Abstract | BACKGROUND: METHODS: The primary outcome was total IV morphine consumption during 0-48 hours postoperatively. Secondary outcomes included time until first patient-controlled analgesia (PCA) demand, pain scores, and adverse opioid effects. After institutional review board approval, 71 subjects undergoing posterior spinal fusion for idiopathic scoliosis completed the study. The subjects were randomly allocated to 7.5 μg/kg IT morphine or 150 μg/kg EREM. The final IT morphine and EREM groups contained 37 and 34 subjects, respectively. Postoperative pain was treated with morphine PCA, ketorolac, oral oxycodone, and acetaminophen. Morphine consumption, pain scores, nausea and vomiting, pruritus, and respiratory depression were measured every 4 hours. Parents completed a caregiver questionnaire about their child's pain control regimen after the first postoperative day. RESULTS: There was no difference in total morphine consumption over the first 48 hours between subjects in the EREM and IT morphine groups: median (range) 42.2 (5.5-123.0) and 34.0 (4.5-128.8) mg, respectively (P = .27). EREM and IT morphine groups had no difference in time until first PCA demand. Pain scores were no different between the groups from 8 to 24 hours after surgery. Compared to IT morphine, EREM subjects had lower pain scores from 28 to 36 hours after surgery. The reported incidence of pruritus was lower in the EREM subjects. CONCLUSIONS:
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Authors | Mindy Cohen, Jeannie Zuk, Nancy McKay, Mark Erickson, Zhaoxing Pan, Jeffrey Galinkin |
Journal | Anesthesia and analgesia
(Anesth Analg)
Vol. 124
Issue 6
Pg. 2030-2037
(06 2017)
ISSN: 1526-7598 [Electronic] United States |
PMID | 28448398
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Analgesics, Opioid
- Delayed-Action Preparations
- Morphine
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Topics |
- Administration, Intravenous
- Adolescent
- Age Factors
- Analgesia, Patient-Controlled
- Analgesics, Opioid
(administration & dosage, adverse effects)
- Child
- Colorado
- Delayed-Action Preparations
- Double-Blind Method
- Female
- Humans
- Injections, Spinal
- Kaplan-Meier Estimate
- Male
- Morphine
(administration & dosage, adverse effects)
- Pain Measurement
- Pain, Postoperative
(diagnosis, etiology, physiopathology, prevention & control)
- Prospective Studies
- Scoliosis
(diagnosis, surgery)
- Spinal Fusion
(adverse effects)
- Time Factors
- Treatment Outcome
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