title: Efficacy of intrathecal morphine for postoperative pain management following open nephrectomy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intrathecal morphine (ITM) for postoperative pain control in patients with renal cell carcinoma undergoing open nephrectomy.
  
  
  METHODS
  Forty-five patients scheduled for open nephrectomy were randomised to receive 300 µg ITM and intravenous patient-controlled analgesia (IV-PCA) (n = 22) or IV-PCA alone (n = 23) for postoperative analgesia. The numeric pain score (NPS), postoperative IV-PCA requirements and opioid-related complications including nausea, vomiting, dizziness, headache, and pruritus were compared between groups.
  
  
  RESULTS
  NPS was significantly lower in the ITM group up to 24 h postoperatively. Upon coughing, NPS at 24 h postoperatively was 50 (interquartile range (IQR) 30-60) in the ITM group and 60 (45-70) in the IV-PCA group. Cumulative morphine consumption at 72 h postoperatively was significantly lower in the ITM group compared with the IV-PCA group (20 (9-33) mg vs. 31 (21-49) mg, respectively). Opioid-related complications were similar in both groups with the exception of pruritus (ITM, 77% vs. IV-PCA, 26%).
  
  
  CONCLUSIONS
  ITM was associated with greater analgesia without serious complications in patients undergoing open nephrectomy.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Keimyung University, School of Medicine, Daegu, Korea.
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jun-Yeol
authors.initials: JY
authors.lastname: Bae
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Tae Kyong
authors.initials: TK
authors.lastname: Kim
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yunseok
authors.initials: Y
authors.lastname: Jeon
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Min
authors.affiliation: Department of Anaesthesiology and Pain Medicine, The Armed Forces Medical Command, Seongnam, Korea.
authors.forename: Eui-Kyoung
authors.initials: EK
authors.lastname: Goo
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea mellyn7@gmail.com.
authors.forename: Deok Man
authors.initials: DM
authors.lastname: Hong
mesh_terms: D016058:Analgesia, Patient-Controlled; D002292:Carcinoma, Renal Cell / Q000601:surgery; D003710:Demography; D006801:Humans; D007278:Injections, Spinal; D007680:Kidney Neoplasms / Q000601:surgery; D009020:Morphine / Q000008:administration & dosage* / Q000627:therapeutic use*; D009392:Nephrectomy / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D009020:Morphine
keywords: Injections; morphine; nephrectomy; pain; postoperative; spinal