Intrathecal morphine: one year's experience in cardiac surgical patients.
OBJECTIVE
This study was designed to assess the benefits and complications associated with the use of intrathecal morphine (ITM) in patients undergoing coronary artery bypass surgery (CABG).


METHODS
This was a retrospective chart review.


METHODS
The study was performed in a single hospital that is affiliated with a university medical school.


METHODS
The charts of all patients who presented for CABG in a 12-month period were reviewed.


METHODS
All patients entered into the study had received ITM (0.03 mg/kg) at induction of anesthesia.


RESULTS
Complete data were available for 152 patients (86%). Median duration of ventilation postoperatively was 12 hours, and median duration of stay in the ICU was 72 hours. All patients received additional postoperative opioid analgesia, many by the epidural route. Fifteen percent developed respiratory complications, and the incidence of respiratory depression was 1.9%. Thirty-five percent required inotropic support; 17% percent were treated for hypertension; and 49% received antiarrhythmic therapy. The re-infarction rate was 2.6%, and 3% developed cardiac tamponade. Three patients developed neurologic complications unrelated to lumbar puncture. There were no in-hospital deaths.


CONCLUSIONS
ITM is safe and provides effective pain relief after cardiac surgery. The high incidence of respiratory depression confirms the need for close observation of these patients postoperatively.
Taylor
A
A
Department of Anaesthesia and Intensive Care, Mater Misericordiae Hospital, Dublin, Ireland.
Healy
M
M
McCarroll
M
M
Moriarty
D C
DC
D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D009020:Morphine