title: Intrathecal morphine analgesia after cervical and thoracic spinal cord tumor surgery.
abstract: OBJECTIVE
  The aim of this study was to provide evidence for the effect of intrathecal morphine application after spinal cord tumor resection.
  
  
  METHODS
  Twenty patients participated in a prospective open proof-of-concept study. During dural closure, morphine (7 μg/kg) was injected into the subarachnoid space. All patients were monitored in an intensive care setting postoperatively. Pain, additional opioids given, and vital parameters were recorded.
  
  
  RESULTS
  Six patients received a mean morphine dose of 365 μg between C-3 and C-7 and 14 patients received a mean dose of 436 μg between T-2 and T-12. In the cervical and thoracic groups, the mean Numeric Rating Scale score was highest upon intensive care unit admission (1.2 and 2.5, respectively) and declined at 12 hours (0.5 and 0.8, respectively). Minimal extra morphine was required. Minor side effects occurred without consequence.
  
  
  CONCLUSIONS
  Intrathecal morphine for postoperative analgesia after resection of cervical and thoracic spinal cord tumors is effective and safe. These preliminary results require confirmation by larger comparative studies and further clinical experience.
authors.affiliation: Departments of 1 Anesthesiology and.
authors.forename: Beate
authors.initials: B
authors.lastname: Poblete
authors.forename: Christoph
authors.initials: C
authors.lastname: Konrad
authors.forename: Karl F
authors.initials: KF
authors.lastname: Kothbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001254:Astrocytoma / Q000601:surgery*; D002574:Cervical Vertebrae / Q000601:surgery; D002648:Child; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007796:Laminectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D013346:Subarachnoid Space; D013904:Thoracic Vertebrae / Q000601:surgery; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine
keywords: ICU = intensive care unit; MABP = mean arterial blood pressure; NRS = Numeric Rating Scale; SaO2 = oxygen saturation; analgesia; cervical; oncology; pain; pediatric; spinal cord tumor; thoracic