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Intrathecal morphine plus general anesthesia in cardiac surgery: effects on pulmonary function, postoperative

Luciana Moraes dos Santos1, Verônica Cavani Jorge Santos, Silvia Regina Cavani Jorge Santos

  • 1Department of Anesthesia, Heart Institute, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. lumoraesrj@yahoo.com.br

Clinics (Sao Paulo, Brazil)
|June 3, 2009
PubMed
Abstract

Insights

Intrathecal morphine improved pain relief and reduced morphine use and plasma levels after cardiac surgery, without significantly impacting pulmonary function. This offers a potential benefit for postoperative recovery.

Area of Science:

  • Anesthesiology
  • Cardiothoracic Surgery
  • Pharmacology

Background:

  • Post-cardiac surgery lung dysfunction is a major cause of mortality.
  • Regional analgesia may improve pulmonary outcomes by mitigating pain.
  • The efficacy of regional analgesia in improving pulmonary function post-cardiac surgery is debated.

Purpose of the Study:

  • To assess the impact of intrathecal morphine on pulmonary function.
  • To evaluate the analgesic effects of intrathecal morphine.
  • To measure morphine plasma concentrations following cardiac surgery.

Main Methods:

  • A randomized trial comparing general anesthesia with intrathecal morphine plus general anesthesia.
  • Pulmonary function tests (FVC, FEV) and blood gas analysis were performed.
  • Pain scores, morphine consumption, and plasma morphine levels were monitored postoperatively.

Main Results:

  • Intrathecal morphine did not significantly alter forced vital capacity (FVC), forced expiratory volume (FEV), or oxygenation.
  • Patients receiving intrathecal morphine reported significantly lower pain intensity, especially during coughing.
  • Morphine consumption and plasma morphine concentrations were significantly reduced in the intrathecal morphine group.

Conclusions:

  • Intrathecal morphine effectively improves analgesia after cardiac surgery.
  • It leads to reduced overall morphine consumption and lower plasma concentrations.
  • No significant adverse effects on pulmonary function were observed.

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