Intrathecal morphine for off-pump coronary artery bypass grafting.
OBJECTIVE
To determine if preinduction intrathecal morphine is associated with successful intraoperative extubation in patients undergoing off-pump coronary artery bypass grafting.


METHODS
A retrospective noncontrolled chart review of all patients undergoing off-pump coronary artery bypass grafting.


METHODS
Single university hospital.


METHODS
One hundred twelve patients.


METHODS
One hundred twelve of 150 patients received preinduction intrathecal morphine as part of routine anesthetic care for off-pump coronary artery bypass grafting. Patients received a mean of 1.0 mg of intrathecal morphine (range 0.3-1.6 mg); average weight-corrected dose was 13.2 microg/kg (range 5-24 microg/kg).


RESULTS
This study included intraoperative extubation rate, delayed respiratory depression, and other complications potentially attributable to intrathecal morphine. An intraoperative extubation rate of 77% was found. Five patients received naloxone postoperatively, 4 of them for delayed respiratory depression.


CONCLUSIONS
It is concluded that intrathecal morphine is associated with a high intraoperative extubation rate in patients undergoing off-pump coronary artery bypass grafting. The authors' practice included 24-hour respiratory monitoring to detect delayed respiratory depression.
Metz
Samuel
S
Department of Anesthesiology, Drexel University College of Medicine, Philadelphia, PA, USA. Samuel.Metz@Drexel.edu
Schwann
Nanette
N
Hassanein
Wael
W
Yuskevich
Brian
B
Nixon
Todd
T
D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000769:Anesthesia, Inhalation; D047549:Coronary Artery Bypass, Off-Pump; D006801:Humans; D007278:Injections, Spinal; D007432:Intraoperative Period; D007442:Intubation, Intratracheal; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009270:Naloxone / Q000008:administration & dosage; D009292:Narcotic Antagonists / Q000008:administration & dosage; D011229:Preanesthetic Medication
D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine