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Intrathecal morphine injections in lumbar fusion surgery: Case-control study
Anaïs De Bie1, Renaud Siboni1, Mohamed F Smati1
1Orthopedic and trauma surgery department,hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Anesthesia and critical care unit, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|August 18, 2020
Summary
Intrathecal morphine (ITM) effectively reduces postoperative pain and opioid use after lumbar fusion surgery. This method also speeds up patient recovery and hospital discharge without increasing complications.
Area of Science:
- Neurosurgery
- Anesthesiology
- Orthopedics
Background:
- Intrathecal morphine (ITM) is used for analgesia but its role in spine surgery is debated.
- Conflicting literature exists regarding the efficacy of ITM in lumbar fusion.
Purpose of the Study:
- To investigate the opioid-sparing effect of intrathecal morphine (ITM) in patients undergoing posterior lumbar fusion.
- To evaluate the impact of ITM on postoperative pain, recovery, and complications.
Main Methods:
- Retrospective study comparing two groups of 30 patients undergoing posterior lumbar fusion.
- Control group received standard analgesia; ITM group received standard protocol plus 100μg of intrathecal morphine hydrochloride.
- Data collected included morphine consumption, pain scores (VAS), complications, and recovery metrics.
Main Results:
- The ITM group showed significantly lower morphine consumption at 24 and 48 hours postoperatively.
- Pain scores (VAS) were significantly reduced in the ITM group at multiple time points.
- Patients receiving ITM ambulated faster and had earlier hospital discharge compared to the control group.
- No significant difference in morphine-specific complications was observed between groups.
Conclusions:
- Adding intrathecal morphine to the analgesia protocol for lumbar fusion improves postoperative pain management.
- ITM accelerates the recovery process and hastens hospital discharge.
- ITM can be safely administered without increasing early opioid-related complications in lumbar fusion patients.
