2009
DOI: 10.1093/bja/aen368
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Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials

Abstract: Intrathecal morphine without local anaesthetic is often added to a general anaesthetic to prevent pain after major surgery. Quantification of benefit and harm and assessment of doseresponse are needed. We performed a meta-analysis of randomized trials testing intrathecal morphine alone (without local anaesthetic) in adults undergoing major surgery under general anaesthesia. Twenty-seven studies (15 cardiac -thoracic, nine abdominal, and three spine surgery) were included; 645 patients received intrathecal morp… Show more

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Cited by 200 publications
(172 citation statements)
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References 42 publications
(26 reference statements)
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“…The advantages of intrathecal morphine include its opioid sparing effect in the postoperative period, 1 targeted site of action in the central nervous system, and extended duration of action mediated by its effect on opioid receptors in the spinal cord. 2 Intrathecal doses of morphine can also be associated with pruritis, urinary retention, nausea, and delayed respiratory depression. 2,3 While hypothermia can be a common consequence of spinal anesthesia due to vasodilatation and the loss of the shivering reflex, 4 several anecdotal reports describe persistent hypothermia in the obstetrical population after spinal anesthesia using intrathecal morphine.…”
Section: Résumémentioning
confidence: 99%
See 1 more Smart Citation
“…The advantages of intrathecal morphine include its opioid sparing effect in the postoperative period, 1 targeted site of action in the central nervous system, and extended duration of action mediated by its effect on opioid receptors in the spinal cord. 2 Intrathecal doses of morphine can also be associated with pruritis, urinary retention, nausea, and delayed respiratory depression. 2,3 While hypothermia can be a common consequence of spinal anesthesia due to vasodilatation and the loss of the shivering reflex, 4 several anecdotal reports describe persistent hypothermia in the obstetrical population after spinal anesthesia using intrathecal morphine.…”
Section: Résumémentioning
confidence: 99%
“…2 Intrathecal doses of morphine can also be associated with pruritis, urinary retention, nausea, and delayed respiratory depression. 2,3 While hypothermia can be a common consequence of spinal anesthesia due to vasodilatation and the loss of the shivering reflex, 4 several anecdotal reports describe persistent hypothermia in the obstetrical population after spinal anesthesia using intrathecal morphine. [5][6][7][8][9] This case report describes persistent hypothermia following spinal anesthesia using intrathecal morphine for total knee arthroplasty and the return to normothermia after sublingual lorazepam.…”
Section: Résumémentioning
confidence: 99%
“…For instance, there is now strong evidence that in patients undergoing major abdominal surgery, intrathecal morphine alone significantly decreases pain intensity and opioid requirements postoperatively [57]. However, dose responsiveness of intrathecal morphine remains obscure and potentially serious adverse effects such as respiratory depression may limit the usefulness of this analgesic technique [57].…”
Section: Introductionmentioning
confidence: 99%
“…The effectiveness of a single injection of an opioid into the subarachnoid space is a long-established but infrequently used analgesic technique in thoracic surgery [92][93][94]. Predominantly, subarachnoidal formulated morphine (100-1,000 lg) and sufentanil (\25 lg) have been used for this purpose [94].…”
Section: Intrathecal Opioidsmentioning
confidence: 99%
“…Predominantly, subarachnoidal formulated morphine (100-1,000 lg) and sufentanil (\25 lg) have been used for this purpose [94]. To date, a low number of studies published an effective pain relief during thoracic surgery but often lacked an evidence-based design [92,95].…”
Section: Intrathecal Opioidsmentioning
confidence: 99%