Intrathecal Morphine for Post-Thoracotomy Pain

Gray, John R.; Fromme, Glenn A.; Nauss, Lee A.; Wang, Josef K.; Ilstrup, Duane M.

doi:10.1213/00000539-198608000-00009

Cited by 45 publications

(20 citation statements)

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“…[3][4][5] Moreover, single-shot intrathecal morphine fails to ensure adequate analgesia beyond 24 hr and supplemental iv opioid agents may be needed. 5,6 Recently, the combined use of intrathecal morphine and patient-controlled iv analgesia (PCA) morphine has been shown to be a valuable approach for analgesia after spinal fusion or thoracic surgeries.…”

Section: Méthode : Soixante Patients Adultes Devant Subir Une Intervementioning

confidence: 99%

Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone

Devys

Mora

Plaud

et al. 2003

Can J Anesth/J Can Anesth

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Section: Méthode : Soixante Patients Adultes Devant Subir Une Intervementioning

confidence: 99%

Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone

Devys

Mora

Plaud

et al. 2003

Can J Anesth/J Can Anesth

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“…[4][5][6][8][9][10][11][12] In our experience, lumbar intrathecal morphine provided adequate postoperative analgesia in all patients, with no patient requiring supplemental analgesic agents for the initial 15-hour postoperative period. [4][5][6][8][9][10][11][12] In our experience, lumbar intrathecal morphine provided adequate postoperative analgesia in all patients, with no patient requiring supplemental analgesic agents for the initial 15-hour postoperative period.…”

Section: Discussionmentioning

confidence: 55%

Postoperative Analgesia

Tobias

Deshpande

Wetzel

et al. 1990

Clin Pediatr (Phila)

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The identification of opiate receptors in the spinal cord gave rise to the suggestion that the use of intrathecal and epidural narcotics may provide effective and safe postoperative analgesia. The authors retrospectively reviewed the records of ten children who received intrathecal morphine as part of their anesthetic care over the last 2 years. Preservative-free morphine (Duramorph) in a dose of 0.02 mg/kg was administered to all patients in the lumbar intrathecal space before the start of the surgical procedure. Adequate postoperative analgesia was achieved in the ten children. No patient required supplemental analgesic agents for the initial 15-hour postoperative period. Surgical procedures included exploratory laparotomy, laryngotracheoplasty, and craniofacial reconstruction. As with narcotics administered by any route, intrathecal morphine can cause respiratory depression, and such depression may be delayed for up to 24 hours after the dose. Therefore, the postoperative respiratory status of these children should be monitored for 24 hours after the dose, preferably in an intensive care unit. With this caveat, the use of intrathecal morphine provides safe and effective postoperative analgesia in children undergoing major surgery.

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“…17 This is most frequently seen at 6 -11 h after IT morphine injection. 2,4 The risk of encountering late respiratory depression after administration of IT morphine has caused anaesthesiologists generally to prefer the epidural administration. 2,10 The present study did not demonstrate late respiratory depression in the 24-h follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 The risk of encountering late respiratory depression after administration of IT morphine has caused anaesthesiologists generally to prefer the epidural administration. 2,10 The present study did not demonstrate late respiratory depression in the 24-h follow-up period. There were significant differences in sedation scores between the two groups at post-operative 10 min, 30 min and 24 h, but neither group had sedation scores > 3 at any assessment time-point.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Intrathecal Morphine in Post-thoracotomy Pain Management

et al. 2007

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This study compared the analgesic efficacy of intrathecal (IT) morphine plus IV patient-controlled analgesia (PCA) morphine with IV PCA morphine alone in 33 patients undergoing thoracotomy randomized to two groups: the IT morphine group (n=17) received 10 microg/kg morphine 1 h before the end of surgery, while the control group (n=16) did not. All patients had access to an IV PCA pump post-operatively that delivered 2 mg morphine boluses. Post-operative pain and sedation scores, respiratory and haemodynamic parameters, and morphine demand and delivery were assessed up to 48 h. Post-operative pain scores and morphine consumption were significantly reduced, while peak expiratory flow rates were significantly increased in the IT morphine group compared with controls. We concluded that IT morphine in addition to IV PCA established superior analgesia and maintained better respiratory function compared with IV PCA alone in post-thoracotomy patients.

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Intrathecal Morphine for Post-Thoracotomy Pain

Cited by 45 publications

References 0 publications

Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone

Intrathecal + PCA morphine improves analgesia during the first 24 hr after major abdominal surgery compared to PCA alone

Postoperative Analgesia

The Efficacy of Intrathecal Morphine in Post-thoracotomy Pain Management

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