors' practice included 24-hour respiratory monitoring to detect delayed respiratory depression.
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