title: Intrathecal morphine in two patients undergoing deep hypothermic circulatory arrest during aortic surgery -A case report-.
abstract: We retrospectively report the first use of intrathecal morphine prior to incision in two male patients undergoing a complex aortic reconstruction, who required complete circulatory arrest under deep hypothermia for intraoperative and postoperative pain control. We administered intrathecal morphine to two male patients undergoing circulatory arrest and deep hypothermia. Patients were fully heparinized prior to cardiopulmonary bypass. Deep hypothermic circulatory arrest was performed by cooling the patients to 18℃. Following the surgery, the neurologic status was monitored. The management of postoperative pain is a quality standard in health care. During the first 24 hours after surgery, we observed excellent analgesia without the associated side effects, thus, reducing the time required for pain control by the nursing staff. A successful analgetic strategy not only enhances the patient satisfaction, but may improve the postoperative outcome. However, complications, such as increased risk of epidural hematoma formation, are of special concern in cardiac surgery.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA. ; Department of Anesthesiology, University of Florida College of Medicine, Gainesville, USA.
authors.forename: Rene
authors.initials: R
authors.lastname: Przkora
authors.forename: Tomas D
authors.initials: TD
authors.lastname: Martin
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Hess
authors.forename: Rama S
authors.initials: RS
authors.lastname: Kulkarni
keywords: Cardiac surgical procedures; Circulatory arrest (hypothermia induced); Morphine; Spinal anesthesia