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Updated: Jun 15, 2026

Intracranial Pharmacotherapy and Pain Assays in Rodents
02:26

Intracranial Pharmacotherapy and Pain Assays in Rodents

Published on: April 9, 2019

Pulmonary complications after intrathecal morphine administration: a systematic review and meta-analysis with

Kariem El-Boghdadly1,2, Yves Renard3, Jean-Benoit Rossel4

  • 1Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Anaesthesia
|April 16, 2025
PubMed
Abstract

Insights

Intrathecal morphine does not increase sedation or hypoxemia after non-obstetric surgery. However, very low-quality evidence suggests a potential increase in respiratory depression, especially at higher doses.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Intrathecal morphine is effective for postoperative pain relief.
  • Concerns exist regarding potential pulmonary complications with its use.
  • Peri-operative management strategies are influenced by these concerns.

Purpose of the Study:

  • To determine the association between intrathecal morphine and pulmonary complications.
  • To investigate a potential dose-dependent effect on pulmonary complications.
  • To analyze outcomes after non-obstetric surgery.

Main Methods:

  • Systematic literature search for randomized controlled trials.
  • Meta-analysis and meta-regression of intrathecal morphine versus control.
  • Inclusion of non-obstetric surgery patients under general or spinal anesthesia.
  • Primary outcomes: sedation, respiratory depression, hypoxemia.

Main Results:

  • 127 trials (7388 patients) included.
  • No significant increase in sedation or hypoxemia (moderate quality evidence).
  • Increased respiratory depression observed (very low quality evidence), not significant when doses >500 μg excluded.

Conclusions:

  • Moderate evidence indicates intrathecal morphine does not elevate sedation or hypoxemia rates.
  • Very low-quality evidence suggests a possible increased risk of respiratory depression.
  • Further data may be needed, particularly for respiratory depression outcomes.
Keywords:
adverse effectsanalgesiaintrathecalopioidspostoperative painsafety

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