Reduction in postoperative pain after spinal fusion with instrumentation using intrathecal morphine.
METHODS
The efficacy of intrathecal (spinal) morphine in the treatment of pain after posterior spinal fusions was assessed.


OBJECTIVE
To investigate improved posterior pain control with fewer side effects in patients with posterior spinal fusions.


BACKGROUND
After multilevel spinal fusion with instrumentation, patients experience considerable pain that is difficult to treat.


METHODS
For this study, 65 patients undergoing elective multilevel posterior spinal instrumentation were randomized to receive spinal morphine as follows: 10 microgram/kg, 20 microgram/kg, or none. These patients were assessed after surgery for pain control and narcotic-associated complications.


RESULTS
The patients who received 20 microgram/kg of spinal morphine were more comfortable immediately after surgery, remained pain free for a longer period, and required significantly less additional narcotic. These patients also had fewer respiratory complications.


CONCLUSIONS
Relatively high-dose spinal morphine administration provides simple, reliable postoperative pain control after posterior spinal fusions. This may contribute to reduced postoperative respiratory morbidity and an improved outcome.
Urban
Michael K
MK
Departments of Anesthesiology and Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA. mkpu@aol.com
Jules-Elysee
Kethy
K
Urquhart
Barbara
B
Cammisa
Frank P
FP
Boachie-Adjei
Oheneba
O
D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009270:Naloxone / Q000008:administration & dosage; D009292:Narcotic Antagonists / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011537:Pruritus / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology / Q000517:prevention & control; D012646:Self Administration; D013123:Spinal Fusion / Q000009:adverse effects; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine