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Related Experiment Videos

Intravesical morphine analgesia after bladder surgery

J W Duckett1, T Cangiano, M Cubina

  • 1Department of Urology, Children's Hospital of Philadelphia, Pennsylvania, USA.

The Journal of Urology
|April 1, 1997
PubMed
Summary

Intravesical morphine infusions effectively reduced postoperative pain in children undergoing ureteral reimplantation for the first 48 hours. Higher concentrations of morphine provided superior pain relief compared to lower doses.

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Area of Science:

  • Urology
  • Anesthesiology
  • Pharmacology

Background:

  • Peripheral opioid receptors in the bladder suggest potential for local morphine delivery.
  • Postoperative bladder irritation and spasms are common after ureteral reimplantation.
  • Continuous intravesical morphine may offer localized pain relief without systemic side effects.

Purpose of the Study:

  • To evaluate the effectiveness and optimal dosage of intravesical morphine infusions.
  • To determine the efficacy of different morphine concentrations in managing postoperative pain.
  • To assess the impact of intravesical morphine on pain levels after ureteral reimplantation.

Main Methods:

  • A prospective randomized study involving 52 children undergoing ureteral reimplantation.

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  • Randomization to receive intravesical morphine at concentrations of 0.05, 0.375, or 0.5 mg/ml via a bladder catheter.
  • Pain assessment using the Baker-Wong faces scale, with plasma morphine levels measured.

    • Main Results:

    • The 0.05 mg/ml morphine group reported significantly more pain in the first 48 hours postoperatively.
    • No significant difference in pain was observed on postoperative day 3.
    • Plasma morphine levels were undetectable, indicating minimal systemic absorption.

    Conclusions:

    • Intravesical morphine infusion is effective in alleviating postoperative pain within the first 48 hours after ureteral reimplantation.
    • A morphine concentration of 0.5 mg/ml is recommended for intravesical administration.
    • This method provides localized pain relief with no detectable systemic morphine levels.