Intrathecal morphine during thoracotomy, Part II: Effect on postoperative meperidine requirements and pulmonary function tests.
The ability of intrathecal morphine (ITM) to reduce post-thoracotomy pain and meperidine requirements was investigated. Thirty adult patients scheduled for thoracic surgery were studied. Following induction with thiamylal sodium and succinylcholine, anesthesia was maintained with 100 micrograms of fentanyl, vecuronium, and enflurane. Prior to skin incision, 16 patients received intrathecal morphine, 12 micrograms/kg, injected at the L3-4 or L4-5 level. The other 14 patients were controls. Postoperatively, patients were evaluated for pain scores and the total doses of meperidine required over 24 hours. The patients in the ITM group required significantly less meperidine compared to the control group (59 +/- 68 v 167 +/- 97 mg, respectively) and had lower pain scores (1.4 +/- 1.1 v 2.4 +/- 0.9 mg, respectively). There were no serious side effects attributable to ITM. It is concluded that ITM is an effective adjunctive treatment for control of post-thoracotomy pain.
Neustein
S M
SM
Department of Anesthesia, Mount Sinai Medical Center, New York, NY 10029-6574.
Cohen
E
E
D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D003243:Consciousness / Q000187:drug effects; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007278:Injections, Spinal; D007430:Intraoperative Care; D007442:Intubation, Intratracheal; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008450:Maximal Midexpiratory Flow Rate / Q000187:drug effects / Q000502:physiology; D008614:Meperidine / Q000008:administration & dosage / Q000627:therapeutic use*; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D012121:Respiration, Artificial; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D014797:Vital Capacity / Q000187:drug effects / Q000502:physiology
D002245:Carbon Dioxide; D009020:Morphine; D008614:Meperidine; D010100:Oxygen