[Spinal anesthesia and morphine analgesia in prostatic surgery].

Area of Science:

• Anesthesiology
• Pharmacology
• Surgical Recovery

Background:

• Postoperative pain management is crucial for patient recovery after transvesical prostatectomy.
• Intrathecal analgesia offers a targeted approach to pain relief.
• Optimizing the dose of intrathecal opioids is essential for balancing efficacy and safety.

Purpose of the Study:

• To compare the efficacy and safety of different doses of intrathecal morphine for postoperative pain control.
• To evaluate the impact of intrathecal morphine on the postoperative course of patients undergoing prostatectomy.
• To determine the optimal dose of intrathecal morphine for analgesia after transvesical prostatectomy.

Main Methods:

• A randomized controlled trial involving 45 patients scheduled for transvesical prostatectomy.
• Patients were assigned to three groups: control (intrathecal prilocaine), 0.5 mg intrathecal morphine plus prilocaine, or 1 mg intrathecal morphine plus prilocaine.
• Postoperative pain, analgesic requirements, and respiratory function were assessed.

Main Results:

• Control group patients experienced significant postoperative pain for 18 hours, requiring a mean of 20 mg subcutaneous morphine.
• Both 0.5 mg and 1 mg intrathecal morphine groups achieved satisfactory analgesia.
• A statistically significant difference in analgesia scores was observed between the 1 mg and 0.5 mg morphine groups, with the 1 mg group showing superior pain relief.
• No respiratory impairment was noted in the 1 mg intrathecal morphine group.

Conclusions:

• Intrathecal morphine provides effective postoperative analgesia after transvesical prostatectomy.
• One milligram of intrathecal morphine appears to be the optimal dose, offering superior pain relief without compromising respiratory function.
• Intrathecal morphine is a safe and effective adjunct for managing pain in patients undergoing prostatectomy.