Comparison of 75 and 150 μg doses of intrathecal morphine for postoperative analgesia after transurethral resection of the prostate under spinal anesthesia.
OBJECTIVE
The administration of single dose intrathecal (IT) morphine with local anesthetics during spinal anesthesia produces an effective postoperative analgesia. In this study, we evaluated the efficacy and safety of two different doses of IT morphine with bupivacaine for postoperative analgesia after transurethral resection of prostate (TURP).


METHODS
Prospective, randomized study.


METHODS
Urology Department.


METHODS
Sixty patients who were scheduled to undergo TURP with spinal anesthesia.


METHODS
Patients were allocated to receive IT morphine (75 μg) with bupivacaine heavy (group I) and IT morphine (150 μg) with bupivacaine heavy (group II). Postoperative pain was evaluated by Visual Analogous Scale during 24 hours. The need for rescue analgesia, adverse effects and patient satisfaction were recorded.


RESULTS
Groups were comparable with respect to demographic data. VAS scores were similarly low in both groups. However, the request for analgesia was significantly higher in group I (27 percent) than group II (7 percent; p = 0.04). The incidence of postoperative nausea was similarly low in both groups. No patients reported pruritis in group I where as six patients (20 percent) reported mild pruritis not necessitating treatment in group II (p = 0.036) Patients satisfaction was similarly high in both the groups.


CONCLUSIONS
IT morphine 150 μg reduced the need for rescue analgesia compared to IT morphine 75 μg in patients undergoing TURP under spinal anesthesia. As the incidence of pruritis was low with no treatment, IT morphine 150 μg may be a suitable dose for postoperative analgesia for patients undergoing TURP under spinal anesthesia.
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey.
Halime
H
Ozbek
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey.
Mustafa N
MN
Deniz
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey.
Arzum
A
Erakgun
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ege University, Izmir, Turkey.
Elvan
E
Erhan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage; D016009:Chi-Square Distribution; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D016896:Treatment Outcome; D014421:Turkey
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D002045:Bupivacaine