Intrathecal morphine for the relief of post‐hysterectomy pain ‐ a double‐blind, dose‐response study

Eighty patients undergoing total abdominal hysterectomy under general anaesthesia were randomly divided into four groups to study the dose‐response relationship of intrathecal morphine (0, 0.1, 0.3 and 0.5 mg) for postoperative pain relief. Pain scores, as assessed by using the visual analogue scale, revealed that intrathecal morphine provided long‐lasting pain relief, was most effective after 0.3 mg and significantly reduced the need for supplementary analgesics (P<0.05). There was no difference as regards the quality of analgesia or the use of supplementary analgesics between the 0.3 and 0.5 mg groups. Adequate pain relief was not evident after a 0.1 mg dose. There was no incidence of respiratory depression in any of the patients in this study. The incidence of side effects was least following 0.3 mg intrathecal morphine, which we consider to be the optimum dose.

[1]  R. Wheatley,et al.  Postoperative pain relief , 1995, The British journal of surgery.

[2]  G. Smith Pain after surgery. , 1991, British journal of anaesthesia.

[3]  M. Yeager Perioperative Stress Reduction with Intraspinal Opioids , 1990 .

[4]  M. Morgan The rational use of intrathecal and extradural opioids. , 1989, British journal of anaesthesia.

[5]  Hiroshi Takahashi,et al.  Minimal effective dose of intrathecal morphine for pain relief following transabdominal hysterectomy. , 1989, Anesthesia and analgesia.

[6]  M. Wattwil,et al.  Effects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomy , 1989, Acta anaesthesiologica Scandinavica.

[7]  H. S. Chadwick,et al.  Intrathecal and epidural morphine sulfate for post-cesarean analgesia--a clinical comparison. , 1988, Anesthesiology.

[8]  P. Hartvig,et al.  Pharmacokinetics of Intrathecal Morphine and Meperidine in Humans , 1987, Anesthesiology.

[9]  N. Rawal,et al.  Present state of extradural and intrathecal opioid analgesia in Sweden. A nationwide follow-up survey. , 1987, British journal of anaesthesia.

[10]  F. I. Weitz,et al.  INTRATHECAL MORPHINEʼS EFFECT ON THE POSTOPERATIVE COURSE OF PATIENTS UNDERGOING ABDOMINAL AORTIC SURGERY , 1987 .

[11]  T. Abboud,et al.  Intrathecal Administration of Hyperbaric Morphine for the Relief of Pain in Labour , 1984, British journal of anaesthesia.

[12]  Cousins Mj,et al.  Intrathecal and epidural administration of opioids , 1984 .

[13]  J. Kinney,et al.  SPLANCHNIC OXYGEN CONSUMPTION AND SUBSTRATE RALANCE FOLLOWING ACCIDENTAL INJURY , 1984 .

[14]  G. Nordberg Pharmacokinetic aspects of spinal morphine analgesia , 1984, Acta anaesthesiologica Scandinavica. Supplementum.

[15]  L. Mather,et al.  Intrathecal and epidural administration of opioids. , 1984, Anesthesiology.

[16]  J. Löfström,et al.  Postoperative Pain Relief with Intrathecal Morphine After Major Hip Surgery , 1983, Regional Anesthesia & Pain Medicine.

[17]  E. Kalso Effects of intrathecal morphine, injected with bupivacaine, on pain after orthopaedic surgery. , 1983, British journal of anaesthesia.

[18]  D. Scott Postoperative Pain Relief , 1982, Regional anesthesia and pain medicine.

[19]  P. Bromage,et al.  Rostral Spread of Epidural Morphine , 1982, Anesthesiology.

[20]  L. Gustafsson,et al.  ADVERSE EFFECTS OF EXTRADURAL AND INTRATHECAL OPIATES: REPORT OF A NATIONWIDE SURVEY IN SWEDEN , 1982 .

[21]  L. Gustafsson,et al.  Adverse Effects of Extradural and Intrathecal Opiates , 1982, Regional Anesthesia & Pain Medicine.

[22]  M. Lippmann,et al.  Relief of postoperative pain with low dose intrathecal morphine , 1981, PAIN.

[23]  M. Chauvin,et al.  Postoperative spinal analgesia with morphine. , 1981, British journal of anaesthesia.

[24]  L. Abrams,et al.  INTRATHECAL MORPHINE IN OPEN HEART SURGERY , 1980, The Lancet.

[25]  D. Deeley,et al.  Intrathecal morphine as sole analgesic during labour. , 1980, British medical journal.

[26]  John E. Thomas,et al.  Pain relief by intrathecally applied morphine in man. , 1979, Anesthesiology.

[27]  P. Cook Experiences in the first year of an "open door" x-ray department. , 1966, British medical journal.