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Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis

M Gehling1, M Tryba

  • 1Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Klinikum Kassel, Kassel, Germany. gehling@klinikum-kassel.de

Anaesthesia
|May 23, 2009
PubMed

Insights

Intrathecal morphine provides postoperative pain relief but can increase side effects like nausea and itching. Lower doses (<0.3 mg) showed no increased respiratory depression compared to placebo.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Pain Management

Background:

  • Intrathecal morphine is a common analgesic after surgery.
  • Understanding its side effect profile is crucial for patient safety.

Purpose of the Study:

  • To meta-analyze the frequency of side effects associated with intrathecal morphine.
  • To compare outcomes between different morphine doses and placebo.

Main Methods:

  • Meta-analysis of 28 studies involving 790 patients receiving intrathecal morphine and 524 controls.
  • Analysis clustered by morphine dose: <0.3 mg and >=0.3 mg versus placebo.

Main Results:

  • Lower morphine doses increased nausea, vomiting, and pruritus compared to placebo.
  • Higher doses significantly increased pruritus but not nausea or vomiting.
  • Overall, intrathecal morphine did not increase respiratory depression; however, higher doses showed a trend towards more events.

Conclusions:

  • Intrathecal morphine is associated with a mild increase in side effects.
  • Doses below 0.3 mg did not elevate respiratory depression risk compared to placebo patients receiving systemic opioids.

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