Analgesic effect of low-dose intrathecal morphine after spinal fusion in children.

Abstract

BACKGROUND:

This study was designed to assess the postoperative analgesic effect of low-dose intrathecal morphine after scoliosis surgery in children.

METHODS:

Thirty children, 9-19 yr of age, scheduled for spinal fusion, were randomly allocated into three groups to receive a single dose of 0 (saline injection), 2, or 5 microg/kg intrathecal morphine. After surgery, a patient-controlled analgesia device (PCA) provided free access to additional intravenous morphine. Children were monitored for 24 h in the postanesthesia care unit.

RESULTS:

The three groups were similar for age, weight, duration of surgery, and time to extubation. The time to first PCA demand was dose-dependently delayed by intrathecal morphine. The first 24 h of PCA morphine consumption was 49 +/- 17, 19 +/- 10, and 12 +/- 12 mg (mean +/- SD) in the saline, 2 microg/kg morphine, and 5 microg/kg morphine groups, respectively. Pain scores at rest were significantly lower over the whole study period after 2 and 5 microg/kg intrathecal morphine than after saline, but there was no difference between intrathecal doses. Pain scores while coughing and the incidence of side effects were similar in the three groups.

CONCLUSIONS:

These data demonstrate that low-dose intrathecal morphine supplemented by PCA morphine provides better analgesia than PCA morphine alone after spinal fusion in children. The doses of 2 and 5 microg/kg seem to have similar effectiveness and side-effect profiles, whereas a reduction of intraoperative bleeding was observed in patients who received 5 microg/kg but not 2 microg/kg intrathecal morphine.

• Authors: O Gall, J V Aubineau, J Bernière, L Desjeux, I Murat
• Journal: Anesthesiology (Anesthesiology) Vol. 94 Issue 3 Pg. 447-52 (Mar 2001) ISSN: 0003-3022 [Print] United States
• PMID: 11374604 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Analgesics, Opioid
• Morphine

Topics

• Adolescent
• Adult
• Analgesia
• Analgesia, Patient-Controlled
• Analgesics, Opioid
• Child
• Dose-Response Relationship, Drug
• Double-Blind Method
• Humans
• Injections, Spinal
• Morphine
• Pain, Postoperative (prevention & control)
• Spinal Fusion