V D Ward1, C R Mc Crory. 1. Department of Pain Medicine, St. James Hospital, Dublin 8, Ireland, vandanward@gmail.com.
Abstract
BACKGROUND: Intrathecal opioid administration yields high quality analgesia with an associated low incidence of side effects and complication. The benefits of spinal "opioid only technique" include absence of neuronal blockade, infusion pump malfunction and sympathetic blockade. This technique declined after serious side effects were reported in the 1990s. AIMS: To report on the safety and efficacy of the intrathecal catheter repeat bolus morphine technique for postoperative analgesia in patients having thoracotomy. METHODS: A 22 gauge intrathecal catheter was inserted through the lumbar 3-4 interspace prior to induction of anaesthesia for postoperative analgesia. Repeat bolus preservative-free morphine was administered for 48 h, target VAS was <4. RESULTS: The mean morphine administered via ITC in 48 h was 2.56 mg (± SD 0.88 mg). Only one patient required rescue morphine. There were no serious complications or sequelae at 6-month follow-up. CONCLUSIONS: Intrathecal morphine for post-op analgesia is efficacious and safe in a post-thoracotomy population.
BACKGROUND: Intrathecal opioid administration yields high quality analgesia with an associated low incidence of side effects and complication. The benefits of spinal "opioid only technique" include absence of neuronal blockade, infusion pump malfunction and sympathetic blockade. This technique declined after serious side effects were reported in the 1990s. AIMS: To report on the safety and efficacy of the intrathecal catheter repeat bolus morphine technique for postoperative analgesia in patients having thoracotomy. METHODS: A 22 gauge intrathecal catheter was inserted through the lumbar 3-4 interspace prior to induction of anaesthesia for postoperative analgesia. Repeat bolus preservative-free morphine was administered for 48 h, target VAS was <4. RESULTS: The mean morphine administered via ITC in 48 h was 2.56 mg (± SD 0.88 mg). Only one patient required rescue morphine. There were no serious complications or sequelae at 6-month follow-up. CONCLUSIONS: Intrathecal morphine for post-op analgesia is efficacious and safe in a post-thoracotomy population.
Authors: T T Horlocker; D G McGregor; D K Matsushige; R C Chantigian; D R Schroeder; J A Besse Journal: Anesth Analg Date: 1997-05 Impact factor: 5.108