Efficacy of intrathecal morphine for postoperative pain management following open nephrectomy

Abstract

ObjectiveTo evaluate the efficacy and safety of intrathecal morphine (ITM) for postoperative pain control in patients with renal cell carcinoma undergoing open nephrectomy.MethodsForty-five patients scheduled for open nephrectomy were randomised to receive 300 µg ITM and intravenous patient-controlled analgesia (IV-PCA) (n = 22) or IV-PCA alone (n = 23) for postoperative analgesia. The numeric pain score (NPS), postoperative IV-PCA requirements and opioid-related complications including nausea, vomiting, dizziness, headache, and pruritus were compared between groups.ResultsNPS was significantly lower in the ITM group up to 24 h postoperatively. Upon coughing, NPS at 24 h postoperatively was 50 (interquartile range (IQR) 30–60) in the ITM group and 60 (45–70) in the IV-PCA group. Cumulative morphine consumption at 72 h postoperatively was significantly lower in the ITM group compared with the IV-PCA group (20 (9–33) mg vs. 31 (21–49) mg, respectively). Opioid-related complications were similar in both groups with the exception of pruritus (ITM, 77% vs. IV-PCA, 26%).ConclusionsITM was associated with greater analgesia without serious complications in patients undergoing open nephrectomy.

Efficiency and safety of intrathecal morphine for analgesia after hysterectomy

“…It should be emphasized that the group A patients were given metoclopramide at the end of surgery as well as in the postoperative period if necessary because of nausea and vomiting, whereas the group B patients were given metoclopramide at the end of surgery and eight hours after the surgery. Similar results have been reported in other studies as well [26,27].…”

Intrathecal hydrophilic opioids for abdominal surgery: a meta-analysis, meta-regression, and trial sequential analysis

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Tratamento Farmacológico E Não Farmacológico No Manejo Da Dor De Pacientes Em Pós-Operatório Imediato (Poi)

“…Concluiu-se que a ME em infusão, com a técnica de PCA foi mais eficaz e preferida pelos participantes da pesquisa. Kim et al (2016) avaliaram a eficácia da morfina intratecal para controle de DPO em 45 pacientes com carcinoma de células renais submetidos à nefrectomia aberta e constataram que uma única injeção intratecal de morfina combinada com PCA proporcionou analgesia PO mais eficaz do que PCA isolada, além de reduzir os requisitos de opioides por até 24 horas.…”