Post operative analgesia with intrathecal morphine

Area of Science:

• Anesthesiology
• Pain Management
• Pharmacology

Background:

• Retrospective study of 68 ASA I and II patients aged 18-84 undergoing minor to medium surgery.
• Patients were divided into two groups based on intrathecal morphine administration.

Purpose of the Study:

• To evaluate the efficacy of adding low-dose preservative-free intrathecal morphine to spinal anesthesia for post-operative analgesia.
• To compare pain management outcomes and side effects between bupivacaine alone and bupivacaine with intrathecal morphine.

Main Methods:

• Group I received spinal anesthesia with bupivacaine (12.5-15 mg).
• Group II received spinal anesthesia with bupivacaine plus 0.1 mg preservative-free intrathecal morphine.
• Pain assessment up to 24 hours post-operatively was based on the need for pethidine intramuscular as salvage medication.

Main Results:

• Twenty-one of 30 patients (70%) in Group I required salvage medication versus 6 of 38 patients (15.8%) in Group II (p < 0.005).
• Intrathecal morphine was associated with increased minor complications: itching/pruritus (14 vs. 1), urinary retention (2 vs. 0), and nausea/vomiting (1 vs. 0) (p < 0.005).

Conclusions:

• A single low dose of intrathecal morphine combined with bupivacaine provides superior post-operative analgesia compared to bupivacaine alone for minor to medium surgical cases.
• This analgesic approach can be effective for up to 24 hours post-operatively, but potential side effects require consideration.