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Post operative analgesia with intrathecal morphine
Authors:Sfeir Samia  Mansour Nabil
Affiliation:Anesthesia Department SGH MUC in Association with the University of Balamand.
Abstract:INTRODUCTION: Sixty eight ASA I and II patients between 18 and 84 years who underwent minor to medium surgery were studied retrospectively. They were divided into 2 groups, on basis on intrathecal morphine administration. MATERIALS AND METHODS: Group I received spinal anesthesia with bupivacaine 12.5-15 mg. Group II received in addition 0.1 mg morphine (preservative free) [MO PF]. Pain assessment, up to 24 hours, was evaluated by the need of salvage medication namely pethidine i.m. (intramuscular). RESULTS: The groups matched for demographic distribution. Twenty one out of 30 patients in Group I needed salvage medication, compared to 6 out of 38 patients in Group II (p < 0.005). Minor complications of intrathecal morphine were noted. These were higher in Group II compared to Group I; itching and pruritis (14 vs. 1); urinary retention (2 vs. 0); nausea and vomiting (1 vs. 0) (p < 0.005). CONCLUSION: This study showed that a single low dose of intrathecal morphine with bupivacaine provides better quality post-operative analgesia than bupivacaine alone, and might offer enough analgesia for minor to medium cases up to 24 hours post-op. However, some side effects have to be taken into consideration.
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