Related Experiment Video
Updated: Aug 10, 2026
Intracranial Pharmacotherapy and Pain Assays in Rodents
Published on: April 9, 2019
Efficacy of low-dose intrathecal morphine for postoperative analgesia after abdominal aortic surgery: a double-blind
Mike Blay1, Jean-Christophe Orban, Laurent Rami
1Department of Anesthesiology and Critical Care East, Saint-Roch Hospital, University of Nice, Nice, France.
Background And Objectives:
Several studies suggest that intrathecal morphine (ITM) improves analgesia after aortic surgery. We tested the hypothesis that in combination with multimodal postoperative pain management, low-dose ITM associated with general anesthesia would decrease postoperative analgesic requirements in patients undergoing abdominal aortic surgery.
Methods:
Thirty patients were randomized to receive either general anesthesia alone or preceded by low-dose ITM (0.2 mg) administration. Patients and providers were blinded to treatment. Postsurgical multimodal pain management was similar in both groups, including parenteral paracetamol, followed by intravenous nefopam and then morphine if not sufficient. Intravenous analgesic requirements, visual analog scale (VAS) scores, and the incidence and severity of side effects were recorded for 48 hours after surgery.
Results:
Intraoperative data were comparable between the 2 groups, except sufentanil consumption, which was significantly lower in the ITM group when compared with the control group (P = .023). ITM decreased postoperative total-morphine requirements with respect to both the number of patients who received morphine (4 v 12 patients, P = .003) and the cumulative dose of morphine administered (0 [0-12.4] v 23 [13.9-45.6] mg, P = .006). VAS scores at rest were higher in the control group than in the ITM group at awakening (P < .01), at 4 hours (P < .01) after surgery, and at 8 hours (P < .05) after surgery but did not differ between groups after this period. Whereas VAS scores on coughing were higher in the control group at awakening (P < .01) and 4 hours after surgery (P < .05), no differences were found between groups from 8 hours after surgery.
Conclusion:
In patients undergoing abdominal aortic surgery, intrathecal morphine (0.2 mg) improves postoperative analgesia and decreases the need in intraoperative and postoperative analgesics. Further studies are indicated to evaluate the role of ITM in postoperative recovery.
Insights
Low-dose intrathecal morphine (ITM) combined with multimodal pain management significantly reduced postoperative analgesic needs and improved pain scores in patients undergoing abdominal aortic surgery. This approach offers enhanced pain control after major surgery.
Area of Science:
- Anesthesiology
- Pain Management
- Surgical Recovery
Background:
- Intrathecal morphine (ITM) is suggested to improve analgesia post-aortic surgery.
- Postoperative pain management after abdominal aortic surgery presents significant challenges.
Purpose of the Study:
- To test if low-dose ITM, combined with multimodal pain management, reduces analgesic requirements after abdominal aortic surgery.
- To evaluate the impact of ITM on postoperative pain and analgesic consumption.
Main Methods:
- A randomized, blinded study involving 30 patients undergoing abdominal aortic surgery.
- Patients received either general anesthesia alone or preceded by low-dose ITM (0.2 mg).
- Both groups received standardized multimodal postoperative pain management, with analgesic needs and pain scores (VAS) recorded for 48 hours.
Main Results:
- The ITM group required significantly less intraoperative sufentanil and postoperative morphine.
- Fewer patients in the ITM group needed morphine postoperatively (4 vs. 12).
- Lower visual analog scale (VAS) pain scores were observed in the ITM group at awakening and up to 8 hours post-surgery.
Conclusions:
- Low-dose intrathecal morphine (0.2 mg) effectively improves postoperative analgesia in abdominal aortic surgery.
- ITM reduces the need for both intraoperative and postoperative analgesics when used with multimodal pain management.
- Further research is warranted to explore the full benefits of ITM on patient recovery.
Related Concept Videos
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...