title: Postoperative intrathecal analgesia for primary total hip arthroplasty--comparative clinical examination of two different small doses of morphium hydrochloride.
abstract: OBJECTIVE
  To prospectively compare the spinal analgesia with two different small doses of morphium hydrochloride after primary total hip arthroplasty.
  
  
  BACKGROUND
  In total hip arthroplasty, several techniques for postoperative analgesia can be used. In this study, we examined analgesia and side effects of intrathecal morphium hydrochloride (MCh) after primary total hip arthroplasty in small doses, namely 0.05 mg and 0.1 mg.
  
  
  METHODS
  Forty patients were randomized to receive either 0.5 ml/0.05 mg, or 0.5 ml/0.1 mg of MCh intrathecally together with 3.5 ml of 0.5% isobaric bupivacine hydrochloride. The duration of postoperative analgesia, the intensity of the initial pain sensation and the frequency of opioid side effects were recorded for the first 24 hours.
  
  
  RESULTS
  The mean duration of analgesia in group M 0.05 was 14.3 +/- 1.1 hours and was significantly shorter than 19.7 +/- 1.7 hours in the M 0.1 group (p < 0.05). Visual analogue scale (VAS) score for the initial pain intensity in M 0.05 group was 5 (median value). That in M 0.1 group was 3 (median value). The difference was not significant (p < 0.05). There was no respiratory depression in the groups. The difference in the frequency of nausea and vomiting was not significant but that of itching was (p < 0.05).
  
  
  CONCLUSIONS
  Intrathecal usage of 0.05 mg and 0.1 mg of MCh provides a long-lasting postoperative analgesia. It is a practical method to be provided after primary total hip arthroplasty. The efficacy of 0.1 mg of MCh is greater compared to that of 0.05 mg of MCh. These doses of MCh do not cause respiratory depression but cause nausea, vomiting and itching (Tab. 4, Fig. 1, Ref. 11).
authors.affiliation: Department ofAnesthesiology, Reanimatology and Intensive medicine, Clinical Hospital Dr. Trifun Panovski, Bitola, R Macedonia. vladodamevski@yahoo.com
authors.forename: V
authors.initials: V
authors.lastname: Damevski
authors.forename: G
authors.initials: G
authors.lastname: Damevska
authors.forename: L
authors.initials: L
authors.lastname: Palasevska
authors.forename: O
authors.initials: O
authors.lastname: Nojkov
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine