title: An audit of intrathecal morphine analgesia for non-obstetric postsurgical patients in an adult tertiary hospital.
abstract: We conducted a retrospective audit of adult non-obstetric patients who had received a single dose of intrathecal morphine for postoperative analgesia. These patients were predominantly admitted to a regular postsurgical ward with strict hourly nursing observations, treatment protocols in place and supervision by an Acute Pain Service for the first 24 hours after intrathecal morphine administration. A total of 409 cases were examined for sedation score, incidence of respiratory depression and other side-effects, admission to the high dependency or intensive care unit and opioid-tolerance. Respiratory depression was defined as requiring treatment with naloxone (implying a sedation score of 3 irrespective of respiratory rate), or a sedation score of 2 with a respiratory rate less than six breaths per minute. The patients were predominantly elderly (57.2% were over the age of 70 years) and 84.8% had undergone vascular surgery. Of the total of 409 cases, only one case of respiratory depression was observed. A total of 77 patients were admitted to high dependency or intensive care unit for various reasons including management of postsurgical complications and patient co-morbidities. Our findings suggest that elderly patients who receive intrathecal morphine analgesia can be safely managed in a regular postsurgical ward.
authors.affiliation: Department of Anaesthesia, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: P C
authors.initials: PC
authors.lastname: Lim
authors.forename: P E
authors.initials: PE
authors.lastname: Macintyre
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001315:Australia; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D012120:Respiration Disorders / Q000139:chemically induced*; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine